My Health, My Future: Promotion of Protective sexual health practices among Apache Youth and young adults through an assests-based self-care intervention

项目总结： 我的健康我的未来的目标是开发和测试自我护理干预的有效性 通过以资产为基础的项目在美国印度青年和青年中促进性健康 接近。研究人群是白山阿帕奇部落(APACHE)，他们有30年的 与约翰·霍普金斯美国印第安人中心合作进行开创性研究的历史 健康(JHU)。这一干预措施将推进性健康自我护理研究和 包括简短的自我评估，通过文本、电话发送相应的个性化消息 和电子邮件，以及用于性传播感染筛查和HPV免疫接种的非诊所替代方案。这个 干预将植根于资产理论，这与土著对健康的信念是一致的，以及 积极的青年发展框架。年龄为11-26岁(n=312)的阿帕奇将单独 随机接受自我护理干预或对照条件(护理标准)。我们会 评价自我护理干预与对照对性传播感染主要结局的影响 在性行为活跃的青年中进行筛查。次要结果将包括：a)性风险和 保护行为；b)HPV疫苗覆盖面(完成2针或3针)；c)心理社会 资产和资源。所有结果将通过音频计算机辅助自我访谈进行评估 技术在基线和干预后6个月。结果的子集将通过以下两种方式进行衡量 在整个后续时间段内每周通过短信发送。这一建议具有紧迫性、创新性和 有可能产生重大影响，因为：1)美国印第安人和年轻人有 美国性传播感染发病率最高；2)美国印第安人宫颈癌的发病率和死亡率很高 癌症，但年轻人对HPV疫苗的接受率较低；3)以提供者为主导、以诊所为基础的替代方案 在性健康差距因性别差异而永久化的社区，需要治疗 获得护理、地理隔离和保密问题；以及4)阿帕奇-JHU研究 团队已经成功地证明了自我管理和资产的可行性和可接受性- 在过去的NARCH努力中，以改善健康结果的方法为基础。如果研究目标是 实现后，我们将为美国印第安人社区提供一种新颖的自我护理干预措施 寻求性健康护理的替代策略。

PROJECT SUMMARY: The goal of My Health My Future is to develop and test the efficacy of a self-care intervention for sexual health promotion among American Indian youth and young adults through an assets-based approach. The study population is the White Mountain Apache Tribe (Apache), who have a 30-year history of pioneering research in collaboration with the Johns Hopkins Center for American Indian Health (JHU). The intervention will advance a new line of sexual health self-care research and includes a brief self-assessment, corresponding personalized messaging delivered via text, phone and email, and non-clinic based alternatives for STI screening and HPV immunization. The intervention will be rooted in asset theory, which is congruent with Native beliefs about wellness, and a positive youth development framework. Apaches ages 11-26 (n=312) will be individually randomized to receive the self-care intervention or comparison condition (standard of care). We will evaluate the impact of the self-care intervention vs. comparison on the primary outcome of STI screening uptake among sexually active youth. Secondary outcomes will include: a) sexual risk and protective behaviors; b) HPV vaccine coverage (completion of doses 2 or 3); and c) psychosocial assets and resources. All outcomes will be evaluated via Audio Computer-Assisted Self-Interview technology at baseline and 6-months post-intervention. A subset of outcomes will be measured bi- weekly via text message throughout the follow-up time period. This proposal is urgent, innovative and has potential for significant impact because: 1) American Indian youth and young adults have the highest rates of STIs in the US; 2) American Indians have high incidence and mortality from cervical cancer but low uptake of HPV vaccination by youth; 3) alternatives to provider-driven, clinic-based treatment are needed in communities where sexual health disparities are perpetuated by differential access to care, geographic isolation and confidentiality concerns; and 4) the Apache-JHU research team has successfully demonstrated the feasibility and acceptability of self-management and assets- based approaches to improving health outcomes in past NARCH endeavors. If study aims are achieved, we will have a novel, self-care intervention available for American Indian communities that seek alternative strategies for sexual health care.