A Culturally Informed Tele-Intervention for Minority High Risk Youth and Parents

针对少数族裔高危青少年和家长的文化知情远程干预

• 批准号: 7938060
• 负责人: DANIEL A. SANTISTEBAN
• 金额: $ 50万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938060
• 关键词: 15 year old; Access to Information; Acquired Immunodeficiency Syndrome; Address; Adolescent; African American; Age; Area; Behavior; Behavioral; Cellular Phone; Characteristics; Child; Clinical; Collaborations; Communities; Computer software; Conflict (Psychology); Control Groups; Cultural Characteristics; Data; Depression and Suicide; Development; Discrimination; Drug usage; Economics; Educational process of instructing; Failure; Family; Family Practice; Focus Groups; HIV; Health; Health system; Hispanics; Immigration; Individual; Intervention; Lead; Life; Location; Manuals; Minority; Occupations; Parenting behavior; Parents; Pattern; Prevention; Professional counselor; Randomized Clinical Trials; Research; Research Personnel; Risk; Risk Factors; Sampling; Schools; Science; Services; Stress; Suicide attempt; System; Technology; Testing; Text; Time; Waiting Lists; Wireless Technology; Youth; base; cost; design; flexibility; health disparity; high risk; high risk sexual behavior; innovation; meetings; programs; psychosocial; randomized trial; response; satisfaction; skills; stressor; telehealth; tool; user-friendly; web-enabled

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (01) Behavior, Behavioral Change, and Prevention and specific Challenge Topic, 06-MD-101* Development of Telehealth Tools to Promote Health and Connect At-Risk Youth to the Health System via Low-Cost, Mobile, and Wireless Technologies. The proposed study is designed to enhance, refine, and test a culturally informed and flexible/tailored intervention for high risk minority adolescents and their parents that is delivered primarily via a mobile/wireless system. This study focuses on high risk African American and Hispanic adolescents and their parents. Rates of HIV, AIDS, STIs, depression and suicide attempts, point to some of the major health disparities that result from an untreated high risk developmental trajectory. The proposed research brings together two teams with strong programs of innovation and research, one with expertise in the use of technology to deliver psychosocial interventions and the PI who has expertise in the development and testing of culturally informed treatments for high risk minority youth. This unique collaboration promises to accelerate each team's individual trajectories and converge on a high innovative tele-intervention for high risk youth. The study: 1) refines and enhances the original Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) to meet the needs of African American and Hispanic high risk youth, 2) refines an innovative wireless mobile technology to deliver the intervention in a multi-media format that includes text, audio, video and graphics, 3) pilot tests the new intervention and its delivery system by implementing the intervention with 10 families and conducting focus groups to identify refinements, and 4) conducts a medium-sized randomized trial of 80 African American and Hispanic adolescents ages 12-15 to test for feasibility, acceptability, and to obtain preliminary effect size estimates on key risk factors (conduct problems, academic failure, risky sexual behavior, family conflict). The original CIFFTA was designed to address unique stressors faced by minority youth in a flexible format that leads to the selection of interventions that best "fit" the clinical needs and cultural characteristics of the youth. It targets: 1) reducing family risk (e.g., poor parenting practices, family conflict) and increasing protective factors (e.g., Parent-child attachment), 2) teaching adolescent and parents skills, 3) delivering culturally congruent material (e.g., handling discrimination), and 4) using a flexible treatment manual to tailor of the treatment to the unique characteristics and needs of minority families (Santisteban & Mena, in press). By modifying and enhancing the original CIFFTA that has shown promising preliminary data, and adapting it for a wireless and mobile technology that is user friendly for adolescents, the intervention has the potential to mitigate issues of underutilization of services and the inability of interventions to be accessible to youth in the moments they need them most. The intervention will seek to identify the high risk people, times of the day, and locations in the adolescents' lives so that contact is made with youth at those most vulnerable times and interventions can be tailored. Rates of HIV, AIDS, STIs, depression and suicide attempts among African American and Hispanic adolescents, point to some of the major health disparities that can result from an untreated high risk developmental trajectory. The proposed research brings together two teams with strong programs of innovation and research, one with expertise in the use of technology to deliver psychosocial interventions and the PI with expertise in the development and testing of culturally informed and tailored treatments for high risk minority youth. The proposed study is designed to enhance, refine, and test using a randomized trial, a culturally informed and tailored intervention for high risk minority adolescents and their parents that will be delivered primarily via a mobile/wireless system using a multi-media format that includes text, audio, video and graphics.

描述（由申请人提供）：该应用程序涉及广泛的挑战领域 (01) 行为、行为改变和预防以及具体挑战主题 06-MD-101* 开发远程医疗工具以促进健康并将高危青少年与健康联系起来采用低成本、移动和无线技术的系统。拟议的研究旨在增强、完善和测试主要通过移动/无线系统提供的针对高风险少数族裔青少年及其父母的文化知情且灵活/量身定制的干预措施。这项研究的重点是高风险非裔美国人和西班牙裔青少年及其父母。艾滋病毒、艾滋病、性传播感染、抑郁症和自杀未遂的发病率表明，由于未经治疗的高风险发展轨迹而导致了一些主要的健康差异。拟议的研究汇集了两个拥有强大创新和研究项目的团队，其中一个拥有利用技术提供社会心理干预的专业知识，而首席研究员则拥有开发和测试针对高危少数族裔青少年的文化知情治疗的专业知识。这种独特的合作有望加速每个团队的个人发展轨迹，并集中于针对高危青少年的高度创新的远程干预。该研究：1) 完善和增强了最初的基于文化的灵活的青少年家庭治疗 (CIFFTA)，以满足非裔美国人和西班牙裔高危青少年的需求，2) 完善了创新的无线移动技术，以在青少年中提供干预措施。多媒体格式，包括文本、音频、视频和图形，3) 通过对 10 个家庭实施干预措施并进行焦点小组以确定改进措施，对新干预措施及其实施系统进行试点测试，以及 4) 进行对 80 名 12-15 岁非裔美国人和西班牙裔青少年进行的中型随机试验，旨在测试可行性、可接受性，并获得对关键风险因素（行为问题、学业失败、危险性行为、家庭冲突）的初步效应大小估计。最初的 CIFFTA 旨在以灵活的形式解决少数族裔青年面临的独特压力源，从而选择最“适合”青年的临床需求和文化特征的干预措施。其目标是：1) 降低家庭风险（例如不良养育方式、家庭冲突）并增加保护因素（例如亲子依恋），2) 教授青少年和家长技能，3) 提供文化上一致的材料（例如处理歧视） ），4）使用灵活的治疗手册，根据少数族裔家庭的独特特征和需求定制治疗（Santisteban & Mena，待出版）。通过修改和增强原始 CIFFTA（已显示出有希望的初步数据），并将其调整为对青少年用户友好的无线和移动技术，干预措施有可能缓解服务利用不足和无法获得干预措施的问题在年轻人最需要的时刻。干预措施将寻求确定青少年生活中的高风险人群、一天中的时间和地点，以便在最脆弱的时期与青少年进行接触，并制定干预措施。非裔美国人和西班牙裔青少年的艾滋病毒、艾滋病、性传播感染、抑郁症和自杀未遂率表明，未经治疗的高风险发育轨迹可能导致一些重大的健康差异。拟议的研究汇集了两个拥有强大创新和研究项目的团队，其中一个拥有利用技术提供社会心理干预的专业知识，而首席研究员则拥有开发和测试针对高危少数族裔青少年的文化背景和定制治疗的专业知识。拟议的研究旨在使用随机试验来增强、完善和测试，这是一种针对高风险少数族裔青少年及其父母的文化知情和量身定制的干预措施，该干预措施将主要通过使用多媒体格式的移动/无线系统提供，包括文本、音频、视频和图形。