Interventions for Risk Reduction and Avoidance in Youth

减少和避免青少年风险的干预措施

• 批准号: 6673314
• 负责人: Valerie Frances Reyna
• 金额: $ 11.93万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-05-03 至 2003-12-05
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6673314
• 关键词: HIV infections; Hispanic Americans; adolescence (12-20); attitude; avoidance behavior; behavioral /social science research tag; child psychology; clinical trials; cognitive behavior therapy; communicable disease control; decision making; disease /disorder proneness /risk; high risk behavior /lifestyle; human subject; human therapy evaluation; judgment; longitudinal human study; outcomes research; patient oriented research; questionnaires; racial /ethnic difference; sex behavior; sex education; sexually transmitted diseases; social psychology; statistics /biometry

Three million new cases of sexually transmitted diseases (STD) are identified in adolescents every year. The proposed research applies recent advances in cognitive-behavioral theory to increase the effectiveness and durability of multicomponent interventions that promote risk reduction and avoidance in adolescents. In Phase I, we investigate adolescents' psychological representations of decision options (i.e. abstinence vs. risk taking), risk estimates of problem behaviors, and relevant beliefs and attitudes. Specifically, 200 adolescents will be surveyed, presented with realistic sexual decision-making scenarios, and questioned in-depth concerning their perceptions of important risks and consequences (e.g., the cumulative risk of contracting a STD). Hispanics will be oversampled to provide sufficient statistical power to evaluate ethnic differences. In Phase II, 800 adolescents will be randomly assigned to one of three groups: a standard multicomponent intervention (Reducing the Risk), a gist-based enhancement of the standard intervention, or a control group receiving an unrelated intervention. The enhanced intervention will be based on cognitive behavioral theory (e.g., Reyna and Ellis, 1994), as well as on differences identified in Phase 1 between adolescents engaging versus not engaging in risky behaviors. Pre- and post-intervention surveys will assess such outcomes as self-reports of risky behaviors and STD treatment, with follow-up surveys at 3, 6, and 12 months. Multivariate analyses of variance (followed by univariate tests) controlling for background and baseline characteristics, will be used to compare differences among standard, enhanced, and control groups. Logistic regression will be used for categorical outcome measures, such as initiation of intercourse. Thus, the proposed research will provide evidence concerning sexual decision processes in Hispanic and non-Hispanic adolescents, and evaluate a theory-based intervention that focuses on specific behaviors and addresses both social (e.g., refusal skills) and cognitive- developmental factors using a randomized assignment design. We will also compare our survey data to results of a statewide evaluation of abstinence-only programs using the same survey instrument. By emphasizing gist representations, which are well preserved over long time periods and are key memories used in decision making, the enhanced intervention should produce larger and more sustained effects on risk reduction and avoidance.

每年在青少年中确定有300万例新的性传播疾病（STD）。 拟议的研究应用了认知行为理论的最新进展，以提高多组分干预措施的有效性和耐用性，从而促进青少年的降低风险和回避。 在第一阶段，我们调查了青少年对决策选择的心理表征（即节制与冒险的风险），问题行为的风险估计以及相关的信念和态度。 具体而言，将对200名青少年进行调查，并呈现出现实的性决策情景，并对他们对重要风险和后果的看法进行了深入的质疑（例如，累积性病的累积风险）。 西班牙裔将被过采样，以提供足够的统计能力来评估种族差异。 在第二阶段，将将800名青少年随机分配给三组之一：标准的多组分干预（降低风险），基于GIST的标准干预措施的增强或接受无关干预的对照组。 增强的干预措施将基于认知行为理论（例如，Reyna和Ellis，1994），以及在参与的青少年与不参与风险行为的青少年之间发现的差异。 干预前后的调查将评估诸如危险行为和性病治疗的自我报告，并在3、6和12个月中进行后续调查。 控制背景和基线特征的多变量分析（然后进行单变量测试）将用于比较标准，增强和对照组之间的差异。逻辑回归将用于分类结果度量，例如性交的开始。 因此，拟议的研究将提供有关西班牙裔和非西班牙裔青少年中性决策过程的证据，并评估一种基于理论的干预措施，该干预措施着眼于特定行为，并使用随机分配设计来解决社会（例如拒绝技能）和认知发展因素。 我们还将将我们的调查数据与使用同一调查工具对仅限节制计划进行评估的结果进行比较。 通过强调长期保存的GIST代表，并且是决策中使用的关键记忆，增强的干预措施应对降低风险和避免产生更大，更持续的影响。