Evaluating the Effectiveness of an eHealth EBI for Latino Youth in Primary Care

评估电子健康 EBI 对拉丁裔青年初级保健的有效性

基本信息

批准号：
9919521
负责人：
GUILLERMO PRADO
金额：
$ 75.52万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-07-01 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9919521
关键词：
Acculturation Adolescent African American Behavior Behavior Disorders Behavioral Caring Childhood Chlamydia Climate Clinic Conflict (Psychology)Data Drug usage Effectiveness Emotional Emotional disorder Family Frequencies Gonorrhea HIV Health Professional Hispanics Human Incidence Institute of Medicine (U.S.)Internet Intervention Knowledge Latino Leadership Mediating Mediator of activation protein Mental Health Mental disorders National Institute of Drug Abuse Not Hispanic or Latino Nurses Outcome Parents Participant Patient Self-Report Pharmaceutical Preparations Physicians Preventive Intervention Primary Health Care Professional counselor Public Health Randomized Reporting Risk Risk Factors Sampling Schools Sex Behavior Sexually Transmitted Diseases Staff Attitudes System Time Unsafe Sex Youth base behavioral health care systems caucasian American cost effective cost effectiveness cost estimate drug abuse prevention eHealth effectiveness evaluation effectiveness testing efficacy testing evidence base experience follow-up health disparity improved innovation intervention effect junior high school member parent-adolescent communication prevent primary care setting protective factors recruit relative cost relative effectiveness sexual risk behavior social

项目摘要

Hispanic adolescents in the U.S. experience significant health disparities, particularly as it relates to drug use, unsafe sexual behaviors and sexually transmitted infections (STIs). In spite of these disparities, a paucity of effective preventive interventions exist for Hispanic adolescents, and even fewer have been disseminated widely (IOM/NRC, 2009). Given that primary care settings are increasingly becoming the entry-point through which parents bring youth with behavioral health concerns, adolescent primary care settings represent ideal, yet underutilized, settings in which to disseminate evidence-based preventive interventions. Preventive interventions which target risk and protective factors within the family, the most proximal and fundamental social system influencing human behavior, have been found to be among the most efficacious interventions in preventing and reducing drug use and sexual risk behaviors. Familias Unidas is a Hispanic-specific, family-based intervention found to be efficacious and effective in preventing and reducing drug use, sexual risk behaviors, and self-reported STIs. Familias Unidas has been cited by the Institute of Medicine report on Preventing, Emotional, and Behavioral among Young People as ready for broad dissemination (IOM/NRC, 2009). To date, however, Familias Unidas has been only tested for efficacy and effectiveness in schools and has not been evaluated for efficacy/effectiveness in primary care. We have adapted and evaluated Familias Unidas for online delivery; successfully retaining 80% of Hispanic parents and their youth (recruited from schools) in the online, eHealth adaptation of Familias Unidas. We have also demonstrated the feasibility and acceptability of delivering eHealth Familas Unidas in primary care. Evaluating innovative eHealth family-based interventions for Hispanic youth whose feasibility and acceptability is established in primary care settings is timely and of high public health significance. Therefore, the proposed study's overarching aim is to evaluate the relative effectiveness and cost effectiveness of eHealth Familias Unidas, compared to a referral to the National Institute Drug Abuse’s (NIDA) online information page for parents of Hispanic youth (referred hereafter as NIDA Online Information). To test the effectiveness of eHealth Familias Unidas Primary Care in preventing drug use, unprotected sexual behavior, and STIs in a universal sample of Hispanic youth, this study will randomize 456 Hispanic youth and their parents to eHealth Familias Unidas or to NIDA Online Information. Participants will be assessed at baseline, 6, 12, 24, and 36 months post baseline. Study hypotheses are that: 1) eHealth Familias Unidas will be effective, relative to NIDA Online Information, in preventing/reducing drug use, unprotected sexual behavior, and STI incidence in Hispanic adolescents over time and 2) Intervention effects will be partially mediated by family functioning for drug use and unprotected sexual behavior and by family functioning and unprotected sexual behavior for STI incidence. The cost effectiveness of eHealth Familias Unidas over a three year follow up will also be estimated.

美国的西班牙裔青少年经历了重大的健康差异，尤其是与药物有关使用，不安全的性行为和性传播感染（STIS）。尽管存在这些差异，但很少西班牙裔青少年存在有效的预防性干预措施，甚至被传播更少广泛（IOM/NRC，2009年）。鉴于初级保健设置越来越多地通过父母将青年带来行为健康问题，青少年的初级保健环境代表理想，尚未得到充分利用的设置，在其中传播基于证据的预防性干预措施。预防性针对家庭内部风险和受保护因素的干预措施，最代理和基本的干预措施已经发现影响人类行为的社会体系是最有效的干预措施之一防止和减少药物使用和性风险行为。 Familias Unidas是一种西班牙裔特定的，基于家庭的干预措施，发现在防止和减少药物使用，性风险行为和自我报告的性传播感染。 Familias Unidas一直医学研究所引用了关于预防，情感和行为的年轻人的报道准备进行广泛传播（IOM/NRC，2009年）。但是，迄今为止，Familias Unidas仅进行了测试在学校的有效性和有效性，尚未评估初级保健中有效性/有效性。我们已经改编和评估了Familias Unidas进行在线交付；成功保留了80％的西班牙裔父母及其青年（从学校招募）在在线，eHealth的适应家庭中。我们有还证明了在初级保健中交付eHealth家族的可行性和可接受性。评估对西班牙裔青年的创新eHealth家庭干预措施，这些年轻人的可行性和在初级保健环境中建立可接受性是及时的，并且具有很高的公共卫生意义。所以，拟议的研究的总体目的是评估eHealth的相对有效性和成本效益 Familias Unidas，与美国国立研究所滥用药物（NIDA）在线信息页面相比对于西班牙裔青年的父母（以下称为NIDA在线信息）。测试有效性 eHealth familias unidas初级保健在预防药物使用，不受保护的性行为和性传播疾病中西班牙裔青年的普遍样本，这项研究将随机将456名西班牙裔青年及其父母纳入eHealth Familias Unidas或NIDA在线信息。参与者将在基线，6、12、24和36中进行评估基线后几个月。研究假设是：1）与NIDA相对于NIDA，eHealth familias unidas将是有效的在线信息，防止/减少药物使用，未受保护的性行为和STI事件随着时间的推移，西班牙裔青少年和2）干预效果将由家庭功能部分介导毒品使用和不受保护的性行为以及通过家庭功能和不受保护的性行为的性行为发病率。 eHealth Familias Unidas在三年后续行动中的成本效益也将得到估计。