TAKING BE PROUD! BE RESPONSIBLE! TO THE SUBURBS

本研究的目的是测试以社区为基础的干预(骄傲！负责!)（Jemmott, Jemmott, Fong， 1998年），通过将该方案纳入5所城市和郊区高中的健康班，以年龄较大的青少年（9 /10年级）为目标，并将结果与其他5所学校提供的替代健康促进干预措施进行比较，旨在接触较年轻的市中心青少年（Jemmott, Fong， 1998年）。该项目的主要目标是确定在下列情况下，具有文化敏感性的BPBR干预是否同样有效：(a)在高中卫生课程中进行；(2)在白人和非裔郊区青年中进行。第二个目标是扩展干预的理论框架，以探索情境因素（个人、课堂、推动者和学校），以便更好地理解干预在改变行为（性活动、伴侣数量、避孕套使用、性开始）和理论上被认为先于行为改变的中介（例如，知识、预防/享乐主义信仰、意图、效力）方面最有效的条件。我们提出了一项采用嵌套队列设计的组随机试验，其中五对社会经济地位和学生群体种族组成相似的学校将被随机分配到干预组或对照组。此外，在每所学校内，教室将随机分配给两名辅导员之一：健康教育教师或学校护士。最后，25%的课程将被选择在同性教室授课。在干预前和干预课程结束后，将从个人（如社会人口统计学、行为结果、中介）、课堂(如年龄/种族/性别构成、教师控制水平、项目保密性、辅导员（高等教育教师与护士、材料舒适度）和学校（城市与郊区种族混合）层面收集数据。将在干预后3个月、6个月和12个月再次收集个人数据。将在随机选择的学校举行助推会，以确定此类会议对维持干预效果的重要性。数据将使用一系列分析技术进行分析，包括方差分析、OLS、路径建模，最后是分层建模，这将允许在嵌套设计（学校内班级内的个人）中检查随时间的变化。这项研究将提供有关干预的复制和推广的有价值的信息，也将更好地理解预测青少年想法和行为的潜在机制。

The purpose of this study is to test the generalizability of a community-based intervention (Be Proud! Be Responsible!) (BPBR) designed to reach younger, inner-city adolescents (Jemmott, Jemmott, Fong, 1998) by taking the program into health classes of 5 urban and suburban high schools, targeting older adolescents (9th/10th graders), and comparing results to alternative health promotion intervention offered in 5 other schools. The primary goal of the project is to determine if the culturally sensitive BPBR intervention will be as effective when conducted: (a) within a high school health curriculum, and (2) among white, as well as African-American suburban youth. The secondary goal is to extend the theoretical framework underlying the intervention to explore contextual factors (individual, classroom, facilitator and school) in order to better understand the conditions under which the intervention is most effective on changing behaviors (sexual activity, number of partners, condom use, sex initiation) and the mediators theoretically assumed to precede behavior change (e.g., knowledge, prevention/hedonistic beliefs, intentions, efficacy). We propose a group-randomized trial with a nested cohort design, whereby five pairs of schools that are similar in SES and racial composition of the student population will be randomized to the intervention or control group. In addition, within each school, classrooms will be randomized to one of the two facilitators: health education teacher or school nurse. Finally, 25% of the classes will be selected to be taught in same gender classrooms. Data will be collected at the individual (e.g., sociodemographics, behavioral outcomes, mediators), classroom (e.g., age/race/sex composition, level of teacher's control, program fidelity, facilitator (HE teacher versus nurse, comfort level with material), and school (urban versus suburban racial mix) level at pre-intervention and immediately following the intervention classes. Individual data will again be collected at 3 months, 6 months and 12 months following the intervention. A booster session will be held in randomly selected schools to determine the importance of such sessions to sustain the intervention effects. The data will be analyzed using an array of analytic techniques including ANOVAs, OLS, path modeling and finally, hierarchical modeling which will permit the examination of change over time within a nested design (individuals within classes within schools). The study will provide valuable information with regard to replication and generalizability of the intervention, but also a better understanding of the underlying mechanisms that predict what adolescents think and do.