Addressing Sexual Behavior Among Disadvantaged Youth

描述(由调查员提供)：该项目旨在减少在地区替代(即继续)学校就读的高中生感染艾滋病毒、其他性传播疾病(STD)和意外怀孕的风险。这项研究涉及三个关键活动：(1)开发和实施基于理论的干预，整合了从循证预防计划中提取的两个计划策略；(2)进行严格的结果和过程评估；以及(3)向现场传播研究结果和材料。这项研究的结果数据还将提供一个机会，更好地了解替代环境中的青年、艾滋病毒、其他性传播疾病和意外怀孕的高风险人群的性行为模式和相关规范和价值观。拟议的研究将评估两个基于理论的干预组成部分的单独和综合影响：(1)以技能和规范为基础的艾滋病毒、其他性传播疾病和怀孕预防课程；(2)社区参与和服务学习。课程内容将涉及支持行为改变的基本技能、规范和知识，并为获得和实践关键技能和降低风险战略提供充足的机会。服务学习部分将有助于增强学生的使命感和未来感，并提供积极联系的机会，这两个方面都是避免冒险行为的潜在动机影响。这些组成部分来自几个有效的干预/研究，包括做出骄傲的选择(Jemmott，Jemmott，&Fong，1998)，更安全的选择(Coyle等，1999,2001)，青少年外展计划(TOP)(Philliber&Allen，1992)，以及争取健康社区青年服务(REACH For Health)(社区青年服务)(O‘Donnell等，2002)。干预效果将采用2x2实验性前测-后测-延迟后测设计，涉及84个教室(1512名青少年)。课堂将被随机分配到四种干预条件中的一种：基于技能和规范的课程、服务学习、技能和规范课程加上服务学习，或者注意力控制课程。学生将在项目开始后的6个月和18个月接受基线评估。将使用多层次分析来说明学生在教室内的聚集情况。很少有研究审查艾滋病毒/性传播疾病/怀孕预防干预措施在替代环境中对青年的影响。此外，还没有发表的研究同时考察了以技能和规范为基础的课程和服务学习的个人和综合影响。因此，该项目将推进对性危险行为的现有研究，并提供有关重要青年人口的新数据。

DESCRIPTION (provided by investigator): This project is designed to reduce the risk of HIV, other sexually transmitted disease (STD), and unplanned pregnancy among high school-aged youth attending district alternative (i.e., continuation) schools. This study involves three key activities: (1) developing and implementing a theoretically-based intervention that integrates two program strategies drawn from evidenced-based prevention programs; (2) conducting a rigorous outcome and process evaluation; and (3) disseminating the study findings and materials to the field. The outcome data from this study also will provide an opportunity to better understand the sexual behavior patterns and related norms and values among youth in alternative settings, an under-studied population at great risk for HIV, other STDs, and unplanned pregnancy. The proposed study will assess the individual and combined effects of two theoretically based intervention components: (1) a skills- and norm-based HIV, other STD, and pregnancy prevention curriculum; and, (2) community involvement and service learning. The curriculum component will address essential skills, norms, and knowledge supporting behavior change and provide ample opportunities for acquisition and practice of key skill and risk reduction strategies. The service learning component will help enhance students' sense of purpose and future and provide opportunities for positive connection, both potential motivational influences to avoid risk-taking behaviors. These components stem from several effective interventions/studies, including Making Proud Choices (Jemmott, Jemmott, & Fong, 1998), Safer Choices (Coyle et al., 1999, 2001), Teen Outreach Program (TOP) (Philliber & Allen, 1992), and Reach for Health Community Youth Service (CYS) (O'Donnell et al., 2002). The intervention effects will be tested using a 2 x 2 experimental pretest-posttest-delayed posttest design involving 84 classrooms (1,512 youth). Classrooms will be randomly assigned to one of four intervention conditions: skills- and norms-based curriculum, service learning, skills and norms curriculum plus service learning, or an attention control curriculum. Students will be assessed at baseline and at 6- and 18-months after program entry. Multilevel analyses will be used to account for the clustering of students within classrooms. Few studies have examined the effects of HIV/STD/pregnancy prevention interventions with youth in alternative settings. Additionally, no published study has examined both the individual and combined effects of a skills- and norm-based curriculum and service learning. Thus, this project will advance existing research on sexual risk behavior as well as provide new data on an important youth population.