Yo Puedo: Future Opportunities for Youth

描述（由申请人提供）：美国的青少年怀孕率仍然高于任何发达国家，拉丁裔青少年的怀孕率不成比例地高。这项拟议的研究建立在我们对旧金山弗朗西斯科使命区拉丁裔青少年的研究基础上，该研究揭示了帮派关系和意外怀孕之间的密切联系，以及街头帮派在塑造社交网络方面发挥的重要作用。我们建议进行造型设计研究和试点的可行性创新干预（我可以：未来的机会，为青年），结合有条件的现金转移支付（CCT）和生活技能教育，以解决社会网络的影响和社会经济机会在一个社区，青年经历大量的帮派曝光和早育率高。根据行为经济学和社会学习理论，并在社区合作伙伴的投入下开发，Yo Puedo将针对16至21岁的年轻人及其社交网络中的同龄成员。接受有条件现金援助的标准将由青年自己确定，并将与教育和技能发展以及参与生殖健康活动挂钩。我们将通过有效的意外怀孕预防课程提供生活技能培训，以补充有条件现金援助，这些课程涉及影响早育和伴侣关系的规范，并将专门用于支持青年实现干预目标。我们将开始进行形成方法研究，以设计一个最适合促进教育和生殖健康的健康为青年在旧金山弗朗西斯科的使命区（目标1）的CCT激励结构。我们将采用经济学中的权变评估方法设计激励结构。为了评估实施Yo Puedo（目标2）的可行性，我们将进行一项试点，将60名3人社交网络（共180名青年）随机分为干预组或观察对照组。我们将评估我们招募年轻人参加随机研究的能力，观察对照组;我们招募和保留3人社交网络的能力;以及我们对CCT和生活技能课程的整合。最后，通过随机研究和对青少年参与者、成人导师和社区提供者进行干预后的8个焦点小组，我们将确定向青少年直接发放奖励是否会产生负面影响，并检查随着时间的推移中间结果的初步模式（目标3）。根据研究结果，我们将修改干预措施，并设计未来的III期有效性评估。 公共卫生相关性：需要创新的干预措施来预防拉丁美洲青年中持续高的意外怀孕率。这项研究包括新的形成性方法研究，采用经济学方法和可行性评估相结合的有条件的现金转移和量身定制的生活技能干预（我可以）：未来的机会，为青年设计的16至21岁的青年在旧金山弗朗西斯科。研究结果将指导未来3期有效性评估的设计。

DESCRIPTION (provided by applicant): Adolescent pregnancy rates in the United States remain higher than in any developed nation, with disproportionately high pregnancy rates in Latina adolescents. The proposed study builds on our research with Latino adolescents in San Francisco's Mission District that revealed the strong connection between gang affiliation and unintended pregnancy and the important role that street gangs play in shaping social networks. We propose to conduct formative design research and pilot the feasibility of an innovative intervention (Yo Puedo ["I can"]: Future Opportunities for Youth) that combines conditional cash transfers (CCTs) and a life skills education to address social network influences and socioeconomic opportunities in a neighborhood where youth experience substantial gang exposure and high rates of early childbearing. Informed by behavioral economics and social learning theory and developed with input from community partners, Yo Puedo will target youth 16 to 21 years old and same-aged members of their social network. Criteria for receipt of the CCTs will be established by youth themselves and will be tied to educational and skill development and participation in reproductive health activities. We will complement the CCTs with life skills training derived from effective unintended pregnancy prevention curriculum that addresses norms that influence early childbearing and partnerships, and that will be tailored to support youth in achieving intervention objectives. We will begin by conducting formative methodological research to design a CCT incentive structure best suited to promoting educational and reproductive health wellness for youth in San Francisco's Mission District (Aim 1). We will design the incentive structure using adapted contingency valuation methods from economics. To evaluate the feasibility of implementing Yo Puedo (Aim 2), we will conduct a pilot with randomization of 60, 3-person social networks (180 youth in total) to the intervention or observational control group. We will assess our ability to recruit youth to a randomized study with an observational control arm; our ability to recruit and retain 3-person social networks; and our integration of the CCTs and life skills curriculum. Finally, through the randomized study and 8 focus groups conducted post- intervention with youth participants, adult mentors and community providers, we will determine whether distributing reward payments to youth directly had negative effects and examine preliminary patterns in intermediary outcomes over time (Aim 3). Based on the study results, we will revise the intervention and design a future Phase 3 effectiveness evaluation. PUBLIC HEALTH RELEVANCE: Innovative interventions to prevent persistently high rates of unintended pregnancy among Latino youth are needed. This study consists of novel formative methodological research using approaches from economics and a feasibility evaluation of a combined conditional cash transfer and tailored life skills intervention (Yo Puedo ["I can"]: Future Opportunities for Youth) designed for youth aged 16 to 21 in San Francisco. The study findings will guide design of a future Phase 3 effectiveness evaluation of this intervention.