Liberia School-Based HIV/STD Prevention Program

利比里亚学校艾滋病毒/性病预防计划

• 批准号: 7495580
• 负责人: Stephen B. Kennedy
• 金额: $ 20.72万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7495580
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Administrator; Adolescent; Adolescent Risk Behavior; Africa South of the Sahara; African; Age; Appendix; Attitude; Behavioral; Behavioral Research; Cessation of life; Characteristics; Child; Cognitive; Cohort Studies; Coitus; Communities; Condition; Conflict (Psychology); Control Groups; Country; Data; Education; Educational Curriculum; Environment; Epidemic; Evaluation; Evidence based program; Female; Focus Groups; Ghana; HIV; HIV Infections; Health; Health Educators; Healthcare; Infection; Institution; Intervention; Interview; Kenya; Liberia; Mediating; Mediation; Methods; Modeling; Needs Assessment; Orphan; Outcome; Outcome Study; Population; Prevalence; Prevention intervention; Prevention program; Process; Public Health; Randomized; Rate; Recording of previous events; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Risk Behaviors; Risk Factors; School Enrollments; School Teachers; Schools; Self Efficacy; Sexual Partners; South Africa; Students; Surveys; Swaziland; Variant; War; Work; Youth; age group; base; behavior change; condoms; design; dosage; health economics; high school; member; pandemic disease; programs; sex; skills; social; stem

DESCRIPTION (provided by applicant): This application is for a two year study to adapt and evaluate the efficacy of a HIV prevention curriculum for 7th grade in-school Liberian youths, ages 14-16 years. The proposed intervention draws on an evidence-based curriculum, Making Proud Choices (Jemmott et al., 1998) that is currently being adapted in other Sub-Saharan African countries (e.g., Ghana, Kenya, South Africa, Swaziland, Liberia, etc.). The proposed study has three aims: (1) Adapt an evidence-based HIV prevention program, designed for community settings in the US, to be delivered in school classrooms in Liberia; (2) Evaluate the impact of the HIV prevention intervention on proximal and primary outcomes including delay sexual initiation, increasing condom use and changes in proximal variables including attitudes, intentions and self efficacy; and (3) Assess the characteristics of program implementation fidelity and its relationship to changes in behavioral outcomes. During the first eight months of the proposed two-year study, we will adapt this community-based curriculum to school-based settings and contexts within Liberia. Members of community-based organizations, health educators, school administrators and 7th-grade students will provide data to guide the integration and cultural adaptation of the curriculum through focus groups and one-on-one key informant interviews. Over the next 16 months we will conduct a cohort study to assess the impact of this adapted curriculum on changing sexual risk behaviors using a randomized controlled group design with schools as the restricted assignment unit. Four matched pairs of junior high schools will be randomly assigned to either an HIV prevention intervention or a comparison general health condition to assess the impact of the intervention on increasing condom use and delaying the initiation of sexual intercourse among Liberian youth (n=800). We will also assess the fidelity of curriculum implementation and its impact on behavioral outcomes. Through rigorous evaluation of the adapted HIV prevention curriculum, we hope to reduce sexual risk behaviors of in-school youth. By assessing the curriculum fidelity and its impact on behavioral outcomes, we will advance the field's understanding of the relationship of implementation fidelity and behavior change in resource deprived environments. Working with our Liberian investigators to implement and evaluate this intervention, we expect to continually build the social and behavioral research capacities of Liberian researchers and their research institutions. PUBLIC HEALTH RELEVANCE The cultural adaptation of an evidence based HIV prevention intervention for in-school Liberian youth and the assessment of its efficacy at reducing sexual risk behaviors will provide Liberian schools with an evidence based program to model and disseminate. Our assessment of curriculum fidelity and its impact on behavioral outcomes will advance the HIV prevention field by providing a more nuanced understanding of the relationship between implementation fidelity and behavior changes in resource deprived environments. Working with our Liberian investigators to implement and evaluate this intervention, we expect to continually build the social and behavioral research capacities of Liberian researchers and their research institutions.

描述（由申请人提供）：本申请是为期两年的研究，以适应和评估艾滋病毒预防课程对14-16岁的7年级利比里亚年轻人的疗效。拟议的干预措施借鉴了基于证据的课程，做出了自豪的选择（Jemmott等，1998），该课程目前正在改编在其他撒哈拉以南非洲国家（例如加纳，肯尼亚，肯尼亚，南非，斯威士兰，利比里亚等）。拟议的研究具有三个目的：（1）改编一项基于证据的预防艾滋病毒预防计划，该计划旨在在美国的社区环境中，在利比里亚的学校教室中交付； （2）评估艾滋病毒预防干预对近端和主要结果的影响，包括延迟性启动，增加避孕套的使用以及近端变量的变化，包括态度，意图和自我效率； （3）评估计划实施忠诚度的特征及其与行为结果变化的关系。在拟议的为期两年的研究的前八个月中，我们将将这项基于社区的课程适应利比里亚境内的基于学校的环境和环境。基于社区的组织，健康教育者，学校管理员和7年级学生的成员将提供数据，以通过焦点小组和一对一的关键信息提供者的访谈来指导课程的整合和文化适应。在接下来的16个月中，我们将进行一项队列研究，以评估适用于该课程对改变性风险行为的影响，使用与学校作为受限制分配单位的随机控制组设计。四个匹配的小学对将随机分配给预防艾滋病毒的干预措施或比较一般健康状况，以评估干预措施对增加避孕套使用的影响，并延迟利比里亚青年中性交的启动（n = 800）。我们还将评估课程实施的保真度及其对行为结果的影响。通过严格评估适应的HIV预防课程，我们希望减少校内青年的性风险行为。通过评估课程保真度及其对行为成果的影响，我们将促进该领域对资源剥夺环境中实施忠诚度和行为变化的关系的理解。与我们的利比里亚调查人员一起实施和评估这种干预措施，我们希望不断建立利比里亚研究人员及其研究机构的社会和行为研究能力。 公共卫生相关性的文化适应基于证据的艾滋病毒预防干预措施对利比里亚人的年轻人以及对减少性风险行为的疗效的评估将为利比里亚学校提供基于证据的计划，以建模和传播。我们对课程保真度及其对行为成果的影响的评估将通过对实施忠诚度与资源剥夺环境中的行为变化之间的关系有更细微的了解，从而推动艾滋病毒预防领域。与我们的利比里亚调查人员一起实施和评估这种干预措施，我们希望不断建立利比里亚研究人员及其研究机构的社会和行为研究能力。