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

描述(由申请者提供)：此应用程序建议评估已经创建的连续剧干预，在加利福尼亚州洛杉矶的公共汽车上的现实检查。年轻的非裔美国人受到艾滋病毒/艾滋病和其他性传播感染(STI)的影响非常大。影响他们风险的社会因素包括贫困、难以获得预防性医疗服务以及同性恋恐惧症，这导致一些男男性行为者(MSM)对这些活动守口如瓶，不愿接受艾滋病毒检测。不幸的是，许多感染艾滋病毒的人没有意识到自己的感染，可能正在传播，特别是在高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的风险相关行为。因此，疾控中心建议进行普遍的艾滋病毒检测，尤其是在高危人群中进行检测。因此，这一应用程序的广泛、长期目标是在年轻的非裔美国人中增加艾滋病毒检测。它提议对一种创新的、基于理论的降低艾滋病毒风险的连续剧干预的效果进行试点测试，在洛杉矶贫困的非裔美国人社区乘坐公共汽车的14岁至24岁的非裔美国人中进行干预。“现实检查”是一种结构性干预，因为它将在公交车乘客的自然环境中实施。它由27集3分钟的剧集组成。每集将于周二、周四、周五和周六在洛杉矶所有配备视频屏幕的公交车上每小时播出一次，为期一周。之前播出的剧集将在运输电视台网站的YouTube链接上提供。这项研究将采用准实验控制组设计，并在干预前和干预后进行多次评估。加利福尼亚州里士满贫困的非裔美国人社区的公共巴士乘客将担任控制者。对14-24岁的非裔美国青年进行的匿名公交车站横断面调查每周至少在这两个城市指定的贫困地区居住3次，调查将在《现实核查》在洛杉矶播出之前、播出后立即以及播出后3个月和6个月进行。研究样本将包括两个城市分别在4个评估点下车的200名青年，总共1600名参与者。采用基于目标人群最高乘车次数的系统抽样策略，将在公交车站附近的私人空间收集下车青年的数据，并将数据记录在手持移动电话上。具体目标包括与对照相比，对“现实检查”在增加艾滋病毒检测(主要结果)、检测、避孕套使用和禁欲的理论中介以及减少同性恋恐惧症和艾滋病毒/艾滋病污名方面的影响进行试点测试。还将检查治疗城市与对照城市对艾滋病毒检测率的影响。这项研究将为干预的效果提供初步证据，这种干预可以非常经济高效地传播，通过公共汽车在另外4个城市实现相当大的覆盖，拥有交通电视的泰佐系统无限公司计划在这些城市进行广播。

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.