'REALITY CHECK' IN TRANSIT: Evaluation of a Serial Drama for Black Youth

描述（由申请人提供）：本申请提出评估一个已经创建的系列戏剧干预，“现实检查”，在公共汽车上洛杉矶，加利福尼亚州。非洲裔美国青年受艾滋病毒/艾滋病和其他性传播感染的影响非常大。影响其风险的社会因素包括贫穷、难以获得预防性医疗服务和仇视同性恋，这导致一些男男性行为者对这些活动保密，不愿接受艾滋病毒检测。不幸的是，许多感染艾滋病毒的人不知道自己感染了艾滋病毒，可能正在传播艾滋病毒，特别是在高度传染性的急性感染阶段。另一方面，那些检测呈阳性的人大大减少了他们与风险相关的行为。因此，疾病预防控制中心建议普遍进行艾滋病毒检测，但特别是在高危人群中进行检测。因此，这一应用的广泛、长期目标是增加非洲裔美国年轻人的艾滋病毒检测。它提出了一个创新的，以理论为基础的艾滋病毒风险降低系列戏剧干预，“现实检查”，在14至24岁的非洲裔美国人谁乘坐公共汽车在贫困的非洲裔美国人社区在洛杉矶的影响试点测试。“现实检查”是一种结构性干预，因为它将在公共汽车乘客的自然环境中实施。它由27个3分钟的情节组成。每一集将在周二、周四、周五和周六播出一周，每小时一次，在洛杉矶的所有公共汽车上，这些公共汽车都配备了视频屏幕。以前播放的剧集将在交通电视网站的YouTube链接上播放。该研究将采用准实验对照组设计，进行干预前和干预后的多项评估。在加利福尼亚州里士满贫困的非洲裔美国人社区，公共汽车上的乘客将作为对照。在洛杉矶放映《现实检查》之前、放映后立即、放映后3个月和6个月，每周至少3次对14-24岁的非洲裔美国青年进行横断面匿名巴士站调查，这些青年乘坐巴士经过并居住在这两个城市的指定贫困地区。研究样本将包括两个城市中每个城市的200名青年，他们在4个评估点中的每个评估点下车，总共有1 600名参与者。根据目标人群的最高乘车次数，采用系统抽样策略，在公共汽车站附近的私人空间收集下车青年的数据，并记录在手持移动的电话上。具体目标包括：与对照组相比，对“现实核查”在增加艾滋病毒检测（主要成果）、检测的理论中介、避孕套的使用和禁欲以及减少仇视同性恋和艾滋病毒/艾滋病污名化方面的效果进行试点测试。还将检查治疗城市与对照城市对艾滋病毒检测率的影响。这项研究将提供干预措施效果的初步证据，这种干预措施可以非常具有成本效益地传播，通过公共汽车在另外4个城市进行大量传播，TEZO Systems Unlimited，Inc.，拥有Transit TV的公司计划播出。 公共卫生相关性：年轻的非洲裔美国人受到艾滋病毒/艾滋病和其他性传播感染（STI）的影响非常不成比例。本研究评估了一个系列戏剧的有效性，在当地的公共汽车上交付，在年轻的非洲裔美国人的态度和/或行为的改变。这项研究回应了迫切的公共卫生需求，即采取结构性干预措施，以减少非洲裔美国年轻人感染性传播感染（包括艾滋病毒）的风险。

DESCRIPTION (provided by applicant): This application proposes to evaluate an already-created serial drama intervention, "Reality Check," on public buses in Los Angeles, CA. Young African Americans are very disproportionately affected by HIV/AIDS and other sexually transmitted infections (STIs). Social factors affecting their risk include poverty, poor access to preventive medical services, and homophobia, which causes some men who have sex with men (MSM) to be secretive about these activities and to be reluctant to be tested for HIV. Unfortunately, many of those infected with HIV are unaware of their infection and may be transmitting it, especially during the highly infectious acute infection stage. On the other hand, those who test positive reduce their risk-related behavior dramatically. Thus, the CDC has recommended universal HIV testing, but especially testing among those at highest risk. Accordingly, the broad, long-term objective of this application is to increase HIV testing among young African Americans. It proposes a pilot test of the effects of an innovative, theory-based HIV risk-reduction serial drama intervention, "Reality Check," among African Americans aged 14 to 24 years who ride public buses in impoverished African American neighborhoods in Los Angeles. "Reality Check" is a structural intervention in that it will be implemented in the natural environment of bus riders. It consists of 27 3-minute episodes. Each episode will be shown for 1 week on Tuesday, Thursday, Friday and Saturday, once each hour, on all public buses in Los Angeles, which are equipped with video screens. Previously shown episodes will be available on a YouTube link from Transit TV's website. The study will use a quasi-experimental control group design with pre- and multiple post-intervention assessments. Riders of public buses in impoverished African American neighborhoods in Richmond, CA, will serve as the control. Cross-sectional anonymous bus stop surveys of African American youth aged 14-24 who ride the bus through-and reside in--designated impoverished areas of both cities at least 3 times each week will be conducted before "Reality Check" is shown in Los Angeles, immediately after it is shown, and 3 and 6 months after it is shown. The study sample will include 200 youth who exit buses in each of the 2 cities at each of the 4 assessment points, for a total of 1,600 participants. Using a systematic sampling strategy based on the target population's times of highest ridership, data will be collected in private spaces near the bus stops from youth who exit the buses and recorded on hand-held mobile phones. The Specific Aims include conducting a pilot test of the effects of "Reality Check" in increasing HIV testing (the primary outcome), theoretical mediators of testing, condom use, and abstinence, and reducing homophobia and HIV/AIDS stigma, as compared with control. Effects on HIV testing rates in treatment versus control city also will be examined. This research would provide preliminary evidence of the effects of an intervention that could be disseminated very cost-effectively, with substantial reach via public buses in 4 additional cities where TEZO Systems Unlimited, Inc., the company that owns Transit TV, plans to broadcast. PUBLIC HEALTH RELEVANCE: Young African Americans are highly disproportionately affected by HIV/AIDS and other sexually transmitted infections (STIs). This study evaluates the effectiveness of a serial drama, delivered on local buses, at changing attitudes and/or behaviors among young African Americans. This research responds to the urgent public health need for structural interventions to reduce the risk of STIs, including HIV, in young African Americans.