Influences on risk behaviors among young men

描述（由申请人提供）：候选人。我追求这个以患者为导向的指导研究职业发展奖（K23），以促进我向艾滋病毒预防科学的独立研究事业过渡。我的长期目标是成为一名富有成效的独立的艾滋病预防行为科学家。我的目标包括发展艾滋病毒预防干预措施——利用新的、越来越容易获得和有影响力的在线媒体——解决性少数群体在关键发展时期的差异。到目前为止，我的培训主要集中在临床心理学（博士）和流行病学（硕士）的核心优势和技能上。我获得了艾滋病毒预防、行为改变理论和研究方法方面的专业知识，重点是成人。这个基础为我接下来的培训做好了准备，即发展青少年风险行为（大多数风险行为模式建立的时候）方面的专业知识，以及发展、实施和评估在线预防干预和研究所需的技能。培训计划。拟议的培训计划将使我准备与青少年性少数群体一起工作，这是一个感染艾滋病毒的重大风险群体。获得K23奖将使我有时间获得必要的技能。具体而言，通过K23培训，我将：(1)获得针对青春期性少数人群的艾滋病毒预防干预所需的理论和方法技能；(2)获得基于在线媒体的干预发展方面的实践培训，包括卫生传播和媒体素养技能；(3)建立必要的合作网络和研究基础设施，使nih资助的研究者能够独立。重要的是，我的培训也将提高我对(4)涉及(a)与年轻，经常被污名化的人群合作以及(b)提供在线干预的独特道德挑战的成熟度。在社会、文化、健康和技术快速发展的时代，这两个领域都充满了伦理复杂性（例如，隐私、同意、保密）。我的训练将使我能够在这个新兴而复杂的研究领域担任领导角色。培训目标将通过教学课程、研讨会、研究经验和指导来实现。环境。在拟议的K23期间，我将担任the Miriam Hospital的研究科学家和Brown University的助理教授。在Miriam，我将有机会接触到行为和预防医学中心以及艾滋病研究中心提供的优秀和高度支持的研究环境。在布朗大学，我将有机会使用医学院和公共卫生学院的学术资源，包括酒精研究中心对艾滋病的研究。这样的环境将加强我的训练，促进我的研究目标。通过这次K23奖获得的培训、经验和技能，我将准备寻求资金，进行一项更大规模的随机对照试验，以降低青少年性少数群体的艾滋病毒风险。导师。我将接受来自HIV预防和行为科学、公共卫生、传播和媒体素养方面国际公认的优秀研究团队的指导。提出了研究。在美国，年轻的性少数群体男性感染艾滋病毒的比例过高。种族和少数民族人口受到的影响尤其严重。发病率反映了早期性经历中的性风险行为。研究表明，性取向少数的男性在青春期（14-18岁）开始有性冒险行为。因此，针对青少年性少数男性进行艾滋病预防干预具有重要意义。在青春期以性少数男性为目标，将有助于他们在性心理发展的早期学习和建立健康的性行为，这将具有即时和长期的健康益处。网络媒体的使用引发并维持了性少数青少年男性的性冒险行为。因此，解决网络媒体对这一人群的影响对艾滋病毒预防干预至关重要。解决这种影响的一种方法是开展在线性健康媒体素养干预。为了促进性少数青少年男性对网络媒体的批判性检查并减少他们的性冒险行为，我提出了一个两阶段的研究计划（即形成性研究和探索性临床试验），有三个目标：(1)利用五个焦点小组（N ~ 30）的反馈，开发方法来招募和保留一个种族/民族多样化的在线性少数青少年男性样本；(2)利用来自青年咨询委员会（N ~ 8）和横断面在线调查（N = 200）的信息，制定一项简短的、在线管理的性健康媒体素养干预措施，以降低青春期性少数男性的艾滋病毒风险行为；(3)开展探索性临床试验，对开发的网络性健康媒介素养干预措施的可行性和可接受性进行试点检验（N = 100）。总的来说，这项拟议的研究有可能在性发育早期接触到性少数群体的广泛受众，最终减少他们的性冒险行为，减少这一人群中新感染艾滋病毒的人数。此外，拟议的研究将扩大我作为艾滋病毒研究者和干预者的能力，并将我置于基于在线媒体的艾滋病毒预防研究的前沿。

DESCRIPTION (provided by applicant): Candidate. I pursue this Mentored Patient-Oriented Research Career Development Award (K23) to facilitate my transition towards an independent research career in HIV prevention science. My long-term goal is to become a productive independent HIV prevention behavioral scientist. My goals include the development of HIV prevention interventions - using new and increasingly accessible and influential online media - to address disparities among sexual minority populations across key developmental periods. To date, my training has focused on core strengths and skills in clinical psychology (PhD) and epidemiology (MPH). I have acquired expertise in HIV prevention, behavior change theory, and research methods, with an emphasis on adults. This foundation has prepared me for the proposed next steps of my training, namely, developing expertise in adolescent risk behavior (the time when most risk behavior patterns are established) and the skills necessary for the development, implementation, and evaluation of online prevention interventions and research. Training plan. The proposed training plan will prepare me to work with adolescent sexual minority populations, a group at significant risk for HIV. Receipt of a K23 award will allow me protected time to acquire the necessary skills. Specifically, with the K23 training I will: (1) acquire the theoretical and methodological skills required for HIV prevention interventions targeting sexual minority populations during adolescence; (2) gain hands-on training in online media-based intervention development, including health communications and media literacy skills; and (3) build the necessary collaboration networks and research infrastructure to enable independence as an NIH-funded investigator. Importantly my training will also increase my sophistication regarding the (4) unique ethical challenges involved in (a) working with a young, often stigmatized population, and (b) delivering online interventions. Both domains are fraught with ethical complexities (e.g., privacy, consent, confidentiality) at a time of rapidly-evolving societal, cultural, health, and technological changes. My training will prepare me to take a leadership role in this emerging and complex research area. Training goals will be achieved through didactic courses, workshops, research experience, and mentoring. Environment. During the proposed K23, I will be a Research Scientist at The Miriam Hospital and an Assistant Professor at Brown University. At the Miriam, I will have access to the outstanding and highly supportive research environments provided by the Centers for Behavioral and Preventive Medicine and the Centers for AIDS Research. At Brown University, I will have access to the academic resources of the Schools of Medicine and Public Health, including the Alcohol Research Center on HIV. This environment will enhance my training and facilitate my research goals. Through the training, experience, and skills gained as a part of this K23 Award, I will be prepared to pursue funding to conduct a larger randomized controlled trial of an intervention to reduce HIV risk among adolescent sexual minority populations. Mentors. I will receive mentoring from an outstanding team of internationally recognized and accomplished investigators in HIV prevention and behavioral science, public health, communications, and media literacy. Proposed research. Young sexual minority males account for a disproportionate number of HIV infections in the United States. Racial and ethnic minority populations are particularly affected. Incidence rates reflect sexual risk behaviors during early sexual experiences. Research suggests that initial sexual risk-taking occurs during adolescence (ages 14-18) among sexual minority males. Therefore, it is important for HIV prevention interventions to target adolescent sexual minority males. Targeting sexual minority males during adolescence will help them learn and establish healthy sexual behaviors early in their psychosexual development, which will have both immediate and long-term health benefits. Online media use triggers and maintains sexual risk-taking among adolescent sexual minority males. Consequently, it is critical for HIV prevention interventions to address the influence of online media on this population. One way to address this influence is by developing an online sexual health media literacy intervention. To promote adolescent sexual minority males' critical examination of online media and to decrease their sexual risk-taking, I propose a two-stage program of research (i.e., formative research and an exploratory clinical trial) with three aims: (1) develop methods to recruit and retain a racially/ethnically diverse sample of adolescent sexual minority males online using feedback from five focus groups (N ~ 30); (2) develop a brief, online-administered, sexual health media literacy intervention to lower HIV risk behaviors among adolescent sexual minority males using information from a youth advisory board (N ~ 8) and a cross-sectional online survey (N = 200); and (3) conduct an exploratory clinical trial to pilot test the developed online sexual health media literacy intervention for feasibility and acceptability (N = 100). Overall, the proposed research has the potential to reach a wide audience of sexual minority males early in their sexual development, ultimately decreasing their sexual risk-taking and reducing the number of new HIV infections in this population. Further, the proposed research will expand my capacities as an HIV researcher and interventionist and place me at the forefront of online media-based HIV prevention research.