Male Teen Pregnancy Prevention Project (Male TPP Project)

 描述(申请人提供)：在美国，青少年意外怀孕和性传播感染仍处于流行水平。在非西班牙裔黑人和西班牙裔青少年中，青少年父亲的比例尤其高。预防青少年怀孕的举措主要集中在女青少年身上；如何有效地向年轻男子提供咨询，以降低他们成为青少年怀孕父亲的风险尚不清楚。我们建议调整、实施并严格评估一种创新的计算机辅助动机访谈(CAMI)干预措施，该干预最初是针对女孩设计和实施的，适用于15-24岁的年轻男性，以降低他们怀孕的风险。我们将使用定性的方法来修改CAMI以供年轻人使用。然后，我们将从市中心的两所高中、一家青年男子诊所和社区机构招募646名年龄在15岁到24岁之间的年轻男子，并将他们随机分配到旨在预防青少年怀孕的改良CAMI(CAMI-TPP)或旨在饮食、体育活动和吸烟的CAMI(CAMI-Fitness)。CAMI-TPP小组将在12周内接受4次30分钟的MI教练培训，并在6个月时使用MI教练进行1次30分钟的强化训练；这些培训将由计算机生成的反馈指导，旨在增加避孕套的使用，支持女性伴侣的避孕使用，并完成有性传播感染检测的生殖健康访问。CAMI-Fitness组将在12周内接受4次30分钟的MI教练培训，并在6个月内接受一名MI教练30分钟的强化训练；这些培训将由针对饮食、体育活动和烟草使用的计算机生成的反馈指导。这两种干预措施在长度和时间上是相同的，但在目标行为(防孕和健身)上有所不同。我们将通过12周的干预阶段和12个月的随访阶段跟踪这两组年轻男性，以按组评估性行为和避孕行为的差异。这项研究的具体目的是评估Cami-TPP与Cami-Fitness相比在减少性行为方面的效果，这些行为通过增加避孕套的使用和女性伴侣使用中等和高度有效的可逆避孕来增加意外怀孕的风险。我们假设CAMI-TPP将增加在最后一次性行为中报告使用避孕套的参与者的比例，以及女性伴侣使用避孕措施的比例。我们还预测，与CAMI-Fitness组相比，接受CAMI-TPP的患者在参与研究过程中报告的性传播感染和/或艾滋病毒检测的生殖健康服务访问完成率更高。如果证明有效，CAMI-TPP可以广泛实施，作为一种降低年轻男性怀孕风险的方法。

 DESCRIPTION (provided by applicant): In the U.S., teen unintended pregnancy and STIs remain at epidemic levels. Rates of teen fatherhood are especially high among non-Hispanic Black and Hispanic teens. Initiatives to prevent teen pregnancy have focused primarily on female adolescents; how to effectively counsel young men to reduce their risk of fathering a teen pregnancy is unclear. We proposed to adapt, implement and rigorously evaluate an innovative computer-assisted motivational interviewing (CAMI) intervention, originally designed and implemented with girls, for use with young men, age 15-24 years old, to reduce their risk of fathering a teen pregnancy. We will use qualitative methods to modify the CAMI for use with young men. Then we will enroll 646 young men, ages 15 to 24 years, from 2 inner city high schools, a young men's clinic and from community agencies and randomize them to either a modified CAMI aimed at Teen Pregnancy Prevention (CAMI-TPP) or a CAMI aimed at diet, physical activity and tobacco use (CAMI- Fitness). The CAMI-TPP group will receive four, 30-minute MI coaching sessions over 12 weeks and one 30 minute booster at 6-months with a MI coach; sessions will be guided by a computer- generated, feedback aimed at increasing condom use, supporting female partners' contraceptive use, and completing a reproductive health visit with STI testing. The CAMI-Fitness group will receive four, 30-minute MI coaching sessions over 12 weeks and one 30 minute booster at 6-months with a MI coach; sessions will be guided by a computer-generated, feedback aimed at diet, physical activity and tobacco use. Both interventions are identical in length and timing but vary in the target behavior (pregnancy prevention versus fitness). We will track the two groups of young men through a 12 week intervention phase and a 12-month follow-up phase to assess differences in sexual and contraceptive behaviors by group. The specific aim of the study is to evaluate the efficacy of the CAMI-TPP compared to CAMI-Fitness in reducing sexual behaviors that increase the risks of fathering an unintended teen pregnancy by increasing condom use and female partner use of moderately and highly effective reversible contraception. We hypothesize that the CAMI-TPP will increase the proportion of participants who report condom use at last intercourse as well as female partner use of contraception. We also predict that those who receive CAMI-TPP will report higher completion of a reproductive health service visit with STI and/or HIV testing over the course of study participation compared to those in the CAMI-Fitness group. If proven effective, the CAMI-TPP could be broadly implemented as a method to decrease the risk of young men fathering a teen pregnancy.