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！要负责任！）（BPBR），旨在达到年轻的，内城青少年（Jemmott，Jemmott，Fong，1998年），通过将该计划纳入5所城市和郊区高中的健康课程，针对年龄较大的青少年（9/10年级），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。该项目的主要目标是确定在以下情况下，具有文化敏感性的BPBR干预措施是否同样有效：（a）在高中健康课程中，（2）在白色以及非裔美国人郊区青年中。第二个目标是扩展干预的理论框架，以探索环境因素（个人、教室、促进者和学校），以便更好地了解干预对改变行为（性活动、伴侣数量、安全套使用、性行为开始）最有效的条件，以及理论上假设在行为改变之前的中介（例如，知识、预防/享乐主义信念、意图、功效）。我们提出了一个组随机试验与嵌套队列设计，即五对学校的SES和种族组成的学生人口相似，将被随机分配到干预组或对照组。此外，在每所学校内，教室将被随机分配给两名促进者之一：健康教育教师或学校护士。最后，25%的班级将被选择在同一性别的教室授课。数据将在个人处收集（例如，社会人口统计学、行为结果、中介），课堂（例如，年龄/种族/性别组成，教师的控制水平，计划的忠诚度，促进者（HE教师与护士，材料的舒适度），和学校（城市与郊区种族混合）水平在干预前和干预后立即上课。将在干预后3个月、6个月和12个月再次收集个体数据。将在随机选择的学校举行一次助推会议，以确定这种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ANOVA，OLS，路径建模，最后，分层建模，这将允许检查嵌套设计（学校内班级内的个人）随时间的变化。这项研究将提供有关干预措施的复制和推广的宝贵信息，而且还将更好地了解预测青少年思想和行为的潜在机制。

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.