Engineering an Online STI Prevention Program

 描述(申请人提供)：拟议研究的总体目标是减少大学生中性传播感染(STI)的发生率。我们建议通过使用创新的、受工程启发的多阶段优化策略(MOST)来实现这一点，以开发一种高效、吸引人、经济且易于扩展的互联网提供的行为干预，目标是酒精使用和性风险行为的交集。大学校园中的性传播感染比率令人担忧：四分之一的大学生在大学期间至少被诊断出一次性传播感染。饮酒时的性行为在大学生中非常普遍。众所周知，饮酒助长了性危险行为，而性危险行为是性传播的最主要原因，即无保护措施的性行为、与许多伴侣的接触以及“勾搭”(随意性接触)。很少有明确针对酒精使用和性危险行为交集的干预措施，也没有优化过的干预措施。为了减少性传播感染在该人群和其他高危人群中的传播，需要一种新的方法。MOST是一个综合的方法论框架，它将工程学原理的力量应用于行为干预的优化。MOST使研究人员能够对干预中的各个组成部分进行实验测试，以确定其有效性，指明哪些组成部分需要修改和重新测试。鉴于大学生饮酒率和性行为的高比率，大学环境为干预饮酒和性危险行为提供了理想的机会。这项拟议的研究将包括4个校区的不同群体的大学生(˜50%是非裔美国人)：2所历史上的黑人学院和大学，1所大型公立大学和1所专科学校。这 将增加我们研究结果的概括性。我们的具体目标是(1)开发和试行一套针对饮酒和性危险行为之间联系的初始在线干预组件，(2)使用MOST方法建立优化的预防干预，以及(3)使用全功率随机对照试验评估新优化的预防干预的有效性。这项工作将产生一种新的、更有效的行为干预措施，将减少美国大学生中性传播感染的发生率，并将为针对其他高危人群的新一代高效性传播感染预防干预奠定基础。

 DESCRIPTION (provided by applicant): The overall objective of the proposed research is to reduce the incidence of sexually transmitted infections (STIs) among college students. We propose to accomplish this by using the innovative, engineering-inspired multiphase optimization strategy (MOST) to develop a highly effective, appealing, economical, and readily scalable internet-delivered behavioral intervention targeting the intersection of alcohol use and sexual risk behavior. The rate of STIs on college campuses is alarming: one in four college students is diagnosed with an STI at least once during their college experience. Sexual activity when drinking alcohol is highly prevalent among college students. Alcohol use is known to contribute to the sexual risk behaviors that are most responsible for the transmission of STIs, namely unprotected sex, contact with numerous partners, and "hook- ups" (casual sexual encounters). Few interventions have been developed that explicitly target the intersection of alcohol use and sexual risk behaviors, and none have been optimized. In order to reduce the incidence of STI transmission among this and other high-risk groups, a new approach is needed. MOST is a comprehensive methodological framework that brings the power of engineering principles to bear on optimization of behavioral interventions. MOST enables researchers to experimentally test the individual components in an intervention to determine their effectiveness, indicating which components need to be revised and re-tested. Given the high rates of alcohol use and sex among college students, the college setting provides an ideal opportunity for intervening on alcohol use and sexual risk behaviors. The proposed study will include a diverse population of college students (˜ 50% African American) on 4 campuses: 2 Historically Black Colleges and Universities, 1 large public university, and 1 junior college. This will increase the generalizability of our findings. Our specific aims are to (1) develop and pilot test an initial set of online intervention components targeting the link between alcohol use and sexual risk behaviors, (2) use the MOST approach to build an optimized preventive intervention, and (3) evaluate the effectiveness of the newly optimized preventive intervention using a fully powered RCT. This work will result in a new, more potent behavioral intervention that will reduce the incidence of STIs among college students in the US, and will lay the groundwork for a new generation of highly effective STI prevention interventions aimed at other subpopulations at risk.