Computer-Aided Counseling to Prevent Teen Pregnancy/STDs

描述(由调查员提供)：青少年意外怀孕和 性传播疾病在美国仍处于流行水平。2010年健康人物 目标是将性行为比例提高到90% 积极使用避孕措施的青少年，既能有效防止 怀孕，并提供屏障保护，防止疾病。如何有效地 建议青少年实现这一目标尚不清楚。咨询和反馈 基于跨理论模型(TTM)已显示出更大的成功 在行为改变的几个领域，比标准的、以行动为导向的建议更重要。 这类心理咨询对改变女性青少年心理健康状况的有效性 性行为和避孕行为没有得到严格的评估。我们 建议招募660名13岁至21岁的女性青少年 市中心以医院为基础的诊所，并将他们随机分配到创新的 计算机辅助动机干预(CAMI)或教学 控制(DEC)。CAM！小组将接受三次30分钟的会议 由计算机生成的辅导员进行一对一咨询 个性化反馈。CAMI是基于TTM的原则和基于 励志面试。DEC提供了三个30分钟的课程 一对一的避孕、性传播疾病预防和 禁欲。这两次干预在长度和时间上是相同的，但有所不同 在教育内容、辅导方式、提供个性化等方面 反馈。在这项研究中，我们将跟踪这两组女性青少年 通过为期6个月的干预阶段和为期12个月的跟踪阶段来评估 不同群体的性行为和避孕行为的差异。 这项研究的主要具体目的是评估CAMI的疗效 与DEC相比，在减少增加风险的性行为方面 意外怀孕和性传播疾病。我们将检查保护性行为 在三个方面：1)防孕行为；2)防孕行为 防止性传播疾病；3)既防孕又防孕的行为 性传播疾病。我们的主要假设是CAMI将减少 参与任何防护不力的性交的受试者 怀孕和防止性传播疾病。我们还预测，在性行为活跃的人群中 受试者，CAMI将增加性交发作的百分比 通过使用两个避孕套和另一种避孕药得到了很好的保护。 最后，我们还预测CAMI将增加疟疾的流行。 在整个样本中的禁欲。如果被证明是有效的，计算机辅助 个性化的动机咨询可以作为一种方法广泛实施 降低女性意外妊娠和性传播疾病的发生率 青少年。

DESCRIPTION (provided by investigator): Adolescent unintended pregnancy and STDs remain at epidemic levels in the United States. Healthy People 2010 Objectives set a goal to increase to 90 percent the proportion of sexually active adolescents who use contraception that both effectively prevents pregnancy and provides barrier protection against disease. How to effectively counsel adolescents to reach this goal is unclear. Counseling and feedback based on the Transtheoretical Model (TTM) have demonstrated greater success than standard, action-oriented advice in several domains of behavior change. The effectiveness of this type of counseling to alter female adolescents' sexual and contraceptive behaviors has not been rigorously evaluated. We propose recruiting 660 female adolescents, ages 13 to 21 years, from an inner-city, hospital-based clinic and randomizing them to either an innovative Computer-Assisted Motivational Intervention (CAMI) or a Didactic Educational Control (DEC). The CAM! group will receive three, 30-minute sessions of one-on-one counseling with a counselor that is guided by computer-generated personalized feedback. The CAMI is based on the principles of the TTM and on Motivational Interviewing. The DEC provides three 30-minute sessions of one-on-one didactic information on contraception, STD prevention, and abstinence. The two interventions are identical in length and timing but vary in educational content, counseling style, and the provision of personalized feedback. We will track the two groups of female adolescents in this study through a 6-month intervention phase and a 12-month follow-up phase to assess differences in sexual and contraceptive behaviors by group. The primary specific aim for the study is to evaluate the efficacy of the CAMI as compared to the DEC in reducing sexual behaviors that increase the risks of both unintended pregnancy and STDs. We will examine protective sexual behaviors in three ways: 1) behaviors that protect against pregnancy; 2) behaviors that protect against STDs; and 3) behaviors that protect against both pregnancy and STDs. Our primary hypothesis is that the CAMI will decrease the proportion of subjects who engage in any intercourse that is poorly protected against pregnancy and against STDs. We also predict that among sexually active subjects, the CAMI will increase the percentage of episodes of intercourse that are well protected by the use of both condoms plus another contraceptive. Finally, we also predict that the CAMI will increase the prevalence of abstinence among the entire sample. If proven effective, computer-assisted personalized motivational counseling could be broadly implemented as a method to decrease the incidence of unintended pregnancy and STDs among female adolescents.