Peer Versus Adult-Led HIV Prevention for Juvenile Offenders: Effectiveness and Costs

青少年罪犯的同伴与成人主导的艾滋病毒预防：有效性和成本

• 批准号: 9065286
• 负责人: GERI R DONENBERG
• 金额: $ 75.26万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-23 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9065286
• 关键词: 17 year old; AIDS prevention; Address; Administrator; Adolescent; Adopted; Adult; Affect; Age; Alcohol or Other Drugs use; Characteristics; Collaborations; Communities; Complex; County; Criminal Justice; Diagnosis; Effectiveness; Employment; Ensure; Evidence based program; Female; HIV; Health; Human Resources; Indigenous; Individual; Infection; Intervention; Justice; Life; Life Experience; Mediator of activation protein; Mental Health; Mental disorders; Minority; Modeling; Monitor; Outcome; Participant; Personal Satisfaction; Pilot Projects; Population; Public Health; Qualitative Methods; Reporting; Research; Resources; Risk; Risk Behaviors; Risk Reduction; Services; Sexually Transmitted Diseases; Societies; Source; Substance abuse problem; Supervision; System; Target Populations; Teenagers; Testing; Training; Youth; arm; base; behavior change; compare effectiveness; cooking; cost; cost effective; cost effectiveness; court; efficacy trial; evidence base; follow-up; health disparity; high risk; innovation; juvenile delinquent; juvenile justice system; life history; male; offender; outreach; peer; probation; programs; public health priorities; public health relevance; role model; screening; sex; sexual risk taking; trial comparing; uptake; young adult

 DESCRIPTION (provided by applicant): Juvenile offenders are disproportionately minorities and affected by HIV, sexually transmitted infections (STI), mental illness, and substance use.1-19 Evidence-based programs (EBP) are sorely needed in juvenile justice settings, yet few exist, and for those that do, implementation has been slow, challenging, and rarely sustained. Yet without intervention, young offenders continue to engage in risk behaviors while on probation, amplifying their own and worsening already serious health disparities. Altering this trajectory is public health priority. This study builds on a 10-year collaboration between the investigative team and Cook County Juvenile Probation and Court Services (the second largest juvenile probation system in the U.S.) to develop and deliver PHAT Life, a uniquely-tailored comprehensive risk reduction EBP for young offenders. Findings from PHAT Life's recent efficacy trial reveal sustained reductions in sexual risk taking and substance use at 12-month follow up. The next step is to identify an implementation strategy that is both sustainable and cost-effective within juvenile probation. Few previous studies have compared peer- vs. adult- led behavior change programs and existing studies suffer from significant methodological deficiencies.20 This study will compare the effectiveness, cost-effectiveness, and sustainability of two implementation strategies, peer-led vs. probation staff-led PHAT Life, in juvenile probation's Evening Reporting Centers. Peers will be young adults formerly involved in juvenile justice who serve on the Juvenile Advisory Council (Youth Representatives). Both Youth Representatives and probation staff will receive extensive training, supervision, and fidelity monitoring. We will compare the impact, costs, and cost-effectiveness of PHAT Life on 300 13-17 year-old male and female offenders' risky sex, STI, substance use, and theoretical mediators when delivered by Youth Representatives vs. probation staff. Using qualitative methods, we will elicit the views of Youth Representatives, probation staff, and probation administrators regarding strategies to enhance PHAT Life's sustainability within juvenile justice, and we will explore the impact delivering PHAT Life on Youth Representatives' sexual risk, substance use, and other important outcomes. This proposal answers a compelling need for EBP in juvenile justice settings by addressing the interrelated issues of HIV/STI risk, substance use, and mental illness among probation youth, and their negative long-term trajectories. Comparing two implementation strategies--peers vs. probation staff--to determine the more effective and cost-effective approach will expedite uptake, delivery, and sustainability of much-needed EBP for teens who are at greatly elevated risk for HIV and other STIs.

 描述（由适用提供）：少年罪犯是少数群体，受艾滋病毒，性传播感染（STI），精神疾病和药物使用的影响。1-19基于证据的计划（EBP）在少年司法环境中迫切需要，但很少有，但对于那些做得很少，实施的人是缓慢的，挑战，挑战，挑战，并且稳定了。然而，在没有干预的情况下，年轻的罪犯在缓刑时继续从事风险行为，扩大自己的健康并担心已经严重的健康分配。改变这一轨迹是公共卫生的重点。这项研究建立在调查团队与库克县少年缓刑和法院服务（美国第二大少年调查系统）之间的10年合作基础上，以开发和提供PHAT Life，这是年轻罪犯的独特销量综合风险降低EBP。 PHAT Life最近的有效性试验的发现表明，在12个月的随访中，性风险服用和使用物质的使用持续减少。下一步是确定少年缓刑中既可持续又具有成本效益的实施策略。先前很少有研究比较了同伴与成人领导的行为改变计划，现有研究遭受了严重的方法论缺陷。20本研究将比较两种实施策略的有效性，成本效益和可持续性，即同行者领导的与缓刑人员与PHAT的phat Life，在少年试用期报告的晚间报告中心。同龄人将是以前参与过少年司法的年轻人，他们在青少年咨询委员会（青年代表）任职。青年代表和缓刑人员都将获得广泛的培训，监督和忠实监测。我们将比较PHAT寿命对300名13-17岁男性和女性罪犯的危险性，STI，药物使用和理论调解人的影响，成本和成本效益，而青年代表与缓刑人员交付。使用定性方法，我们将引起青年代表，缓刑人员和缓刑管理员的观点，以提高PHAT司法中PHAT生活的可持续性的策略，我们将探索对PHAT生活对青年代表的性风险，物质使用，其他重要成果的影响。该提案通过解决缓刑青年中的艾滋病毒/性传播感染风险，药物使用和精神疾病的相互关联的问题及其负面的长期轨迹，回答了少年司法环境中对EBP的迫切需求。比较两种实施策略 - 同事与缓刑人员 - 确定更有效和成本效益的方法将加快急需的EBP的吸收，交付和可持续性，而EBP对于艾滋病毒和其他性传播感染的风险大大提高的青少年。