'REALITY CHECK' IN TRANSIT: Evaluation of a Serial Drama for Black Youth

旅途中的“现实检验”：对黑人青年连续剧的评价

• 批准号: 8210535
• 负责人: JOHN BARTON JEMMOTT
• 金额: $ 35.8万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8210535
• 关键词: AIDS/HIV problem; Abstinence; Acute; Adult; Affect; African American; Age; Area; Asians; Attitude; Behavior; Behavioral; Car Phone; Centers for Disease Control and Prevention (U.S.); Cities; Communities; Control Groups; County; Data; Development; Diffusion; Drama; Effectiveness; Environment; Epidemic; Evaluation; Event; Expectancy; Focus Groups; Frequencies; Friends; Gays; HIV; HIV Infections; HIV Seropositivity; Hand; Health Communication; Health behavior; Hip region structure; Hispanics; Home environment; Hour; Human immunodeficiency virus test; Humulus; Incidence; Individual; Infection; Intention; Intervention; Interview; Lesbian; Link; Los Angeles; Mediator of activation protein; Medical; Methods; Modeling; Music; Native Americans; Neighborhoods; Outcome; Participant; Patient Self-Report; Pilot Projects; Poverty; Prevention approach; Preventive; Preventive Health Services; Public Health; Research; Risk; Risk Reduction; Sampling; Sampling Studies; Self Efficacy; Series; Services; Sexual Abstinence; Sexually Transmitted Diseases; Source; Staging; Stigmata; Surveys; System; Target Populations; Testing; Time; Youth; aged; base; behavior change; boys; condoms; cost; design; digital; efficacy testing; experience; girls; health disparity; health organization; high risk; innovation; interest; intervention effect; member; men who have sex with men; post intervention; primary outcome; skills; social; social stigma; theories; web site

DESCRIPTION (provided by applicant): This application proposes to evaluate an already-created serial drama intervention, "Reality Check," on public buses in Los Angeles, CA. Young African Americans are very disproportionately affected by HIV/AIDS and other sexually transmitted infections (STIs). Social factors affecting their risk include poverty, poor access to preventive medical services, and homophobia, which causes some men who have sex with men (MSM) to be secretive about these activities and to be reluctant to be tested for HIV. Unfortunately, many of those infected with HIV are unaware of their infection and may be transmitting it, especially during the highly infectious acute infection stage. On the other hand, those who test positive reduce their risk-related behavior dramatically. Thus, the CDC has recommended universal HIV testing, but especially testing among those at highest risk. Accordingly, the broad, long-term objective of this application is to increase HIV testing among young African Americans. It proposes a pilot test of the effects of an innovative, theory-based HIV risk-reduction serial drama intervention, "Reality Check," among African Americans aged 14 to 24 years who ride public buses in impoverished African American neighborhoods in Los Angeles. "Reality Check" is a structural intervention in that it will be implemented in the natural environment of bus riders. It consists of 27 3-minute episodes. Each episode will be shown for 1 week on Tuesday, Thursday, Friday and Saturday, once each hour, on all public buses in Los Angeles, which are equipped with video screens. Previously shown episodes will be available on a YouTube link from Transit TV's website. The study will use a quasi-experimental control group design with pre- and multiple post-intervention assessments. Riders of public buses in impoverished African American neighborhoods in Richmond, CA, will serve as the control. Cross-sectional anonymous bus stop surveys of African American youth aged 14-24 who ride the bus through-and reside in--designated impoverished areas of both cities at least 3 times each week will be conducted before "Reality Check" is shown in Los Angeles, immediately after it is shown, and 3 and 6 months after it is shown. The study sample will include 200 youth who exit buses in each of the 2 cities at each of the 4 assessment points, for a total of 1,600 participants. Using a systematic sampling strategy based on the target population's times of highest ridership, data will be collected in private spaces near the bus stops from youth who exit the buses and recorded on hand-held mobile phones. The Specific Aims include conducting a pilot test of the effects of "Reality Check" in increasing HIV testing (the primary outcome), theoretical mediators of testing, condom use, and abstinence, and reducing homophobia and HIV/AIDS stigma, as compared with control. Effects on HIV testing rates in treatment versus control city also will be examined. This research would provide preliminary evidence of the effects of an intervention that could be disseminated very cost-effectively, with substantial reach via public buses in 4 additional cities where TEZO Systems Unlimited, Inc., the company that owns Transit TV, plans to broadcast. PUBLIC HEALTH RELEVANCE: Young African Americans are highly disproportionately affected by HIV/AIDS and other sexually transmitted infections (STIs). This study evaluates the effectiveness of a serial drama, delivered on local buses, at changing attitudes and/or behaviors among young African Americans. This research responds to the urgent public health need for structural interventions to reduce the risk of STIs, including HIV, in young African Americans.

描述（由申请人提供）：该应用程序旨在评估加利福尼亚州洛杉矶公共巴士上已创建的连续剧干预“现实检查”。年轻的非裔美国人受艾滋病毒/艾滋病和其他性传播感染 (STI) 的影响尤为严重。影响其风险的社会因素包括贫困、难以获得预防性医疗服务以及恐同症，这导致一些男男性行为者 (MSM) 对这些活动秘而不宣，并且不愿意接受艾滋病毒检测。不幸的是，许多艾滋病毒感染者并不知道自己已感染艾滋病毒，并且可能正在传播艾滋病毒，尤其是在传染性极强的急性感染阶段。另一方面，那些检测呈阳性的人会大大减少与风险相关的行为。因此，疾病预防控制中心建议普遍进行艾滋病毒检测，尤其是对高危人群进行检测。因此，该应用程序的广泛、长期目标是增加年轻非裔美国人的艾滋病毒检测。它提议对洛杉矶贫困非裔美国人社区乘坐公共巴士的 14 至 24 岁非裔美国人进行试点测试，以测试一种创新的、基于理论的艾滋病毒风险降低系列戏剧干预措施“现实检查”的效果。 “现实检查”是一种结构性干预，它将在公交车乘客的自然环境中实施。它由 27 集 3 分钟组成。每集将于周二、周四、周五和周六在洛杉矶所有配备视频屏幕的公共巴士上每小时播放一次，为期一周。之前播放过的剧集可通过 Transit TV 网站上的 YouTube 链接观看。该研究将采用准实验对照组设计，并进行干预前和多次干预后评估。加利福尼亚州里士满贫困非裔美国人社区的公共巴士乘客将作为对照。在洛杉矶上映“现实检查”之前，将对乘坐公交车经过并居住在两市指定贫困地区的 14 至 24 岁非裔美国青年进行横断面匿名公交车站调查，每周至少 3 次安吉利斯，上映后立即，上映后 3 个月和 6 个月。研究样本将包括 200 名青少年，他们在 2 个城市的 4 个评估点各下公交车，总共 1,600 名参与者。采用基于目标人群客流量最高时间的系统抽样策略，将在公交车站附近的私人空间中从下车的青少年那里收集数据并记录在手持手机上。具体目标包括与对照相比，对“现实检查”在增加艾滋病毒检测（主要结果）、检测的理论中介、安全套使用和禁欲以及减少同性恋恐惧症和艾滋病毒/艾滋病耻辱方面进行试点测试。还将检查治疗城市与对照城市对艾滋病毒检测率的影响。这项研究将提供干预措施效果的初步证据，这种干预措施可以非常经济有效地传播，通过公共巴士在另外 4 个城市进行广泛传播，拥有 Transit TV 的公司 TEZO Systems Unlimited, Inc. 计划在这些城市进行广播。 公共卫生相关性：年轻的非裔美国人受艾滋病毒/艾滋病和其他性传播感染 (STI) 的影响非常严重。本研究评估了在当地公交车上播放的连续剧在改变年轻非裔美国人的态度和/或行为方面的有效性。这项研究响应了公共卫生对结构性干预措施的迫切需求，以降低年轻非洲裔美国人感染包括艾滋病毒在内的性传播感染的风险。