Recruiting, engaging & retaining families for interventions to prevent HIV transm

描述(由申请人提供)：本申请的目标是通过加强家庭的招募、参与和保留，显著加强对有艾滋病毒感染风险的非裔美国青年--犯罪青少年--的简短家庭干预的参与率和有效性。这项拟议的研究将利用“关爱的家庭：指导好的选择”(GGC)(又名“为无毒品年做准备”)；这是一种简短有效的家庭干预措施，可增加家庭联系，减少药物使用。我们将试图通过制定一项改进的议定书，解决与招聘、参与和留用有关的背景障碍，从而优化参与。改进后的议定书将包括一张供父母使用的励志DVD，一次励志招募会议，以及一次供家庭讲述他们的故事和描述他们目前的家庭目标的预先会议。通过为非裔美国犯罪青少年及其家庭定制GGC，将进一步提高GGC的有效性。这项研究将分为两个阶段。第一阶段将包括GGC的调整和增强型议定书的制定。第二阶段将对60名目前在洛杉矶县教育办公室社区日间学校注册的正在缓刑的非裔美国青少年及其父母(父母包括一名成年监护人)进行增强方案和GGC的试点测试。家庭(缓刑中的非裔美国学生及其父母)将被随机分配到一种礼仪条件(增强礼仪/GGC或标准礼仪/GGC)，并在3个月时进行监测。研究的目的是：1)制定一项改进的方案，以招募、吸引和留住缓刑学校的非裔美国犯罪青少年及其父母；2.通过定性焦点小组和主要线人访谈，检查GGC对新人群(缓刑学校中的非裔美国人犯罪青少年及其家长)的适当性，如行政人员、教师、学生和家长所认为的那样；以及使用随机两组设计对增强方案和GGC进行试点测试，以评估增强方案在实现最佳招募、参与和保留方面的有效性，并初步检查GGC在改善家庭功能、心理健康和问题行为(艾滋病毒危险行为、学校表现和累犯率)方面的有效性。 与公共卫生有关的非裔美国人面临长期消极的艾滋病毒相关后果的高风险(Anderson&Smith，2005年；疾病控制和预防中心，2005年；Shaver-Hornaday等人，1997年)，以及缓刑中的犯罪青少年(Morris等人，1995年)和进出少年司法系统的犯罪青少年(Benda等人，2001年)。最近取得成功的努力表明，需要将个别集中的预防努力嵌入到更广泛的社会背景中，如家庭系统，以维持行为改变(LightFoot等人，2006；Rotheram-Borus，2005；Pequegnat等人，2001；Boyd-Franklin等人，2001)。这项R21应用的目标是表明，通过加强家庭的招募、参与和保留，可以显著加强对处于艾滋病毒感染风险的非裔美国人青年的基于证据的简短家庭干预的参与率和有效性。

DESCRIPTION (provided by applicant): The goal of this application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of a brief family intervention for African American youth at risk for HIV infection - delinquent adolescents - can be significantly strengthened. The proposed study will utilize "Families that Care: Guiding Good Choices" (GGC) (aka "Preparing for the Drug Free Years"); a brief efficacious family intervention that increases family connectedness and decreases drug use. We will attempt to optimize participation by developing an enhanced protocol that addresses contextual barriers pertaining to recruitment, engagement and retention. The enhanced protocol will include a motivational DVD for parents, a motivational recruitment session and a pre-session for families to tell their stories and describe their current family goals. The efficaciousness of the GGC will be further increased by customizing it for use with African American delinquent adolescents and their families. The research will entail two phases. Phase 1 will encompass the tailoring of GGC and development of the enhanced protocol. Phase 2 will pilot test the enhanced protocol and GGC with 60 African American delinquent adolescents currently on probation who are enrolled in 6 Los Angeles County Office of Education's Community Day Schools and their parents (parents includes an adult guardian). Families (African American students on probation and their parents) will be randomly assigned to a protocol condition (enhanced protocol/GGC or standard protocol/GGC) and monitored at 3 months. The research aims are to: 1.) develop an enhanced protocol for recruiting, engaging and retaining African American delinquent adolescents in probation schools and their parents in GGC; 2.) examine the appropriateness of GGC for a new population (African American delinquent adolescents in probation schools and their parents) as perceived by administrators, teachers, students and parents through qualitative focus groups and key informant interviews; and 3.) pilot test the enhanced protocol and GGC using a randomized two groups design to evaluate the efficacy of the enhanced protocol in achieving optimal recruitment, engagement and retention, and preliminarily examine the efficacy of GGC to improve family functioning, mental health, and problem behaviors (HIV risk behaviors, school performance and recidivism). PUBLIC HEALTH RELEVANCE African Americans are at high risk for long-term negative, HIV-related outcomes (Anderson & Smith, 2005; Centers for Disease Control and Prevention, 2005; Shavers-Hornaday et al., 1997) as are delinquent adolescents on probation (Morris et al., 1995), and delinquent adolescents who cycle in and out of the juvenile justice system (Benda et al., 2001). Recent efforts that have achieved success suggest that individually focused prevention efforts need to be embedded within broader social contexts, such as the family system, to sustain behavior change (Lightfoot et al., 2006; Rotheram-Borus, 2005; Pequegnat et al., 2001; Boyd-Franklin et al., 2001).The goal of this R21 application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of an evidence based brief family intervention for African American youth at risk for HIV infection can be significantly strengthened.