Reducing HIV Risks among African American Teens in High Poverty Urban Settings

这项严格的三臂随机实验将测试一种创新的父母介导的艾滋病毒干预措施，为我们的儿子和女儿准备健康的未来，降低生活在高度贫困的城市社区的非洲裔美国人和其他黑人青年的艾滋病毒风险。根据之前的NICHD拨款，一套三张包含与文化相关的榜样故事的音频CD被发送给有青春期前儿子和女儿的家庭。一项对800多个主要是非洲裔美国人家庭进行的随机试验的结果表明，收到音频CD的父母报告说，他们在监测、亲子沟通、对青少年行为的影响以及解决青少年性行为和艾滋病毒风险的自我效能方面的水平明显提高。干预条件下的青少年报告了更多的家庭规则，更高水平的家庭支持，更重要的是，与对照组青少年相比，与性开始相关的行为风险更少。扩展这项工作，这项研究的目的是：（1）开发更多的健康未来音频CD，以促进积极的育儿实践，并支持青年建立预防艾滋病毒的行为模式;（2）进行随机现场试验，其中1500名非洲裔美国人/黑人父母及其六年级的儿子和女儿被随机分配三种条件之一：（a）一个多年的音频-CD干预，健康的未来;（B）一个注意力控制的条件;或（c）一个非注意力控制的条件;（3）在基线和从七年级到十年级的四个随访时间点调查父母，以测试健康的未来是否有效地促进和维持积极的父母行为;（4）在基线和七至十年级的四个时间点进行青年评估，以测试健康未来是否推迟性行为的开始，减少风险行为，并在十年级导致更少的性传播感染;（5）检查青少年的结果是否由父母的做法解释，并确定哪些父母的做法介导了实验条件和青少年结果之间的关系;（6）检查干预效果是否不同（即，（7）检查在不同的环境中，在哪里以及如何使用音频CD促进父母介导的干预（我们最初的为期一年的“为以后保存性行为”），以告知传播策略。“健康的未来”通过帮助父母应对其青春期子女面临的挑战，解决高度贫困城市社区非裔美国人/黑人中的艾滋病毒流行问题。

DESCRIPTION (provided by applicant): This rigorous three-arm randomized experiment will test whether an innovative parent-mediated HIV intervention, Preparing Our Sons and Daughters for Healthy Futures, reduces HIV risks among African American and other Black youth living in high-poverty urban neighborhoods. Under a prior NICHD grant, a set of three audio-CDs containing culturally relevant role-model stories were sent to families with preteen sons and daughters. Results of a randomized trial with over 800 mostly African American families indicate that parents receiving the audio-CDs reported significantly higher levels of monitoring, parent-child communication, perceived influence over youths' behaviors, and self efficacy to address adolescent sexuality and HIV risks. Adolescents in the intervention condition reported more household rules, higher levels of family support and, importantly, fewer behavioral risks related to sexual initiation than control- group youth. Extending this work, this study aims to: (1) Develop additional Healthy Futures audio-CDs to promote positive parenting practices and support youth in establishing patterns of behavior that are protective against HIV; (2) Conduct a randomized field trial in which 1500 African American/Black parents and their 6th grade sons and daughters are randomly assigned one of three conditions: (a) a multi-year audio-CD intervention, Healthy Futures; (b) an attention-controlled condition; or (c) a non-attention controlled condition; (3) Survey parents at baseline and at four follow up time-points extending from 7th into 10th grade, to test whether Healthy Futures is effective in promoting and sustaining positive parenting practices; (4) Conduct youth assessments at baseline and four time-points from 7th to 10th grade to test whether Healthy Futures delays sexual initiation, reduces risk behaviors and, at 10th grade, results in fewer STI; (5) Examine whether youth outcomes are explained by parenting practices and identify which parenting practices mediate the relationship between experimental condition and youth outcomes; (6) Examine whether intervention effects vary (i.e., are moderated) by youths' gender or level of baseline risk behaviors to better understand for whom the intervention works; (7) Examine where and how an audio-CD facilitated parent-mediated intervention (our original one-year Saving Sex for Later) is being used in diverse settings to inform dissemination strategies. Healthy Futures addresses the HIV epidemic among African Americans/Blacks in high-poverty urban communities by preparing parents to address the challenges their adolescent sons and daughters face.