Enhancing Message Design in Tailored Computerized HIV/STI Interventions

描述(由申请人提供)：拟议的研究将涉及开发和试点测试互动的计算机化定制干预计划，用于在18-44岁的高危异性活跃的非裔美国人性传播感染诊所患者中预防艾滋病毒/性传播感染。态度-社会-影响效能模型将作为干预和量身定做的反馈的概念基础，将分别对主要/稳定和其他/临时伴侣的参与者进行评估和反馈。将为关键的理论概念开发单独的模块，然后将它们捆绑在一起形成一个综合系统。此外，还将通过制作具有高信息感知价值的干预信息以及开发以社会认知理论和技能培训原则为指导的技能培养互动干预活动来加强量身定制的反馈。将利用从目标受众收集的数据来开发和指导计算机化干预，以确保以经验为基础的方法进行调整。还将根据目标受众的意见制定干预措施，以最大限度地提高反馈和节目的适当性和说服力，包括互动部分。该项目的最后一年将需要对干预措施进行试点测试，以便收集关于这种干预措施的可接受性和有效性的初步数据，以增加高危异性恋者活跃的非裔美国人的安全性行为。这项研究的具体目的是：1)基于ASE模式，制定针对HIV/STI预防的量身定做的反馈，包括避孕套态度、社会影响、自我效能(包括沟通/谈判技能、伴侣和行为风险、正确使用避孕套以及避孕套的更换阶段)；2)使用感觉寻求定向(SENTAR)增强定制信息的传递，并通过在社会认知理论(SCT)和技能培训原则指导的互动活动中进行技能培养；3)将各个理论模块捆绑在一起，开发一个针对HIV/STI预防的计算机干预计划，该计划基于对参与者特征的评估向参与者提供量身定制的降低风险信息；4)针对目标受众制定经验上合理的切入点，以指导信息定制；以及5)在等待名单控制组设计中，试行测试干预措施在高危异性恋活跃的非裔美国人中增加与主要和临时伴侣使用避孕套的可接受性和有效性，而不是“通常护理”的比较条件。目前的应用与公共卫生有关，因为它侧重于在高危群体，即非裔美国人中预防艾滋病毒/艾滋病。该应用程序旨在开发和评估一个基于计算机的程序，以帮助来性传播疾病诊所就诊的非裔美国人采取更安全的性行为方式。

DESCRIPTION (provided by applicant): The proposed study will involve the development and pilot testing of an interactive computerized tailored intervention program for HIV/STI prevention among at-risk heterosexually active African-American STI clinic patients, aged 18-44. The Attitude-Social-Influence Efficacy model will serve as a conceptual foundation for the intervention and tailored feedback, which will assess and give feedback to participants separately for main/steady and other/casual partners. Individual modules will be developed for key theoretical concepts and subsequently tied together into an integrated system. The tailored feedback will additionally be enhanced by crafting intervention messages to be high in message sensation value and by developing interactive intervention activities for skill-building, which will be guided by both Social Cognitive Theory and skills training principles. The computerized intervention will be developed and guided using data collected from the target audience to ensure an empirically-based approach to tailoring. The intervention will also be developed with input from the target audience in order to maximize the appropriateness and persuasiveness of the feedback and the program, including interactive components. The final year of the project will entail a pilot test of the intervention in order to gather preliminary data on the acceptability and efficacy of such an intervention for increasing safer sexual behaviors among at-risk heterosexually active African- Americans. The specific aims of the study are: 1) to develop tailored feedback on HIV/STI prevention based on the ASE model, including condom attitudes, social influences, self-efficacy including communication / negotiation skills, partner and behavioral risk, correct condom use, and condom stages of change; 2) to enhance the delivery of the tailored messages using sensation- seeking targeting (SENTAR) and skill-building using interactive activities guided by Social Cognitive Theory (SCT) and skills training principles; 3) to tie the individual theoretical modules together and develop a computerized intervention program for HIV/STI prevention, which provides tailored risk reduction messages to participants based upon an assessment of participant characteristics; 4) to develop empirically sound cutpoints, specific to the target audience, to guide the message tailoring; and 5) in a wait-list control group design, to pilot test the intervention for acceptability and efficacy in increasing condom use with main and casual partners among at-risk heterosexually active African-Americans, relative to a "usual care" comparison condition. The current application is relevant to public health because it focuses on preventing HIV/AIDS in a high-risk group, namely African-Americans. The application aims to develop and evaluate a computer-based program to help African-Americans who come to a sexually transmitted disease clinic adopt safer sex practices.