CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females

CHOICES-TEEN：针对青少年司法女性的捆绑风险降低干预措施的功效

基本信息

批准号：
10212073
负责人：
Danielle Elizabeth Parrish
金额：
$ 70.42万
依托单位：
BAYLOR UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-15 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10212073
关键词：
Address Adolescent Adult Affect Alcohol consumption Alcohols Behavior Behavior Therapy Behavioral Centers for Disease Control and Prevention (U.S.)Cognitive Communities Criminal Justice Development Diversion Program Ethnic Origin Female Female Adolescents Female of child bearing age Gender Goals Gold HIV Health Health behavior change Individual Infection Informal Social Control Intervention Journals Justice Low Prevalence Marijuana Mediating Mediator of activation protein Minority Mobile Health Application Modeling Motivation Nature Pilot Projects Population Pregnancy Process Public Health Race Readiness Recording of previous events Reporting Research Risk Risk Behaviors Risk Reduction Services Sexually Transmitted Diseases Teenagers Testing Time Tobacco Underserved Population Vulnerable Populations Woman Work Youth alcohol exposure alcohol risk base behavior change condoms design efficacy testing efficacy trial ethnic minority population follow-up high risk improved infection risk juvenile justice system male marijuana cessation marijuana use motivational enhancement therapy nicotine use peer post intervention pregnant prevent preventive intervention probation programs racial diversity reduced alcohol use sexual HIV transmission sexual risk behavior sexually active skills societal costs standard care substance use substance use prevention therapy design unintended pregnancy web site young woman

项目摘要

PROJECT SUMMARY/ABSTRACT NOT-DA-19-048 Adolescent females in juvenile justice settings engage in multiple health risk behaviors that place them at risk for HIV and pregnancy affected by alcohol and marijuana. Specifically, they engage in frequent sexual risk behaviors, placing them at risk of pregnancy, STIs and HIV, while also using marijuana, and alcohol. With nearly half of U.S. pregnancies being unplanned, females unaware of their pregnancy will continue to drink or use marijuana during the early and critical weeks of gestation, which places them at risk of substance-exposed pregnancy. The long-term goal of this proposed line of research is to develop efficient and opportunistic interventions that reduce the risk of substance-exposed pregnancy (SEP) and HIV/STIs for justice involved female youth. Therefore, the overall objective of this study is to test the efficacy of CHOICES-TEEN (CT) for reducing the risks of SEP and HIV/STI in young women involved in community probation or diversion programs. CT was adapted from the CHOICES preconception intervention and its shorter version, CHOICES-PLUS, which have a robust history of efficacy in reducing the risk of alcohol and tobacco-exposed pregnancy with high-risk adult women. CT utilizes Motivational Interviewing (MI), which has demonstrated significant promise with adolescents and criminal justice populations. Our recent pilot study (R03DA034099; CHOICES-TEEN; CT-P), in which we adapted CHOICES for teens and tested its feasibility with youth on community probation, produced promising results. CT was modified based on this pilot work to 1) focus on marijuana (reported by 89% in CT-P study) rather than tobacco given the low prevalence and sporadic nature of nicotine use reported by the teens; 2) add a mobile health application to increase engagement with the daily journal and; 3) incorporate a post-CT self-regulation component targeting behavioral processes of change (POC). This study will move the field vertically by elucidating important factors influencing youth health behavior change, while testing an intervention designed to reduce individual and societal costs for this high risk, underserved adolescent population. The next logical step is to conduct a rigorous RCT to assess the efficacy of this gender-responsive, tailored bundled risk reduction intervention for young, primarily minority, women involved in a community-based juvenile justice diversion or probation program. A stage II behavioral intervention efficacy trial will: 1) Primary Aim: Test the efficacy of CHOICES-TEEN (CT) on reducing the risk of substance-exposed pregnancy (SEP) and HIV/STI among high-risk female youth involved with the juvenile justice system by reducing alcohol use, increasing marijuana cessation, reducing pregnancy risk, and increasing condom use. Aim 2: Test the efficacy of CT, compared to SC, in increasing cognitive self-regulation abilities; Aim 3: Test proposed intervention mediators/mechanisms of action for CT overall and by race/ethnicity; Aim 4: Test the moderating effect of initial readiness to change on risk of SEP and risk of HIV/STI. If efficacious, CT is readily scalable and has the potential for dissemination not only to juvenile justice settings, but to a wealth of settings that serve young adolescent women at risk of substance-exposed pregnancies and HIV/STI.

项目摘要/摘要非da-19-048少年司法环境中的青春期女性从事多种健康风险行为他们有受酒精和大麻影响艾滋病毒和怀孕的风险。具体来说，他们经常进行性风险行为，使他们面临怀孕，性传播感染和艾滋病毒的风险，同时还使用大麻和酒精。和女性未知怀孕的女性将继续喝酒或使用大麻在妊娠的早期和关键的几周中，这使它们处于暴露的风险怀孕。这项拟议的研究线的长期目标是发展高效和机会主义降低暴露于妊娠的风险（SEP）和艾滋病毒/性传播疾病的干预措施涉及女性青年。因此，这项研究的总体目的是测试选择（CT）减少选择的功效参与社区缓刑或转移计划的年轻妇女中SEP和HIV/STI的风险。 CT是改编的从选择性看法干预及其较短版本的选择中，可以选择强大高危成年女性降低酒精和烟草暴露妊娠风险的疗效历史。 CT 利用动机访谈（MI），这表现出对青少年和犯罪的巨大希望司法人口。我们最近的试点研究（R03DA034099;选择； CT-P），其中我们适应了青少年的选择，并在社区缓刑方面测试了其对青年的可行性，从而产生了令人鼓舞的结果。 CT 根据这项试验作品进行修改为1）关注大麻（在CT-P研究中报告了89％）而不是烟草鉴于青少年报道的尼古丁使用的患病率低和零星性质； 2）增加移动健康申请增加与《每日日报》的参与以及； 3）结合CT后自我调节组件针对变化的行为过程（POC）。这项研究将通过阐明重要的重要性来垂直移动该领域影响青年健康行为改变的因素，同时测试旨在减少个体和的干预措施这种高风险，服务不足的青少年人口的社会成本。下一个逻辑步骤是进行严格的 RCT评估这种性别响应性的，定制的捆绑风险降低干预措施的功效，主要是少数派，妇女参与了社区的少年司法改道或缓刑计划。第二阶段行为干预效力试验将：1）主要目的：测试选择（CT）的疗效，以减少与少年有关通过减少饮酒，增加大麻停止，降低怀孕风险并增加的司法系统避孕套使用。 AIM 2：与SC相比，测试CT的疗效，在提高认知自我调节能力方面；目标3：测试建议的干预介质/CT总体和种族/种族的作用机制；目标4：测试初步准备改变SEP风险和HIV/STI风险的调节作用。如果有效，CT很容易可扩展的，不仅有可能传播到少年司法环境，而且还具有许多环境服务年轻的青少年妇女，有暴露于物质的妊娠和HIV/STI的风险。