Yo Puedo: Future Opportunities for Youth

描述(由申请人提供)：美国的青少年怀孕率仍然高于任何发达国家，其中拉丁裔青少年的怀孕率高得不成比例。这项拟议的研究建立在我们对旧金山任务区拉美裔青少年的研究基础上，该研究揭示了帮派从属关系和意外怀孕之间的密切联系，以及街头帮派在塑造社交网络方面发挥的重要作用。我们建议进行形成性设计研究，并试验一种创新干预(Yo Puedo[“I Can”]：青年的未来机会)的可行性，该干预将有条件现金转移(CCT)和生活技能教育相结合，以应对社区的社会网络影响和社会经济机会，因为在这个社区，年轻人经历了大量的帮派接触和高早产率。Yo Puedo受到行为经济学和社会学习理论的启发，并在社区合作伙伴的参与下开发，目标是16至21岁的年轻人和他们社交网络中的同龄成员。接受有条件现金援助的标准将由青年自己制定，并将与教育和技能发展以及参与生殖健康活动挂钩。我们将用从有效的意外怀孕预防课程中获得的生活技能培训来补充有条件现金援助，这些课程涉及影响早育和伙伴关系的规范，并将为支持青年实现干预目标而量身定做。我们将首先进行形成性方法论研究，以设计一个最适合于促进旧金山任务区年轻人的教育和生殖健康的有条件现金转移激励结构(目标1)。我们将采用经济学中的权变估值方法来设计激励结构。为了评估实施Yo Puedo(目标2)的可行性，我们将进行一项试点，将60个三人社交网络(总共180名青少年)随机分配到干预组或观察对照组。我们将评估我们招募年轻人参加随机研究的能力，以及我们招募和保留三人社交网络的能力，以及我们整合CCT和生活技能课程的能力。最后，通过随机研究和8个焦点小组对青年参与者、成人导师和社区提供者进行干预后，我们将确定直接向青年发放奖励是否有负面影响，并检查随着时间的推移中介结果的初步模式(目标3)。根据研究结果，我们将对干预措施进行修订，并设计未来的第三阶段效果评估。 与公共卫生相关：需要采取创新的干预措施，防止拉美裔青年意外怀孕率居高不下。这项研究包括使用经济学方法的新的形成性方法研究，以及为旧金山16至21岁的青年设计的有条件现金转移和量身定做的生活技能干预(Yo Puedo[“I Can”]：青年的未来机会)的可行性评估。研究结果将指导未来这一干预措施的第三阶段有效性评估的设计。

DESCRIPTION (provided by applicant): Adolescent pregnancy rates in the United States remain higher than in any developed nation, with disproportionately high pregnancy rates in Latina adolescents. The proposed study builds on our research with Latino adolescents in San Francisco's Mission District that revealed the strong connection between gang affiliation and unintended pregnancy and the important role that street gangs play in shaping social networks. We propose to conduct formative design research and pilot the feasibility of an innovative intervention (Yo Puedo ["I can"]: Future Opportunities for Youth) that combines conditional cash transfers (CCTs) and a life skills education to address social network influences and socioeconomic opportunities in a neighborhood where youth experience substantial gang exposure and high rates of early childbearing. Informed by behavioral economics and social learning theory and developed with input from community partners, Yo Puedo will target youth 16 to 21 years old and same-aged members of their social network. Criteria for receipt of the CCTs will be established by youth themselves and will be tied to educational and skill development and participation in reproductive health activities. We will complement the CCTs with life skills training derived from effective unintended pregnancy prevention curriculum that addresses norms that influence early childbearing and partnerships, and that will be tailored to support youth in achieving intervention objectives. We will begin by conducting formative methodological research to design a CCT incentive structure best suited to promoting educational and reproductive health wellness for youth in San Francisco's Mission District (Aim 1). We will design the incentive structure using adapted contingency valuation methods from economics. To evaluate the feasibility of implementing Yo Puedo (Aim 2), we will conduct a pilot with randomization of 60, 3-person social networks (180 youth in total) to the intervention or observational control group. We will assess our ability to recruit youth to a randomized study with an observational control arm; our ability to recruit and retain 3-person social networks; and our integration of the CCTs and life skills curriculum. Finally, through the randomized study and 8 focus groups conducted post- intervention with youth participants, adult mentors and community providers, we will determine whether distributing reward payments to youth directly had negative effects and examine preliminary patterns in intermediary outcomes over time (Aim 3). Based on the study results, we will revise the intervention and design a future Phase 3 effectiveness evaluation. PUBLIC HEALTH RELEVANCE: Innovative interventions to prevent persistently high rates of unintended pregnancy among Latino youth are needed. This study consists of novel formative methodological research using approaches from economics and a feasibility evaluation of a combined conditional cash transfer and tailored life skills intervention (Yo Puedo ["I can"]: Future Opportunities for Youth) designed for youth aged 16 to 21 in San Francisco. The study findings will guide design of a future Phase 3 effectiveness evaluation of this intervention.