CHOICES-TEEN: A Bundled Risk Reduction Intervention for Juvenile Justice Females

CHOICES-TEEN：针对少年司法女性的捆绑风险降低干预措施

• 批准号: 8356131
• 负责人: Danielle Elizabeth Parrish
• 金额: $ 11.61万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356131
• 关键词: AIDS prevention; Adherence; Adolescent; Adult; Affect; Alcohol consumption; Alcohols; Award; Behavior; Behavior Therapy; Bundling; Centers for Disease Control and Prevention (U.S.); Client; Clinic; Communities; Comorbidity; County; County Hospitals; Criminal Justice; Data; Development; Elements; Female; Female Adolescents; Fetal Alcohol Exposure; Gender; Goals; HIV; HIV Infections; Health; Health Professional; High Prevalence; Indium; Individual; Intervention; Intervention Studies; Jail; Justice; Manuals; Measures; Medical; Mental Health; Modeling; Morbidity - disease rate; Nicotine; Outcome; Pilot Projects; Population; Population Intervention; Pregnancy; Pregnancy in Adolescence; Prevention; Prevention Research; Prevention approach; Prevention program; Primary Prevention; Randomized Clinical Trials; Research; Risk; Risk Behaviors; Risk Reduction; Science; Services; Smoking; Staging; Testing; Texas; Treatment Efficacy; Unplanned pregnancy; Vulnerable Populations; Woman; Youth; aged; arm; base; brief intervention; condoms; efficacy trial; ethnic minority population; evidence base; follow-up; high risk; high risk drinking; juvenile justice system; knowledge base; male; member; motivational enhancement therapy; multidisciplinary; prevent; probation; research and development; satisfaction; sex risk; substance use prevention; therapy development; transmission process; AIDS prevention; Adherence; Adolescent; Adult; Affect; Alcohol consumption; Alcohols; Award; Behavior; Behavior Therapy; Bundling; Centers for Disease Control and Prevention (U.S.); Client; Clinic; Communities; Comorbidity; County; County Hospitals; Criminal Justice; Data; Development; Elements; Female; Female Adolescents; Fetal Alcohol Exposure; Gender; Goals; HIV; HIV Infections; Health; Health Professional; High Prevalence; Indium; Individual; Intervention; Intervention Studies; Jail; Justice; Manuals; Measures; Medical; Mental Health; Modeling; Morbidity - disease rate; Nicotine; Outcome; Pilot Projects; Population; Population Intervention; Pregnancy; Pregnancy in Adolescence; Prevention; Prevention Research; Prevention approach; Prevention program; Primary Prevention; Randomized Clinical Trials; Research; Risk; Risk Behaviors; Risk Reduction; Science; Services; Smoking; Staging; Testing; Texas; Treatment Efficacy; Unplanned pregnancy; Vulnerable Populations; Woman; Youth; aged; arm; base; brief intervention; condoms; efficacy trial; ethnic minority population; evidence base; follow-up; high risk; high risk drinking; juvenile justice system; knowledge base; male; member; motivational enhancement therapy; multidisciplinary; prevent; probation; research and development; satisfaction; sex risk; substance use prevention; therapy development; transmission process

DESCRIPTION (provided by applicant): Adolescent females detained or on probation in juvenile justice settings engage in multiple health risk behaviors that place them at risk for HIV and pregnancy affected by nicotine or alcohol. Specifically, they engage in frequent sexual risk behaviors, placing them at risk of unplanned pregnancy, STIs and HIV, while also smoking and engaging in high risk alcohol use, placing them at risk of both nicotine- and alcohol-exposed pregnancy. The long-term goal of the proposed line of research is to develop and test bundled (targeting more than one behavior) interventions to reduce HIV transmission and the risk of pregnancies exposed to nicotine and alcohol among females in the juvenile justice system. Bundling efficiently aggregates services to promote "synergistic gain" when intervening with high-risk populations. The overall objective of this study is to assess the feasibility and promise of an adapted CHOICES preconception intervention (CHOICES-TEEN) in reducing the risk of HIV, nicotine-exposed pregnancy (NEP), and alcohol-exposed pregnancy (AEP) in adolescent females on intensive community probation. The original CHOICES intervention consisted of four sessions and was efficacious for adult women in reducing the risk of AEP in several high risk settings. Given the comorbidity of smoking and risky drinking, and similar outcomes of those completing two sessions compared to four in this efficacy trial, a shorter, two-session bundled CHOICES intervention to reduce both AEP and NEP risk is being tested in a randomized clinical trial in the Harris County Hospital District clinics with adult females. To this end, the current study posits that a two-session CHOICES intervention adapted to target multiple bundled health risks-AEP, NEP, and HIV-will be feasible, acceptable, and promising in reducing these risks among females on community-based juvenile probation. This study will: Aim 1: Modify the efficacious CHOICES preconception intervention to target the prevention of HIV, AEP, and NEP. The result will be a two session individual intervention (CHOICES-TEEN) and accompanying therapy manual based on the Transtheoretical Model (TTM) and Motivational Interviewing. Aim 2: Conduct a one-arm feasibility trial with females in the juvenile justice system to assess the promise of CHOICES-TEEN. This pilot study will: 1) demonstrate the feasibility of delivering CHOICES-TEEN with master's level mental health professionals within a juvenile justice setting; 2) determine acceptance of CHOICES-TEEN as measured by client adherence, retention, and treatment satisfaction; and 3) assess client improvement at 3-month follow-up (e.g., reduction of risk of HIV, NEP, and AEP). This study will inform subsequent Stage II/III behavioral intervention studies and contribute to a missing, fundamental element in the knowledge base - further understanding of the feasibility of targeting bundled health risks in high-risk adolescents, and the potential promise of a gender-specific intervention for this population. PUBLIC HEALTH RELEVANCE: Adolescent females detained or on probation in juvenile justice settings present with a unique health risk profile, including the risk of HIV infection. Ths project will investigate the feasibility and promise of a gender-specific "bundled" brief intervention to target multiple health risks for this high-risk population. Findings will inform fuure evidence-based prevention programming for this vulnerable population, many of whom are ethnic minorities disproportionately at risk.

描述（由申请人提供）：青少年司法环境中被拘留或缓刑的青春期女性从事多种健康风险行为，使他们处于受尼古丁或酒精影响的艾滋病毒和怀孕的风险。具体来说，他们从事频繁的性风险行为，使他们处于计划外怀孕，性传播感染和艾滋病毒计划外的风险，同时还吸烟并从事高风险的饮酒风险，使他们面临尼古丁和酒精暴露的妊娠风险。拟议的研究线的长期目标是开发和测试捆绑（针对多种行为）干预措施，以减少艾滋病毒的传播以及少年司法系统中女性中暴露于尼古丁和酒精的妊娠风险。捆绑有效地汇总服务，以促进与高风险人群进行干预。这项研究的总体目的是评估可行性和承诺 在青春期女性中，在降低艾滋病毒，暴露于尼古丁的妊娠（NEP）和酒精暴露的妊娠（AEP）的风险方面，在降低艾滋病毒的风险，降低艾滋病毒的风险方面的选择（选择）。最初的选择干预措施包括四个会议，对于成年妇女降低了几种高风险环境的AEP风险，这是有效的。鉴于吸烟和危险饮酒的合并症，以及在此功效试验中进行的四次疗程相比，完成了两次课程的结果类似，在哈里斯县医院地区诊所与成年女性的一项随机临床试验中，在一项随机临床试验中测试了一个较短的，两协议的捆绑选择干预措施，以降低AEP和NEP风险。为此，当前的研究表明，两项选择的干预措施适合于针对多个捆绑的健康风险，NEP和HIV，将是可行的，可接受的，并且有望降低基于社区的少年试用期女性的这些风险。这项研究将：目标1：修改有效的选择，以靶向艾滋病毒，AEP和NEP的预防。结果将是基于跨理论模型（TTM）和动机访谈的两节个人干预（选择）和随附的治疗手册。目标2：与少年司法系统中的女性进行一臂可行性试验，以评估选择的承诺。这项试点研究将：1）证明在少年司法环境中与大师级的心理健康专业人员一起提供选择的可行性； 2）确定通过客户遵守，保留和治疗满意度来衡量的选择的接受； 3）评估3个月随访的客户改善（例如，降低HIV，NEP和AEP的风险）。这项研究将为随后的II/III期行为干预研究提供信息，并有助于知识基础中缺失的基本要素 - 进一步了解针对高风险青少年捆绑健康风险的可行性，以及对该人群的性别特定干预的潜在希望。 公共卫生相关性：在少年司法环境中被拘留或缓刑的青春期女性，其健康风险特征，包括艾滋病毒感染的风险。 THS项目将调查针对该高危人群的多种健康风险的性别特定“捆绑”简短干预的可行性和承诺。调查结果将为这一脆弱人群提供基于循证的预防计划，其中许多人面临着不成比例的少数民族。