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Behavioral Ecological Model


This proposal tests the feasibility of implementing a multi-component program designed to increase social activism for the prevention of HIV infection among high-risk male and female multi-racial/ethnic adolescents. The intervention will focus on establishing the motivation to employ knowledge and skills in order to promote safer behavior in high-risk youth. The program is based on pilot testing within the targeted alternative school system (San Diego Juvenile Court and Community Schools [JCCS]). Specific Aims are: 1) To determine whether training increases condom use and decreases drug use relative to controls (STD and HIV screening will be used to enhance the validity of the self-report condom use measures); 2) To determine whether training increases AIDS prevention knowledge and use of assertive skills to promote condom use and drug use avoidance relative to controls; 3) To determine whether training results in an increase in social activism outcomes (e.g., number of friends agreeing to support safer behavior, etc.) relative to controls; and 4) To collect quantitative and qualitative process measures of various intervention components (e.g., length of time required to contact participating community agencies, total number of agency contacts attempted, feasibility of urine and oral HIV testing etc.). Eight JCCS sites (120 youth) will be randomly assigned to an Experimental or Usual Treatment Control condition. Specially trained Experimental teachers assisted by college student mentors will deliver a 64-hour, semester-long program covering skills, knowledge, and recruitment of social reinforcement for safer behaviors related to HIV/STD infection and drug use prevention. Controls will receive usual JCCS education. Over 2 semesters, 60 youth per condition will participate. The unit of analysis will be the individual. The primary dependent variable will be condom use. Additional dependent variables include: STD and HIV screening results; drug use; change in use of skills to promote condom use and drug use avoidance; social activism outcomes; and process measures. Confidential interviews and urine tests for chlamydia will be conducted at pre-/post-intervention, and at 3 or 9 months follow-up. A subset of the highest risk subjects will also be tested for HIV infection at each time period. A generalized estimating equation approach will be used to assess the extent of interaction between cases and controls, group differences at baseline and successive measurement periods, and overall change. Ordinary least squares regression analyses or logistic regression will be used to evaluate hypotheses with cross-sectional data, following a Behavioral-Ecological Model.

Principal Investigator: Mel Hovell, PhD, MPH

Project Coordinator: Carol Sipan, MPH

Funded 1998 - 2000

Source: Universitywide AIDS Research Program of the University of California


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