Targeting Mass Media Campaigns for HIV, STD, and Pregnancy Prevention

描述(由申请人提供)：这项拟议的研究是美国国立卫生研究院资助的一项成功研究计划的继续，该计划旨在提高针对高度性风险倾向的个人的大众媒体宣传活动的有效性。我们目前的项目评估了电视转播的PSA干预活动的影响，该活动专门为减少年轻人的高危性行为而设计。结果令人印象深刻，在一项中断的时间序列、2个城市的现场试验中，对避孕套的使用产生了4-6个月的影响，并在高感觉寻求(HSS)和冲动决策(IDM)的年轻人中使用避孕套的关键媒介。拟议的继续研究将检验密集的电视宣传活动在说服青少年推迟在两个可比较的125个尼尔森市场(南卡罗来纳州查尔斯顿和佐治亚州奥古斯塔)开始性行为方面的有效性，采用与当前项目类似的受控时间序列设计。它将包括3个高饱和度的电视公益广告宣传活动(2个在1个社区，1个在另一个社区)，重点是推迟开始性行为，使用基于理论的、适合年龄的、针对性别的和文化敏感的信息。在27个月的评估期内，这项研究将通过对这两个社区公立学校学生每月随机抽样的采访，监测PSA暴露、关于等待性行为的性规范、拒绝自我效能、卷入一段关系、性行为意向和推迟性行为、将自己置于潜在的性情境中，以及个人差异变量(特别是寻求感觉和冲动的决策)。随之而来的过程研究将提供对个人和社会过程的洞察，通过这些过程，运动对行为产生了影响。这项研究的主要目标是：1)测试有针对性的电视PSA运动的能力，以通过推迟性行为的开始来向高危青少年传达减少艾滋病毒相关危险行为的信息；2)对这种运动随着时间的推移在性行为开始和相关的中介变量中产生显著变化的能力进行受控测试；3)探索感觉寻求和冲动决策在调节这种影响方面的作用；4)探索运动如何通过影响上述中介和结果变量的过程在非裔美国人和白人青少年中相似或不同，5)探索助推活动增强或维持先前活动的影响的能力，以及6)加强对与活动效果相关的个人和社会过程的理解。该项目的潜在公共卫生意义包括推迟数百名早期青少年的性行为，从而在较长一段时间内显著降低意外怀孕和性传播疾病(包括艾滋病毒)的发生率。电视公共服务公告也将提供给其他社区在那里播出，可能会产生重大的公共卫生后果。

DESCRIPTION (provided by applicant): The proposed study represents a continuation of a successful NIH-funded research program on improving the effectiveness of mass media campaigns targeted toward individuals predisposed to high levels of sexual risk-taking. Our current project assessed the impact of a televised PSA intervention campaign designed specifically to reduce high-risk sexual behavior in young adults. Results have been impressive, with 4-6 month effects on condom use and critical mediators of condom use for high-sensation-seeking (HSS) and impulsive decision-making (IDM) young adults in an interrupted time-series, 2-city field experiment. The proposed continuation study will examine the effectiveness of intensive television campaigns in persuading young adolescents to delay initiation of sexual activity in 2 comparable top 125 Nielsen markets (Charleston, SC and Augusta, GA), employing a controlled time-series design similar to that in the current project. It will involve 3 high-saturation 3-month TV PSA campaigns (2 in 1 community and 1 in the other) focusing on delay of initiation of sexual activity, employing theory-based, age-appropriate, gender-targeted, and culturally sensitive messages. Over the 27-month assessment period, the study will monitor PSA exposure, sexual norms about waiting to have sex, refusal self-efficacy, involvement in a relationship, intentions to have sex and delay having sex, placing oneself in potentially sexual situations, as well as individual difference variables (particularly sensation-seeking and impulsive decision-making), through interviews with monthly random samples from a cohort of students in public schools in the 2 communities. An accompanying process study will provide insight into the individual and social processes through which the campaign has its effects on behavior. The principal objectives of the study are to: 1) test the ability of a targeted televised PSA campaign to reach at-risk adolescents with messages to reduce HIV-related risky behavior by delaying initiation of sexual activity, 2) provide a controlled test of the ability of such a campaign to produce significant changes over time in initiation of sexual activity and related mediating variables, 3) explore the roles of sensation-seeking and impulsive decision-making in moderating such effects, 4) explore how the processes through which the campaign affects the above mediating and outcome variables are similar or different for African-American and Caucasian adolescents, 5) explore the ability of a booster campaign to enhance or sustain the impact of a previous campaign, and 6) enhance understanding of the individual and social processes related to campaign effects. The potential public health significance of this project includes delaying sexual activity for hundreds of early adolescents, resulting in significant reductions in rates of unwanted teen pregnancy and STDs (including HIV) over an extended period of time. The televised public service announcements will also be made available to other communities for airing there, with potentially significant public health outcomes.