CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females

CHOICES-TEEN：针对青少年司法女性的捆绑风险降低干预措施的功效

基本信息

批准号：
10596634
负责人：
Danielle Elizabeth Parrish
金额：
$ 62.4万
依托单位：
BAYLOR UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-15 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10596634
关键词：
Address Adolescent Adult Affect Alcohol consumption Alcohols Behavior Behavior Therapy Behavioral Cognitive Communities Conceptions Criminal Justice Development Diversion Program Ethnic Origin Female Female Adolescents Female of child bearing age Gender Goals HIV Health Health behavior change Individual Infection Informal Social Control Intervention Journals Justice Low Prevalence Marijuana Mediating Mediator Minority Mobile Health Application Motivation Nature Pilot Projects Population Pregnancy Process Public Health Race Readiness Recording of previous events Reporting Research Risk Risk Behaviors Risk Reduction Services Sexually Transmitted Diseases Teenagers Testing Theoretical model Time Tobacco Underserved Population Vulnerable Populations Woman Work Youth alcohol exposure alcohol risk alcohol risk reduction behavior change condoms consistent condom use design efficacy evaluation efficacy testing efficacy trial ethnic minority follow-up high risk improved infection risk juvenile justice system male marijuana cessation marijuana use motivational enhancement therapy nicotine use peer post intervention pregnant prevent preventive intervention probation programs racial diversity racial population reduced alcohol use sexual risk behavior sexually active skills societal costs standard care substance use substance use prevention therapy design unintended pregnancy web site young woman

项目摘要

PROJECT SUMMARY/ABSTRACT NOT-DA-19-048 Adolescent females in juvenile justice settings engage in multiple health risk behaviors that place them at risk for HIV and pregnancy affected by alcohol and marijuana. Specifically, they engage in frequent sexual risk behaviors, placing them at risk of pregnancy, STIs and HIV, while also using marijuana, and alcohol. With nearly half of U.S. pregnancies being unplanned, females unaware of their pregnancy will continue to drink or use marijuana during the early and critical weeks of gestation, which places them at risk of substance-exposed pregnancy. The long-term goal of this proposed line of research is to develop efficient and opportunistic interventions that reduce the risk of substance-exposed pregnancy (SEP) and HIV/STIs for justice involved female youth. Therefore, the overall objective of this study is to test the efficacy of CHOICES-TEEN (CT) for reducing the risks of SEP and HIV/STI in young women involved in community probation or diversion programs. CT was adapted from the CHOICES preconception intervention and its shorter version, CHOICES-PLUS, which have a robust history of efficacy in reducing the risk of alcohol and tobacco-exposed pregnancy with high-risk adult women. CT utilizes Motivational Interviewing (MI), which has demonstrated significant promise with adolescents and criminal justice populations. Our recent pilot study (R03DA034099; CHOICES-TEEN; CT-P), in which we adapted CHOICES for teens and tested its feasibility with youth on community probation, produced promising results. CT was modified based on this pilot work to 1) focus on marijuana (reported by 89% in CT-P study) rather than tobacco given the low prevalence and sporadic nature of nicotine use reported by the teens; 2) add a mobile health application to increase engagement with the daily journal and; 3) incorporate a post-CT self-regulation component targeting behavioral processes of change (POC). This study will move the field vertically by elucidating important factors influencing youth health behavior change, while testing an intervention designed to reduce individual and societal costs for this high risk, underserved adolescent population. The next logical step is to conduct a rigorous RCT to assess the efficacy of this gender-responsive, tailored bundled risk reduction intervention for young, primarily minority, women involved in a community-based juvenile justice diversion or probation program. A stage II behavioral intervention efficacy trial will: 1) Primary Aim: Test the efficacy of CHOICES-TEEN (CT) on reducing the risk of substance-exposed pregnancy (SEP) and HIV/STI among high-risk female youth involved with the juvenile justice system by reducing alcohol use, increasing marijuana cessation, reducing pregnancy risk, and increasing condom use. Aim 2: Test the efficacy of CT, compared to SC, in increasing cognitive self-regulation abilities; Aim 3: Test proposed intervention mediators/mechanisms of action for CT overall and by race/ethnicity; Aim 4: Test the moderating effect of initial readiness to change on risk of SEP and risk of HIV/STI. If efficacious, CT is readily scalable and has the potential for dissemination not only to juvenile justice settings, but to a wealth of settings that serve young adolescent women at risk of substance-exposed pregnancies and HIV/STI.

项目概要/摘要 NOT-DA-19-048 少年司法机构中的青春期女性从事多种健康风险行为，导致她们面临感染艾滋病毒和受酒精和大麻影响怀孕的风险。具体来说，他们经常进行性行为危险行为，使她们面临怀孕、性传播感染和艾滋病毒的风险，同时还吸食大麻和酒精。和近一半的美国怀孕是计划外的，不知道自己怀孕的女性会继续饮酒或使用在怀孕的早期和关键几周吸食大麻，这使她们面临接触物质的风险怀孕。该研究方向的长期目标是开发高效且机会主义的降低物质暴露妊娠 (SEP) 和艾滋病毒/性传播感染风险的干预措施，为女性伸张正义青年。因此，本研究的总体目标是测试 CHOICES-TEEN (CT) 减少参与社区缓刑或转移计划的年轻女性感染 SEP 和 HIV/STI 的风险。 CT已调整来自 CHOICES 孕前干预及其较短的版本 CHOICES-PLUS，它们具有强大的降低高危成年女性酒精和烟草暴露妊娠风险的功效历史。 CT 采用动机访谈 (MI)，该方法已在青少年和犯罪分子中展现出巨大的前景正义的人民。我们最近的试点研究（R03DA034099；CHOICES-TEEN；CT-P），我们在其中进行了调整青少年的选择并在青少年社区缓刑中测试了其可行性，产生了有希望的结果。 CT 根据这项试点工作进行了修改，1) 重点关注大麻（CT-P 研究中 89% 的人报告）而不是烟草鉴于青少年报告的尼古丁使用流行率低且零星； 2）添加移动健康增加与日报互动的申请； 3) 纳入 CT 后自我调节组件针对变革的行为过程（POC）。这项研究将通过阐明重要的内容来垂直推动该领域影响青少年健康行为变化的因素，同时测试旨在减少个人和这一高风险、服务不足的青少年群体的社会成本。下一个合乎逻辑的步骤是进行严格的随机对照试验旨在评估这种性别敏感、量身定制的捆绑式风险降低干预措施对年轻人、主要是参与基于社区的少年司法分流或缓刑计划的少数族裔妇女。第二阶段行为干预功效试验将： 1) 主要目标：测试 CHOICES-TEEN (CT) 在减少与青少年相关的高危女性青少年中物质暴露妊娠 (SEP) 和 HIV/STI 的风险通过减少饮酒、提高大麻戒烟率、降低怀孕风险以及增加避孕套的使用。目标 2：测试 CT 与 SC 相比在提高认知自我调节能力方面的功效；目标 3：测试总体上和按种族/族裔提出的 CT 干预中介/作用机制；目标 4：测试改变的初始准备度对 SEP 风险和 HIV/STI 风险的调节作用。如果有效，CT 很容易具有可扩展性，不仅有可能传播到少年司法环境，而且有可能传播到许多需要为面临物质暴露怀孕和艾滋病毒/性传播感染风险的年轻女性提供服务。