Interventions to Reduce Health Disparities in Youth of Dual Protection

描述(由申请人提供)：防止性传播感染，包括艾滋病毒(性传播感染/艾滋病毒)和意外怀孕，对于改善非裔美国人的性健康和生殖健康和生活结果至关重要。生殖健康差距很大。需要采取新颖的干预措施，解决非洲裔年轻妇女面临的独特挑战，将性传播感染/艾滋病毒和怀孕预防工作与她们的生活联系起来。拟议的研究促进双重保护，将避孕套与高效避孕措施(如宫内节育器、植入物、注射避孕药)相结合，从降低风险的角度确定行为目标，帮助年轻女性采取最佳(如“双重方法”)以及次优但有效的行为(如单独使用避孕套--提供“双重保护”的单一方法)。多媒体咨询干预计划运用了跨理论模型和计划行为理论，以鼓励行为改变。此外，激励性访谈将告知妇女接受的避孕咨询，随之而来的印刷教育材料将帮助妇女保持和防止新行为的复发。该项目将分两个阶段进行。在第一阶段，我们将组建一个10人的利益相关者咨询团队，以调整PreCounselor应用程序，使其专注于双重保护。PreCounselor应用程序最初是作为人口事务办公室赠款的一部分开发的。我们将培训生殖健康顾问，并制作与之配套的印刷教材。在第二阶段，将通过检测前后检查双重方法使用的改善、避孕坚持和继续、避孕套的使用增加以及性传播感染/艾滋病毒感染的减少来评估干预的可行性、可接受性和有效性。我们假设，使用miPlan应用程序的年轻非裔美国女性将发现它是全面的、文化上的定制和吸引人的，参与干预最终将改善双重方法的使用、避孕的坚持和继续，并减少性传播感染/艾滋病毒感染。如果被证明是可行和有效的，将提交后续的R01申请，以使用大规模多临床站点随机对照试验设计评估miPlan。

DESCRIPTION (provided by applicant): Preventing sexually transmitted infections including HIV (STI/HIV) and unintended pregnancies is critical to improving sexual and reproductive health and life outcomes for African Americans. The reproductive health disparities are severe. There is a need for novel interventions that address the unique challenges faced by young African American women, contextualizing both STI/HIV and pregnancy prevention efforts within their lives. The proposed research promotes dual protection, combining condoms with a highly effective contraceptive (e.g., intrauterine device, implant, injectable), by framing behavioral targets in terms of risk reduction, helping young women adopt optimal (e.g., "dual method") as well as suboptimal but effective behaviors (e.g., condoms alone -a single method that offers "dual protection"). The multimedia counseling intervention miPlan operationalizes the Transtheoretical Model and the Theory of Planned Behavior in order to encourage behavior change. In addition, motivational interviewing will inform the contraceptive counseling women receive and concomitant printed educational materials will help women maintain and prevent relapse for new behaviors. The project will proceed in two phases. In Phase I, we will assemble a 10-member stakeholder advisory team to adapt the PreCounselor app, originally developed as part of a grant from the Office of Population Affairs, to focus on dual protection. We will train reproductive health counselors and create concomitant printed educational materials. In Phase II, the feasibility, acceptability, and effectiveness of the intervention will be assessed through pre- and post-testing examining improvement in dual method use, enhancement of contraception adherence and continuation, increase of condom use, and decrease of STI/HIV infection. We hypothesize the young African American women who use the miPlan app will find it to be comprehensive, culturally tailored, and engaging, and that participation in the intervention will ultimately improve dual method use, contraceptive adherence and continuation, and decrease STI/HIV infection. If proven to be feasible and effective, a subsequent R01 application will be submitted to assess miPlan using a large-scale multiple clinic site RCT design.