Evidence-based sexual and reproductive health intervention using a multiphase optimization strategy

使用多阶段优化策略进行循证性健康和生殖健康干预

• 批准号: 10253629
• 负责人: Katherine Gannett Merrill
• 金额: $ 14.38万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-11 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10253629
• 关键词: 18 year old; AIDS/HIV problem; Acculturation; Address; Adolescent; Adult; Affect; African American; Award; Awareness; Behavior Therapy; Biological; Chicago; Chlamydia; Communities; Competence; Control Groups; Data Collection; Daughter; Development; Educational workshop; Effectiveness; Effectiveness of Interventions; Evidence based intervention; Evidence based program; Faculty; Family; Feedback; Female Adolescents; Focus Groups; General Population; Goals; Gonorrhea; Grant; Health; Health Promotion; Home environment; Incidence; Individual; Infection; Intervention; Knowledge; Language; Latina; Learning; Link; Literature; Measures; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Mentors; Mentorship; Methodology; Methods; Mothers; Outcome; Parents; Phase; Population Heterogeneity; Positioning Attribute; Pregnancy in Adolescence; Preparation; Process; Publishing; Randomized Controlled Trials; Reading; Religion; Research; Research Design; Research Personnel; Risk; Running; Scientist; Sexual Health; Sexually Transmitted Diseases; Shapes; South African; Syphilis; Testing; Training; Translating; Trichomonas; United States; Youth; adolescent health; adolescent health outcomes; adolescent sexual behavior; adverse outcome; base; behavioral outcome; career; community based participatory research; contextual factors; design; driving force; effectiveness evaluation; emotion regulation; evidence base; experience; experimental study; girls; health disparity; high risk; high risk sexual behavior; implementation science; innovation; interest; intervention mapping; intimate partner violence; meetings; multiphase optimization strategy; peer; primary outcome; programs; reproductive health intervention; scale up; secondary outcome; sexual health intervention; substance use; symposium; tenure track; theories; tool

ABSTRACT Latina adolescents in the U.S. are disproportionately affected by HIV/AIDS/sexually-transmitted infections (STIs) and other adverse consequences of risky sexual behavior. The home environment is recognized to shape adolescents' health outcomes, but only one Latina mother-daughter sexual health program was identified in the literature. IMARA (Informed, Motivated, Aware, and Responsible Adolescents and Adults) is an evidence-based intervention for African American adolescent girls and their mothers, which is well-suited to be adapted for Latinas. In a randomized controlled trial (RCT) in Chicago, the program reduced the risk of new STIs by 45% compared to the control group among 14-18-year-olds. In this K99/R00 award, I propose to adapt IMARA to a Latina audience and pilot an optimization trial within community-based organizations (CBOs) in Chicago, using the multiphase optimization strategy (MOST). MOST is a methodological framework for developing an optimal intervention package by assessing the effectiveness of an intervention's components prior to subjecting the intervention to an RCT. This grant focuses on the preparation phase of MOST, using an implementation science (IS) approach and drawing on community-based participatory research (CBPR) principles to pursue three specific aims: 1) adapt the intervention for Latinas by establishing a community advisory board and engaging 12 mother-daughter dyads in 4 focus group discussions (K99 phase); 2) establish the acceptability, feasibility, and appropriateness of the intervention components through piloting among 24 new dyads (K99 phase); and 3) pilot an optimization trial of the adapted intervention among 92 new dyads and examine intervention component effects on risky sexual behavior (primary outcome) and STI incidence (secondary outcome) (R00 phase). These research aims will allow me to build on my strong research and publishing experience in adolescent health and capitalize on the expertise of my mentorship team in sexual risk interventions for youth to achieve four training aims, to: 1) gain knowledge in CBPR principles and their application; 2) develop expertise in IS theory/design and its application; 3) learn to employ innovative research designs, analysis strategies, and frameworks for behavioral interventions, including MOST; and 4) further my professional development to obtain a tenure-track faculty position prior to the R00 phase. I will accomplish my training aims through meetings, directed readings, and conference/workshop attendance, with support from my mentors (Primary Mentor: Geri Donenberg). Findings will form the basis of an R01 application for a fully-powered optimization trial to test intervention component impacts on STI incidence among Latina adolescents. The long-term goal is to generate an efficient, sustainable adapted intervention with potential for scale-up with CBOs serving Latinas. This K99/R00 award will give me a platform on which to launch my career as an independent adolescent health researcher, specialized in innovative methods for developing, implementing, and evaluating behavioral interventions.

抽象的 美国的拉丁裔青少年受艾滋病毒/艾滋病/性传播感染的影响不成比例 （性传播感染）和风险性行为的其他不利后果。家庭环境已公认 塑造青少年的健康成果，但只有一个拉丁裔母女性健康计划是 在文献中确定。 Imara（知情，有动力，意识到和负责任的青少年和成年人）是 对非裔美国青少年女孩及其母亲的循证干预，非常适合 适用于拉丁裔。在芝加哥的一项随机对照试验（RCT）中，该计划降低了新的风险 与14-18岁的对照组相比，性传播感染率为45％。在这个K99/R00奖中，我建议 将IMARA适应拉丁裔受众，并在社区组织中进行优化试验 （CBO）在芝加哥使用多相优化策略（大多数）。大多数是方法论 通过评估干预措施的有效性来开发最佳干预套件的框架 对干预进行RCT之前的组件。该赠款重点是 大多数，使用实施科学（IS）方法并利用基于社区的参与性 研究（CBPR）追求三个特定目标的原则：1）通过建立拉丁裔的干预措施 一个社区顾问委员会，并参与了4个焦点小组讨论中的12个母女二元组（K99 阶段）; 2）通过通过 在24个新二元组（K99阶段）中驾驶； 3）试行对改编干预措施的优化试验 92新的二元组并检查干预成分对风险性行为的影响（主要结果）和 STI发病率（次要结果）（R00期）。这些研究目标将使我能够以自己的强大为基础 青少年健康的研究和出版经验，并利用我的指导专业知识 为年轻人实现四个培训目标的性风险干预措施的团队：1）获得CBPR知识 原则及其应用； 2）发展理论/设计及其应用方面的专业知识； 3）学会雇用 创新的研究设计，分析策略和行为干预的框架，包括大多数； 4）进一步的我的专业发展，以在R00阶段之前获得终身教师职位。我 将通过会议，定向阅读和会议/研讨会的出席来实现我的培训目标， 在我的导师的支持下（主要导师：Geri Donenberg）。调查结果将构成R01的基础 申请全功率优化试验以测试干预组件对STI发病率的影响 在拉丁青少年中。长期目标是与 使用CBO为拉丁裔提供扩展的潜力。这个K99/R00奖将为我提供一个平台 启动我作为独立青少年健康研究员的职业，专门从事创新方法 用于开发，实施和评估行为干预措施。