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面临着巨大的健康差异，尤其是与毒品相关的问题尽管存在这些差异，但仍然很少有性行为和性传播感染。针对西班牙裔青少年存在有效的预防干预措施，但得到传播的则更少鉴于初级保健机构日益成为切入点（IOM/NRC，2009）。父母给青少年带来行为健康问题，青少年初级保健环境是理想的，但尚未得到充分利用，以传播基于证据的预防性干预措施。针对家庭内最直接、最根本的风险和保护因素的干预措施影响人类行为的社会制度已被发现是最有效的干预措施之一预防和减少吸毒和危险性行为。 Familias Unidas 是一项针对西班牙裔的、以家庭为基础的干预措施，被发现在以下方面有效且有效：预防和减少吸毒、危险性行为和自我报告的性传播感染。医学研究所关于年轻人的预防、情绪和行为的报告引用了这样的内容：准备广泛传播（IOM/NRC，2009 年），但迄今为止，Familias Unidas 只经过了测试。我们尚未对初级保健中的功效/效果进行评估。对 Familias Unidas 进行了调整和评估，成功保留了 80% 的西班牙裔美国人；家长及其青少年（从学校招募）参与 Familias Unidas 的在线电子健康改编版。还证明了在初级保健中提供 eHealth Familas Unidas 的可行性和可接受性。评估针对西班牙裔青年的基于家庭的创新电子卫生干预措施的可行性和在初级保健机构中建立可接受性是及时的，并且具有很高的公共卫生意义。拟议研究的总体目标是评估电子医疗的相对有效性和成本效益 Familias Unidas，与转介至国家药物滥用研究所 (NIDA) 在线信息页面相比西班牙裔青少年家长（以下简称 NIDA 在线信息）的有效性。 eHealth Familias Unidas 初级保健预防吸毒、无保护性行为和性传播感染西班牙裔青少年的普遍样本，这项研究将随机将 456 名西班牙裔青少年及其父母纳入 eHealth Familias Unidas 或 NIDA 在线信息将在基线、6、12、24 和 36 日对参与者进行评估。研究假设是：1) 相对于 NIDA，eHealth Familias Unidas 将会有效。在线信息，预防/减少吸毒、无保护性行为和性传播感染发病率随着时间的推移，西班牙裔青少年的干预效果将部分由家庭功能调节吸毒和无保护的性行为以及家庭功能和无保护的性行为对性传播感染的影响还将估计 eHealth Familias Unidas 在三年随访期间的成本效益。