Reducing HIV Risks among African American Teens in High Poverty Urban Settings

描述（由申请人提供）：这项严格的三组随机实验将测试一项创新的父母介导的艾滋病毒干预，为我们的儿子和女儿的健康未来做好准备，是否能降低生活在高度贫困城市社区的非洲裔美国人和其他黑人青年的艾滋病毒风险。根据儿童与发展中心以前的一笔赠款，一套三张载有与文化有关的榜样故事的音频光盘被送往有青春期前儿子和女儿的家庭。对800多个主要是非裔美国家庭进行的随机试验结果表明，收到音频光盘的父母在监测、亲子沟通、对青少年行为的感知影响以及应对青少年性行为和艾滋病毒风险的自我效能方面表现出明显更高的水平。与控制组的青少年相比，干预组的青少年报告了更多的家庭规则，更高水平的家庭支持，更重要的是，与性开始相关的行为风险更少。在这项工作的基础上，本研究旨在：(1)制作更多的“健康未来”音频光盘，以推广积极的育儿做法，并支持青年建立预防艾滋病毒的行为模式；(2)进行一项随机实地试验，其中1500名非裔美国人/黑人父母及其六年级子女被随机分配到三个条件之一：(a)多年的音频- cd干预，健康的未来；(b)注意力受控制的情况；或(c)非注意控制状态；(3)在基线和从7年级到10年级的四个随访时间点对父母进行调查，以检验健康未来是否有效促进和维持积极的育儿实践；(4)在基线和7 - 10年级的四个时间点进行青少年评估，以检验健康未来是否延迟性开始，减少风险行为，并在10年级减少性传播感染；(5)考察父母教养方式是否可以解释青少年结果，并确定哪些父母教养方式可以调解实验条件与青少年结果之间的关系；(6)检查干预效果是否因青少年的性别或基线风险行为水平而变化（即被调节），以更好地了解干预对谁有效；(7)检查音频- cd促进的父母调解干预（我们最初的为期一年的“为以后保存性”）在不同的环境中被使用的地点和方式，以告知传播策略。“健康的未来”解决了非洲裔美国人/高度贫困城市社区黑人中艾滋病毒流行的问题，使父母作好准备，应对其青春期子女面临的挑战。

DESCRIPTION (provided by applicant): This rigorous three-arm randomized experiment will test whether an innovative parent-mediated HIV intervention, Preparing Our Sons and Daughters for Healthy Futures, reduces HIV risks among African American and other Black youth living in high-poverty urban neighborhoods. Under a prior NICHD grant, a set of three audio-CDs containing culturally relevant role-model stories were sent to families with preteen sons and daughters. Results of a randomized trial with over 800 mostly African American families indicate that parents receiving the audio-CDs reported significantly higher levels of monitoring, parent-child communication, perceived influence over youths' behaviors, and self efficacy to address adolescent sexuality and HIV risks. Adolescents in the intervention condition reported more household rules, higher levels of family support and, importantly, fewer behavioral risks related to sexual initiation than control- group youth. Extending this work, this study aims to: (1) Develop additional Healthy Futures audio-CDs to promote positive parenting practices and support youth in establishing patterns of behavior that are protective against HIV; (2) Conduct a randomized field trial in which 1500 African American/Black parents and their 6th grade sons and daughters are randomly assigned one of three conditions: (a) a multi-year audio-CD intervention, Healthy Futures; (b) an attention-controlled condition; or (c) a non-attention controlled condition; (3) Survey parents at baseline and at four follow up time-points extending from 7th into 10th grade, to test whether Healthy Futures is effective in promoting and sustaining positive parenting practices; (4) Conduct youth assessments at baseline and four time-points from 7th to 10th grade to test whether Healthy Futures delays sexual initiation, reduces risk behaviors and, at 10th grade, results in fewer STI; (5) Examine whether youth outcomes are explained by parenting practices and identify which parenting practices mediate the relationship between experimental condition and youth outcomes; (6) Examine whether intervention effects vary (i.e., are moderated) by youths' gender or level of baseline risk behaviors to better understand for whom the intervention works; (7) Examine where and how an audio-CD facilitated parent-mediated intervention (our original one-year Saving Sex for Later) is being used in diverse settings to inform dissemination strategies. Healthy Futures addresses the HIV epidemic among African Americans/Blacks in high-poverty urban communities by preparing parents to address the challenges their adolescent sons and daughters face.