Long-term Effects of Behavioral Intervention in Minority Women

行为干预对少数民族妇女的长期影响

• 批准号: 6224240
• 负责人: ROCHELLE N SHAIN
• 金额: $ 12.91万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6224240
• 关键词: African American; Mexican Americans; age difference; behavior modification; behavioral /social science research tag; chlamydial disease; clinical research; clinical trials; cooperative study; counseling; female; gonorrhea; group therapy; health behavior; human subject; human therapy evaluation; sex abuse; sex behavior; sexually transmitted diseases; socioenvironment; substance abuse related disorder; violence

This project is a continuation of an ongoing controlled randomized trial evaluation the efficacy of two risk-reduction intervention modules (standard intervention with and without the option of attending support groups) versus enhanced clinical counseling. The standard intervention without support groups, evaluated in a prior study, had a significant impact on subsequent rates of gonorrhea and chlamydia and high-risk behavior. Preliminary results from the ongoing study show significant STD reduction for both interventions, controlling for age, abuse and drug use. The proposed work will extend existing 2-year follow-up to 5 years (annual interviews/exams and semi-annual brief interviews). Because the 2-year retention rate is expected to be 90%, anticipated sample size at 3 years is 706 women. The sample consists of 830 high-risk, Mexican- and African-American women; 54% are <20 years, 80% are ,25, 34% are substance users and 64% have been sexually or physically abused. Broad goals are to determine long-term intervention efficacy; to more fully understand the relationships between clinical outcomes, behavioral strategies, and behavioral measures; and to determine the effects of physical/sexual abuse and substance use on sexual behavior, infection, and intervention efficacy. Specific aims are to 1) determine psychosocial and situational factors (and combinations) associated with high-risk sexual behavior over time, 2) determine psychodynamic factors (derived primarily from ARRM constructs [the theory we adapted to guide this research]) associated with high-risk behavior over time, 3) determine the effects of various psychosocial and situational factors particularly abuse, on ARRM constructs, 4) determine patterns of sexual behavior and effects modifiers (e.g., douching) that contribute to infection over time; behavioral risk-reduction strategies will be evaluated by determining their impact on infection. 5) assess the utility of various measures of similar behavioral constructs with respect to explaining infection; risk indices incorporating multiple constructs will be developed. 6) evaluated long- term (3-5 years) effects of standard and support-group intervention versus enhanced counseling on ARRM constructs, sexual behavior, health- seeking behavior, and infection with gonorrhea and/or chlamydia. 7) evaluate intervention effects with respect to age, abuse, and substance use. A prospective random design, using repeated measures is employed. Repeated measures analysis of variance and linear and logistic regression are the principal multivariate analysis techniques used.

该项目是一项正在进行的对照随机试验的延续，该试验评估了两种降低风险干预模块（可选择参加支持小组和不参加支持小组的标准干预）与强化临床咨询的功效。先前的研究评估了没有支持小组的标准干预措施对随后的淋病和衣原体感染率以及高危行为产生了显着影响。正在进行的研究的初步结果显示，在控制年龄、滥用和药物使用的情况下，这两种干预措施可显着减少性传播疾病。拟议的工作将把现有的 2 年随访延长至 5 年（年度面试/考试和半年度简短面试）。由于 2 年保留率预计为 90%，因此 3 年预计样本量为 706 名女性。该样本由 830 名高风险墨西哥裔和非裔美国女性组成； 54% 的人年龄小于 20 岁，80% 的人年龄为 25 岁，34% 的人吸毒，64% 的人遭受过性虐待或身体虐待。广泛的目标是确定长期干预效果；更全面地了解临床结果、行为策略和行为测量之间的关系；并确定身体/性虐待和药物使用对性行为、感染和干预效果的影响。具体目标是 1) 确定与高风险性行为相关的社会心理和情境因素（及其组合），2) 确定与高风险性行为相关的心理动力学因素（主要源自 ARRM 结构[我们用来指导这项研究的理论]）。 - 随着时间的推移，风险行为，3) 确定各种社会心理和情境因素，特别是虐待，对 ARRM 结构的影响，4) 确定随时间推移导致感染的性行为模式和影响调节因素（例如，冲洗）；将通过确定行为风险降低策略对感染的影响来评估这些策略。 5）评估类似行为结构的各种措施在解释感染方面的效用；将开发包含多种结构的风险指数。 6) 评估了标准干预和支持小组干预与强化咨询对 ARRM 结构、性行为、求医行为以及淋病和/或衣原体感染的长期（3-5 年）影响。 7) 评估年龄、滥用和物质使用方面的干预效果。采用使用重复测量的前瞻性随机设计。方差重复测量分析以及线性和逻辑回归是使用的主要多元分析技术。