A Computerized family-based youth HIV and drug abuse prevention in Kazakhstan

哈萨克斯坦基于家庭的计算机化青少年艾滋病毒和药物滥用预防

基本信息

批准号：
8720740
负责人：
Leyla Ismayilova
金额：
$ 20.64万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8720740
关键词：
17 year old AIDS prevention Address Adolescence Adolescent Adopted Adult Affect Africa South of the Sahara Age Alcohol consumption Alcohol or Other Drugs use Area Asians C10 Caregivers Centers for Disease Control and Prevention (U.S.)Central Asia Client Collaborations Communication Communities Computers Country Development Drug abuse Drug usage Enrollment Epidemic Epidemiologic Studies Ethnic Origin Family Family member Feasibility Studies Female Female Adolescents Frequencies Funding Future Gender General Population Growth HIV HIV Infections HIV risk Health Health education Hearing Heroin Home environment Human Resources Individual Intervention Intervention Studies Kazakhstan Language Letters Life Male Adolescents Media Intervention Monitor Multimedia Multiple Partners Outcome Parents Participant Peer Pressure Persons Pharmaceutical Preparations Phase Play Population Prevention Prevention program Preventive Intervention Public Health Randomized Controlled Trials Recruitment Activity Religion Research Research Personnel Resistance Risk Risk Behaviors Risk Reduction Risk-Taking Role Route Russia Safety Self Efficacy Services Sex Behavior Sexual Partners Staging Technology Testing USSR United States National Institutes of Health Universities Unsafe Sex Work Youth aged arm base computerized condoms cost cost effective drug abuse prevention efficacy trial evidence base experience follow-up global health grandparent high risk injection drug use knowledge base male operation outreach peer prevent programs response satisfaction scale up sex sex risk sexual risk taking sexually active skills substance use prevention theories therapy design tool trafficking treatment as usual

项目摘要

DESCRIPTION (provided by applicant): The proposed study is the first randomized controlled trial (RCT) adapting an evidence-based HIV and substance use prevention intervention for most at-risk adolescents and their caregivers (parents or other adult family members) from drug-risk communities in Kazakhstan. Located on major drug trafficking routes, Central Asia and Kazakhstan, in particular, are experiencing one of the fastest growing rates of HIV infection in the world, disproportionately affecting young people. Youth exposed to drugs at home and in the community are particularly at risk. A quarter of at-risk youth in Kazakhstan initiates sexual or substance use risk behaviors between the ages 15-17, making it a crucial stage for prevention. The country's HIV prevention efforts are limited to a knowledge-based approach, which does not equip at-risk youth with skills required to deal with situations of risk exposure. Parents or other caregivers, who represent a significant protective force in a family- oriented culture of Central Asia, are largely excluded from youth prevention efforts in Kazakhstan. In response to PA-09-146, the proposed study will adapt and test the feasibility and estimate the effect size parameters of Kazakhstani Family Together (KFT), a family-based multi-media intervention designed to reduce sexual and drug-related risks for HIV infection among at-risk 15-17 year old females and males living in communities highly affected by heroin trade and use in Almaty, Kazakhstan. To address the dual risk of HIV and substance use, the proposed intervention combines empirically tested skills-based and family involvement approaches and utilizes multi-media computer technology to develop an engaging and potentially cost-effective tool with high fidelity and easy scalability. The US/Kazakhstani investigative team will conduct formative research and will work closely with the Community Collaborative Board to adapt the intervention to the cultural context of at-risk families in Kazakhstan. The KFT intervention will be tested in a pilot RCT with 144 adolescents and 144 of their caregivers. Intervention arm adolescent-caregiver pairs will receive four 45- minute interactive multi-media sessions with avatars customized to participants' ethnicity and gender that will focus on risk reduction self-efficacy, resistance to peer pressure, and caregiver-adolescent communication, support and monitoring. Adolescents from both intervention and control arms will receive the usual care services available for at-risk youth, which includes health education sessions on HIV and drug use delivered by peer educators and outreach workers. To inform a larger efficacy trial, the proposed pilot feasibility study will provide estimates of recruitment, attrition, intervention fidlity, youths' and caregivers' levels of participation and satisfaction with the intervention and preliminary estimates of effects on adolescents' sexual and substance use-related outcomes (current sexual activity, unprotected sex, current use of alcohol or drugs). The study will be led by an investigative team from Columbia University Global Health Research Center of Central Asia (PI: Dr. Ismayilova) in collaboration with local partners providing services to at-risk youth.

描述（由申请人提供）：拟议的研究是第一个随机对照试验（RCT），针对大多数高危青少年及其照顾者（父母或其他成年家庭成员）采用基于证据的艾滋病毒和药物使用预防干预措施。哈萨克斯坦的风险社区。尤其是位于主要贩毒路线的中亚和哈萨克斯坦，是世界上艾滋病毒感染率增长最快的国家之一，对年轻人的影响尤为严重。在家里和社区接触毒品的青少年面临的风险尤其大。哈萨克斯坦四分之一的高危青少年在 15 岁至 17 岁之间开始出现性或药物使用危险行为，这使其成为预防的关键阶段。该国的艾滋病毒预防工作仅限于基于知识的方法，这种方法没有使高危青年具备应对危险情况所需的技能。父母或其他照顾者在中亚以家庭为中心的文化中代表着重要的保护力量，但在哈萨克斯坦很大程度上被排除在青少年预防工作之外。为了响应 PA-09-146，拟议的研究将调整和测试哈萨克斯坦家庭在一起 (KFT) 的可行性并估计其效果大小参数，这是一种基于家庭的多媒体干预措施，旨在减少性和毒品相关的风险哈萨克斯坦阿拉木图，生活在受海洛因贸易和使用严重影响的社区的 15-17 岁高危女性和男性中的艾滋病毒感染情况。为了解决艾滋病毒和药物滥用的双重风险，拟议的干预措施结合了经过实证检验的基于技能的方法和家庭参与方法，并利用多媒体计算机技术开发了一种具有高保真度和易于扩展性的有吸引力且具有潜在成本效益的工具。美国/哈萨克斯坦调查小组将进行形成性研究，并将与社区合作委员会密切合作，以使干预措施适应哈萨克斯坦高危家庭的文化背景。 KFT 的干预将在对 144 名青少年及其 144 名照顾者进行了试点随机对照试验。干预组青少年-看护者对将接受四场时长 45 分钟的交互式多媒体会议，其中的化身根据参与者的种族和性别定制，重点关注降低风险的自我效能、抵抗同伴压力以及看护者与青少年的沟通、支持和监控。干预组和控制组的青少年都将获得为高危青少年提供的常规护理服务，其中包括由同伴教育者和外展工作人员提供的有关艾滋病毒和吸毒的健康教育课程。为了为更大规模的功效试验提供信息，拟议的试点可行性研究将提供对招募、消耗、干预忠诚度、青少年和护理人员的参与程度以及对干预措施的满意度的估计，以及对青少年性和药物使用相关影响的初步估计结果（当前的性活动、无保护的性行为、当前使用酒精或药物）。该研究将由哥伦比亚大学中亚全球健康研究中心（首席研究员：Ismayilova 博士）的一个调查小组领导，并与为高危青少年提供服务的当地合作伙伴合作。