Development of an HIV Risk Reduction Intervention Protocol for Adolescent Africn-

制定非洲青少年艾滋病毒风险降低干预方案

• 批准号: 8043665
• 负责人: GWENDOLYN D CHILDS
• 金额: $ 9.27万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-11 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8043665
• 关键词: 14 year old; AIDS/HIV problem; Address; Adolescence; Adolescent; Adolescent Risk Behavior; Adult; African; African American; Age; Age Reporting; Alabama; Anal Sex; Audiotape; Behavior; Behavioral Sciences; Benefits and Risks; Case Study; Categories; Centers for Disease Control and Prevention (U.S.); Child; Chlamydia; Code; Cognitive; Coitus; Computer software; Contracts; Data; Data Analyses; Decision Making; Deep South; Demographic Analyses; Development; Development Plans; Economics; Effectiveness; Elements; Epidemic; Evidence based intervention; Face; Female; Female Adolescents; Focus Groups; Funding; Gender; Goals; Gonorrhea; HIV; Heterosexuals; Incidence; Individual; Infection; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Life; Masturbation; Mediation; Mentored Research Scientist Development Award; Modification; Newly Diagnosed; Oral Sex; Participant; Peer Pressure; Perception; Population Process; Pregnancy; Process; Protocols documentation; Public Health; Qualitative Research; Recruitment Activity; Reporting; Research; Research Methodology; Research Personnel; Risk; Risk Reduction; Risk-Taking; Rural; Safe Sex; Sex Behavior; Sexual Abstinence; Sexually Transmitted Diseases; Social Environment; Sorting - Cell Movement; Staging; Surveys; Syphilis; Target Populations; Testing; Time; Training; Transcript; United States; Woman; age group; aged; base; boys; career; career development; condoms; contextual factors; delay sexual debut; design; early adolescence; evidence base; girls; high risk; high risk sexual behavior; improved; parental influence; programs; public health relevance; risk perception; safer sex; sex risk; sexual debut; skills; theories; therapy design; therapy development

DESCRIPTION (provided by applicant): Alabama STI surveillance reports reveal rates of chlamydia, syphilis, and gonorrhea among African American (AA) girl increase more than 1000% between age groups 10 to 14 and 15 to 19, suggesting increase vulnerability among the 15 to 19 age group for contracting HIV/AIDS. The high incidence of STIs among AA adolescent girls aged 15 to 19 in Alabama is an indication that current sexual risk reduction programs have resulted in very little change in sexual risk-taking behaviors. With the rapidly increasing HIV epidemic among AA women in the South, there is an urgent need for HIV risk reduction interventions that target AA adolescent girls. It is imperative that these interventions target girls prior to the onset of high-risk sexual behavior, which according to the Alabama STI surveillance reports would be those females age 14 and younger. The purpose of the proposed research is to modify/extend an evidence-based HIV risk reduction intervention (EBI) protocol to be culturally relevant and developmentally appropriate for use with AA adolescent girls aged 12 to 14. Formative qualitative research using individual interviews and focus groups will be conducted to identify developmental and socio-contextual factors that influence the sexual decision-making processes of AA adolescent girls. The research plan will be carried out in two stages. Specific aims for Stage 1: 1) explore descriptions of factors that influence decisions about initiating or abstaining from sexual activity; 2) explore perceptions of risks/benefits of engaging in or abstaining from sexual activity; 3) explore perceptions of ability to delay sexual debut; and 4) explore perceptions of ability to negotiate condom use. Specific aims for Stage 2: 5) identify themes and concepts associated with sexual decision-making processes of AA adolescent girls; 6) compare identified themes and concepts to the core elements of EBIs designed for AA adolescents; 7) integrate findings to inform the modification/extension of an EBI protocol; and 8) assess the relevance and acceptability of the modified/extended intervention protocol to the target population. In Stage 1, 30 girls will be recruited to participate in individual interviews to generate data about the developmental and socio-contextual factors that influence their sexual decision-making processes. An additional 40 girls will be recruited to participate in focus groups to validate content identified in individual interviews. In Stage 2, the findings from Stage 1 will be used to inform the modification/extension of an EBI protocol, which will be validated through focus group discussions with the target population. Verbatim transcripts of audiotapes from interviews and focus groups, observation notes, and demographic data will be the primary data for analysis. Content analysis will be used in analysis and interpretation of the data. The qualitative research software, QSR N-Vivo(R), will be used in coding and sorting data into thematic categories. Descriptive statistical analyses will be conducted using SPSS version 16.0 to analyze demographic data. The evidence-based intervention protocol will be modified/extended based on application of the findings within a framework for modification of evidence-based interventions. The proposed research career development plan is designed to provide additional training in qualitative research methods, cognitive development, behavioral science research methods and theory, and intervention development. The knowledge and skills acquired through this additional training are essential for 1) conducting exploratory qualitative, descriptive research to identify developmental, socio-contextual and personal factors that influence the sexual decision-making process of African American adolescent girls, and 2) developing a culturally relevant, and developmentally appropriate HIV risk reduction intervention protocol. The K01 award period will culminate in a R21 or R01 application to pilot test the modified intervention protocol developed under the K01 Career Development Award. Dr. Childs' long-term career goal is to become a funded independent investigator and recognized leader in the field of adolescent sexual decision-making with expertise in development of interventions that are culturally relevant and developmentally appropriate. PUBLIC HEALTH RELEVANCE: Alabama STI surveillance reports showed rates of chlamydia, syphilis, and gonorrhea among African American (AA) girls increase more than 1000% between age groups 10 to 14 and 15 to 19 age groups. The high incidence of STI suggests increasing vulnerability for contracting HIV/AIDS. The Southern United States has been underrepresented in HIV risk reduction intervention studies. With a growing HIV epidemic in the Southern part of the United States, it is imperative to develop HIV risk reduction programs for African American adolescent girls prior to sexual debut or onset of high-risk sexual behavior.

描述（由申请人提供）：阿拉巴马州性传播感染监测报告显示，在 10 至 14 岁和 15 至 19 岁年龄段的非裔美国 (AA) 女孩中，衣原体、梅毒和淋病的患病率增加了 1000% 以上，这表明 15 岁至 19 岁的女孩的脆弱性增加。 19 年龄组感染艾滋病毒/艾滋病。阿拉巴马州 15 至 19 岁的 AA 少女中性传播感染的高发病率表明，当前的性风险降低计划对性冒险行为的影响很小。随着南方 AA 妇女中艾滋病毒流行率迅速上升，迫切需要针对 AA 少女的艾滋病毒风险降低干预措施。这些干预措施必须在高风险性行为发生之前针对女孩，根据阿拉巴马州性传播感染监测报告，这些干预措施将针对 14 岁及以下的女性。拟议研究的目的是修改/扩展基于证据的艾滋病毒风险降低干预 (EBI) 方案，使其具有文化相关性且适合 12 至 14 岁 AA 青春期女孩的发展。使用个人访谈和焦点小组进行形成性定性研究将进行以确定影响 AA 青春期女孩性决策过程的发育和社会背景因素。研究计划将分两个阶段进行。第一阶段的具体目标： 1) 探讨影响开始或放弃性活动决策的因素的描述； 2) 探讨对从事或放弃性活动的风险/益处的看法； 3）探索对延迟首次性行为能力的看法； 4) 探讨对协商使用安全套的能力的看法。第二阶段的具体目标： 5) 确定与 AA 少女性决策过程相关的主题和概念； 6) 将确定的主题和概念与为 AA 青少年设计的 EBI 的核心要素进行比较； 7) 整合调查结果，为 EBI 协议的修改/扩展提供信息； 8) 评估修改/扩展的干预方案与目标人群的相关性和可接受性。在第一阶段，将招募 30 名女孩参加个人访谈，以生成有关影响她们性决策过程的发展和社会背景因素的数据。另外 40 名女孩将被招募参加焦点小组，以验证个人访谈中确定的内容。在第二阶段，第一阶段的研究结果将用于为 EBI 协议的修改/扩展提供信息，该协议将通过与目标人群的焦点小组讨论进行验证。访谈和焦点小组的录音带逐字记录、观察笔记和人口统计数据将成为分析的主要数据。内容分析将用于数据的分析和解释。定性研究软件 QSR N-Vivo(R) 将用于将数据编码和分类为主题类别。将使用 SPSS 16.0 版进行描述性统计分析来分析人口统计数据。循证干预方案将根据研究结果在循证干预修改框架内的应用进行修改/扩展。 拟议的研究职业发展计划旨在提供定性研究方法、认知发展、行为科学研究方法和理论以及干预发展方面的额外培训。通过这种额外培训获得的知识和技能对于以下方面至关重要：1) 进行探索性定性、描述性研究，以确定影响非裔美国青春期女孩性决策过程的发展、社会背景和个人因素，以及 2) 发展文化相关且适合发育的艾滋病毒风险降低干预方案。 K01 奖励期将在 R21 或 R01 申请中达到高潮，以试点测试根据 K01 职业发展奖开发的修改干预方案。查尔兹博士的长期职业目标是成为一名受资助的独立调查员和青少年性决策领域公认的领导者，拥有开发与文化相关且适合发育的干预措施的专业知识。 公共卫生相关性：阿拉巴马州 STI 监测报告显示，在 10 至 14 岁和 15 至 19 岁年龄段的非洲裔美国 (AA) 女孩中，衣原体、梅毒和淋病的发病率增加了 1000% 以上。性传播感染的高发病率表明感染艾滋病毒/艾滋病的可能性越来越大。美国南部在降低艾滋病毒风险干预研究中的代表性不足。随着美国南部艾滋病毒疫情的日益严重，必须在首次性行为或高风险性行为开始之前为非洲裔美国少女制定降低艾滋病毒风险的计划。