IYG-Family: Beyond "the talk" to effective pregnancy, STI, and HIV prevention

描述(由申请者提供)：这个为期3年的快速跟踪STTR的目标是开发和评估以家庭为基础的干预措施(这是你的游戏-家庭)，为儿童(11-14岁)提供适龄的性健康生活技能教育和培训，并提高父母的 支持此次培训的技能和自信。IYG-Family(IYG-F)将是一款在线游戏- 基于可用的计划和资源，帮助父母和他们的孩子超越“性谈话”，参与持续的、适合发育的怀孕、性传播感染(STI)和人类免疫缺陷病毒(HIV)预防教育体验。研究包括两个阶段和10个具体目标：第一阶段：开发基于理论和经验的IYG-F原型，并进行可用性和可行性测试(1-12个月)。第一阶段的具体目标：1.1开展焦点小组，与我们的亲子-青年咨询小组一起进行可接受性测试，并查阅文献，为IYG-F的设计提供信息；1.2开发IYG-F设计文件并规划原型；1.3测试IYG-F原型的功能和内容(阿尔法测试)和可用性；1.4评估(试行测试)IYG-F原型在家庭环境中的可行性和感知价值；1.5传播第一阶段的结果：第一阶段报告和同行评议的出版物。第二阶段：根据第一阶段的数据制定IYG-Family，并进行一项RCT，以评估IYG-F(13-36个月)的影响。第二阶段具体目标：2.1修订IYG-F设计文件(基于第一阶段数据)并获得P-YAG批准；2.2开发完整的IYG-F计划；2.3测试IYG-F原型的功能和内容(阿尔法测试)和可用性；2.4在80个家庭进行IYG-F的随机对照试验，以测试4个主要假设(如下)；2.5传播第二阶段的研究结果：第二阶段报告和同行评议的出版物。4个主要假设为1。与没有接受IYG-F的青少年相比，获得IYG-F的年轻人将表现出明显更大的戒止性行为的意图。2.与未接受IYG-F的青少年相比，获得IYG-F的青少年将表现出显著改善的性行为心理社会决定因素(包括知识、拒绝性行为的自我效能增加；较少允许的信仰和感知的规范)。3.与没有访问IYG-F的父母相比，访问IYG-F的父母将报告关于亲子性健康沟通和父母监测的心理社会决定因素(包括知识、态度和自我效能)显著改善，与青少年性行为相关的不那么宽容的信念。4.与没有接受IYG-F的青少年和父母相比，使用IYG-F的青少年和父母将报告更多关于性健康的沟通，加强父母监测，增加亲子联系，并改善育儿评级。这个项目是建立在这个经验丰富的合作调查团队之前的研究基础上的，该团队开发和测试了一个成功的中学怀孕、性传播感染和艾滋病毒预防计划，这是你的游戏...保持它真实，(IYG)，涉及与健康的关系、约会和性相关的知识、态度、感知的规范、拒绝和沟通技能。在德克萨斯州中学进行的两项随机对照试验的结果表明，在7年级和8年级进行干预后，心理社会结果是积极的，到9年级，行为结果是显著的、持续的。IYG-Family将在本课程中包括成功的技能培养部分，但也将重点放在与家庭环境中性健康有关的亲子沟通和联系上。IYG-Family意义重大，因为它解决了家庭为其性成熟青年做好准备的需要与目前可用于支持他们的发展方面适当的干预资源之间的差距。它解决了青少年怀孕、性传播感染和艾滋病毒感染等更广泛的公共卫生问题。IYG-Family在提供独特的基于家庭的资源方面具有创新性，以应对每个性成熟青年家庭所面临的挑战。除了为中学生提供适合发展的性健康教育外，IYG-Family还致力于为缺乏信心或技能的父母提供不适和不确定的解决方案，以充分提供有效的信息和技能培训，帮助他们的孩子就健康的友谊、约会关系和性行为做出健康和负责任的决定。它提供了一种经济实惠、高保真且易于获取的解决方案。 公共卫生相关性：尽管美国在过去十年中稳步下降，但青少年出生和性传播感染(STI)仍然是严重的公共卫生问题。青少年怀孕花费了美国纳税人超过90亿美元。4每四名女性(14-19岁)中就有一人感染了STI5，青少年(15-24岁)占所有新发性传播感染病例的910万例(48%)，6估计医疗费用为65亿美元。7这项研究将有助于我们理解在家中通过互联网向中学生提供艾滋病毒/STI和怀孕预防计划，并通过父母的参与。

DESCRIPTION (provided by applicant): The goal of this 3 year Fast-Track STTR is to develop and evaluate a home-based intervention ('it's Your Game- Family') to provide age-appropriate sexual health life skills education and training for children (11-14 years) and to enhance parents' skills and self-confidence in support of this training. IYG-Family (IYG-F) will be an on-line game- based program and resource available to help parents and their children go beyond "the sex talk" to engage in an ongoing, developmentally appropriate, pregnancy, sexually transmitted infection (STI), and human immunodeficiency virus (HIV) prevention education experience. The study comprises 2 phases and 10 specific aims: Phase 1: Develop the theoretically- and empirically-based IYG-Family (IYG-F) prototype and conduct usability and feasibility testing (Months 1-12). Phase 1 Specific Aims: 1.1 Conduct focus groups, acceptability tests with our Parent-Youth Advisory Group (P-YAG) and literature review to inform IYG-F design; 1.2 Develop IYG-F design documents and program the prototype; 1.3 Test the IYG-F prototype functions and content (alpha test), and usability; 1.4 Evaluate (pilot-test) the IYG-F prototype fo feasibility and perceived value in the home setting; 1.5 Disseminate Phase 1 findings: Phase 1 report and peer reviewed publications. Phase 2: Develop IYG-Family informed from Phase 1 data and conduct a RCT to evaluate the impact of IYG-F (Months 13-36). Phase 2 Specific Aims: 2.1 Revise IYG-F design documents (based on Phase 1 data) and obtain P-YAG sign-off; 2.2 Develop the full IYG-F program; 2.3 Test the IYG-F prototype functions and content (alpha test), and usability; 2.4 Conduct a randomized controlled trial of IYG-F in 80 homes to test the 4 primary hypotheses (below); 2.5 Disseminate Phase 2 findings: Phase 2 report and peer reviewed publications. The 4 primary hypotheses are 1. Compared to those not receiving IYG-F, youth who access IYG-F will demonstrate significantly greater intentions to abstain from initiation of sexual behavior. 2. Compared to those not receiving IYG-F, youth who access IYG-F will demonstrate significantly improved psychosocial determinants of sexual behavior (including knowledge, increased self-efficacy for refusing sexual activity; less permissive beliefs and perceived norms). 3. Compared to parents not accessing IYG-F, parents who access IYG-F will report significantly improved psychosocial determinants (including knowledge, attitudes, and self-efficacy) regarding parent-child sexual health communication and parental monitoring and less permissive beliefs related to youth sexual behavior. 4. Compared to youth and parents not receiving IYG-F, youth and parents who access IYG-F will report increased communication about sexual health, increased parental monitoring, increased parent-child connectedness, and improved parenting ratings. This project is founded on previous studies by this experienced collaborative investigative team on developing and testing a successful middle school pregnancy, STI, and HIV prevention program, It's Your Game...Keep it Real, (IYG) that addresses knowledge, attitudes, perceived norms, refusal, and communication skills related to healthy relationships, dating, and sex. Results from two randomized controlled trials conducted in Texas middle schools indicate positive psychosocial outcomes after 7th and 8th grade interventions, and significant, sustained behavioral outcomes to 9th grade. IYG-Family will include the successful skill building components of this curriculum but will be developed to also focus on parent-child communication and connectedness regarding sexual health in the home environment. IYG-Family is significant because it addresses the gap between the needs of families in preparing their sexually maturing youth and the developmentally appropriate intervention resources currently available to support them. It addresses the broader public health concerns of adolescent pregnancy, and STI and HIV infection. IYG-Family is innovative in providing a unique home-based resource for a challenge faced by every family with sexually maturing youth. In addition to providing developmentally appropriate sexual health education for the middle school child IYG-Family is positioned to contribute a solution for the discomfort and uncertainty of parents who lack confidence or skills to adequately provide effective information and skills training to help their child make healthy and responsible decisions about healthy friendships, dating relationships, and sex. It contributes a solution that is cost-effective, of hih-fidelity, and readily accessible. PUBLIC HEALTH RELEVANCE: Despite steady decline in the United States over the past decade, adolescent births and sexually transmitted infections (STIs) remain serious public health issues. Teen pregnancy costs US taxpayers over $9 billion.4 One in four females (14-19 years) are infected with an STI5 and youth (15- 24 years) account for 9.1 million (48%) of all new STI cases, 6 with estimated medical costs of $6.5 billion.7 This study will contribute to our understanding of using the Internet to deliver an HIV/STI and pregnancy prevention program to middle school-aged students in home and mediated by parent involvement.