The Effects of Client Change Talk on Risky Sexual Behavior

描述（由申请人提供）：此提交是为了响应NIDA PAR-10-021艾滋病科学跟踪奖的研究过渡（R 03），题为“客户改变语言对青少年危险性行为的影响。“25岁以下的人，特别是那些与司法系统有关的人，感染包括艾滋病毒在内的性传播感染的风险更高。降低这一人群性风险的方法取得的成功有限，目前尚不清楚青少年是否可以从已被证明对成年人有效的干预措施中受益。其中一种方法是动机访谈（MI），这是一种指导性的，以客户为中心的方法，用于治疗有问题的健康行为。在多元智能中，最具实证支持的行动机制是“改变谈话”，即客户在会话中自发承诺改变其问题行为。接受过MI培训的临床医生采用特定的策略来确认，引发和加强这种变化谈话，目的是增加其频率和强度。一个因果链已经建立连接治疗师的讲话，客户端的变化谈话，并随后在成人的健康结果。本研究将使用动机访谈技巧代码来量化客户改变语言从一个正在进行的研究涉及犯罪的青少年。母研究的参与者被随机分配到MI或行为技能训练（BST）条件下，这两种条件都有两次干预课程，间隔一周，并在三个月和六个月时进行随访评估。本研究中的编码客户语言提供了从两种治疗方法的随机对照试验（MI和BST）中测量语言变化的机会。我们将量化196个治疗疗程的样本中的客户语言，每个条件98。父母研究的结果指标包括一个时间线跟踪查询过去30天的性行为和物质使用。将在3个月和6个月随访时评价疗效，预计在3个月时达到最大治疗效果。以前没有研究成功地将客户语言编码应用于青少年性风险的研究。该二次分析将通过使用青少年样本并比较两种治疗条件下的这些影响来测试在成年人群中形成的因果链，这种方法将通过证实或质疑青少年中客户改变语言的影响来指导临床实践。

DESCRIPTION (provided by applicant): This submission is designed in response to NIDA PAR-10-021 AIDS-Science Track Award for Research Transition (R03), titled "The effects of client change language on adolescent risky sexual behavior." People under age 25, and those involved with the justice system in particular, are at heightened risk for sexually transmitted infections including HIV. Approaches to reduce sexual risk this population have had limited success, and it remains unclear whether adolescents can benefit from interventions that have been proven effective in adults. One approach that has shown promise is motivational interviewing (MI), a directive, client- centered method employed in the treatment of problematic health behaviors. The mechanism of action with the most empirical support in MI is "change talk", spontaneous within-session commitments by clients to change their problem behavior. Clinicians trained in MI employ specific tactics to acknowledge, elicit, and strengthen this change talk, with the goal of increasing its frequency and strength. A causal chain has been established linking therapist speech, client change talk, and subsequent health outcomes in adults. This study will use the Motivational Interviewing Skill Code to quantify client change language from an ongoing study of criminally- involved adolescents. Participants in the parent study are randomized to either MI or a behavioral skills training (BST) condition, both of which have two intervention sessions one week apart, with follow-up assessments at three and six months. Coding client language in this study presents the opportunity to measure change language from a randomized controlled trial of two treatments: MI and BST. We will quantify client language in a sample of 196 treatment sessions, 98 from each condition. Outcome measures in the parent study include a time-line follow-back querying sexual behavior and substance use over the previous 30 days. Effects will be evaluated from both the 3- and 6-month follow-ups, with the maximal effect of treatment expected at 3 months. No previous study has successfully applied client language coding to the study of adolescent sexual risk. This secondary analysis will test a causal chain developed in adult populations by using an adolescent sample and comparing those effects in two treatment conditions, an approach that will guide clinical practice by either corroborating or challenging the effects of client change language in adolescents.