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Drug User Intervention Trial (DUIT)
Investigators: Richard S. Garfein, PhD, MPH, Steffanie Strathdee, Ph.D, Lawrence Ouellet, PhD, Sharon Hudson, PhD, Mary Latka, PhD, Holly Hagan, PhD, Hanne Thiede, DVM, MPH, Elizabeth Golub, PhD, Marie Bailey-Kloch, Karen Yen-Hobelman, PhD, Susan Bailey, PhD, Joyce Fitzgerald, Peter Kerndt, MD, MPH, Karla Wagner, PhD, David Vlahov, PhD, Farzana Kapadia, PhD, Nadine Snyder, BA, Jennifer V. Campbell, MPH, David Purcell, PhD, JD, Ian Williams, PhD, Paige Ingram, RN, Andrea Swartzendruber, MPH
DUIT is a small-group, clinic-based, behavioral intervention that aims to reduce risky injection and sexual behaviors among injection drug users who are HIV and HCV negative. During six 2-hour sessions, two trained health advisors promote group cohesion and peer education within the DUIT group. The health advisors also encourage behavior change by teaching peer-education tactics, risk-reduction strategies, and safer sex and injection negotiation skills. Ultimately, the DUIT program increases participants. perceived risk of HIV/HCV, their motivation to practice safer injection and sexual behaviors, their knowledge of risky behaviors, and key risk-reduction strategies. Click here to view more detailed information on this program.
Entre Nous Jeunes
Investigators: Simon-Pierre Tegang, M.Sc., Jean Paul Tchupo, M.A., Gdon Yomi, M.Sc., & Blanche Djofang, B.A.
During the 18-month program, Entre Nous Jeunes utilizes a peer-education strategy to increase contraceptive prevalence and reduce the prevalence of STI/HIV and unintended pregnancies. Young adult peer educators in the community educate youth about HIV prevention and safer sex. Peer educators are trained during a one week-long session for the program. For two years, peer educators engage youth in the community by leading discussion groups, creating and using promotional materials, and referring peers to social and health services. The main objective of the program is for young people who have been exposed to a peer-educator to gain greater knowledge and practice more protective behaviors than those not exposed. The findings indicate the important contribution of the ENJ peer-educator program to the promotion of protective reproductive health behaviors to reduce unintended pregnancies and STIs among adolescents. In particular, the program was significantly associated with greater spontaneous knowledge of modern contraceptives and STI symptoms. Findings also suggest positive intervention effects on contraceptive knowledge for males, and virginity and contraceptive use at last intercourse for sexually active females. Click here to view more detailed information on this program.
Expressive Language Delay (ELD) Treatment Program: An Early Intervention for Children with Early Expressive Language Delay
Investigators: Grover J. Whitehurst, PhD & Janet E. Fischel PhD
Specific expressive language delay (ELD) is an early childhood condition characterized by a substantial delay in the child's development of expressive language relative to their receptive language skills and non-verbal intelligence. Young children with ELD are only able to produce a few single words, at an age at which most children are able to produce hundreds of words and a variety of syntactic combinations. The Expressive Language Delay (ELD) Treatment Program is a home- and clinic-based intervention that trains parents of young children diagnosed with ELD, with skills to improve their child's expressive language abilities. The ELD Treatment Program consists of seven 30-minute training sessions, in which parents receive training on seven language therapy skills. Parents are asked to practice each of these skills at-home with their child during the two-week intervals between training sessions. Parent training sessions were conducted on a one-on-one basis at an outpatient pediatric clinic and took place every other week during a three and a half month period. The evaluation of the ELD Treatment Program demonstrated short-term success in helping to improve the expressive vocabulary skills of children diagnosed with ELD. Click here to view more detailed information on this program.
FOCUS: Preventing Sexually Transmitted Infections and Unwanted Pregnancies among Young Women
Investigators: Cherrie Boyer, Mary-Ann Shafer, Lance Pollack, Kelli Betsinger, Y. Jason Yang, Julius Schachter, Richard Shaffer, Stephanie Brodine, Heidi Kraft
The FOCUS program, a four-session cognitive-behavioral group intervention addressing prevention of sexually transmitted infections (STIs) and unintended pregnancies, was originally delivered to young women US Marine Corps recruits. Following a baseline survey, 2,157 women were randomized into either the experimental group (n=1,062) or the control group (n=1,095). Both groups received interventions of four two-hour sessions. Follow-up surveys were conducted with both groups at approximately four months post-baseline and approximately 14 months post-baseline. The evaluation results revealed that a higher proportion of the control group had a post-intervention STI or unintended pregnancy than the intervention group (Odds Ratio = 1.41, 95% Confidence Interval = 1.01-1.98). Among study participants who had no pre-intervention history of STIs or pregnancy, but who engaged in risky sexual behaviors just before recruit training, the control group was significantly more likely to acquire a post-intervention STI than the intervention group (OR = 2.05, CI = 1.74-4.08). Among study participants who reported not being sexually experienced at baseline, control group participants were significantly more likely to have had multiple sexual partners post-intervention than intervention group participants (OR = 1.87, CI = 1.01-3.47). FOCUS is supported by the Office of Adolescent Health (OAH)'s Teen Pregnancy Prevention (TPP) program as an EBI that is medically accurate, age appropriate, and has been proven through rigorous evaluation to prevent teen pregnancy and/or associated sexual risk behaviors. Click here to view more detailed information on this program.
Family Growth Center: A Community-Based Social Support Program for Teen Mothers and Their Families
Investigators: Richard Solomon & Linda Solomon
The Family Growth Center (FGC) is a comprehensive, community-based family support program designed to reduce repeat pregnancy and school drop-out rates among adolescent mothers. The program aims to provide teen mothers in high-risk neighborhoods with a comprehensive set of educational and support services, offered within family and neighborhood contexts. Young women are recruited for the program by perinatal counselors/coaches when they arrive at participating hospital clinics for prenatal visits. Thereafter, they are offered a range of intervention components, coordinated by FGC Case Managers. Program components include home visits, crisis intervention, bimonthly parenting classes, supervised daycare, transportation services, recreational opportunities, and advocacy and referral services. The evaluated FGC Pilot Program took place in several of Pittsburgh's high-risk urban neighborhoods. Of the 88 first-time mothers recruited for the study, 49 were assigned to the intervention group and 39 to the control group. An attrition group was formed to follow the 25 women (15 intervention, 10 control) who dropped out of the program. Protocol assessment measures were diverse and included interview and questionnaire data and psychosocial and behavioral outcomes of mothers and their children. Researchers found that the proportion of the intervention group mothers who dropped out of school (3/34) was significantly less than the proportion of the control group (12/29), a pattern which held at both Time 1 (two years after recruitment) and Time 2 (three years after recruitment) analysis points. Significant differences were also found in the frequency of repeat pregnancies between the two groups. At Time 1, three repeat pregnancies occurred in the intervention group (less than 10%) versus 11 repeat pregnancies (38%) in the control group (p=0.006). The Time 2 pattern was the same, with a total of 7 repeat pregnancies among the intervention group and 21 within the control group (p=0.020). Click here to view more detailed information on this program.
Focus on Youth (FOY) with ImPACT
Investigators: Bonita Stanton, MD, PhD, Jennifer Galbraith, PhD, Cherri Gardner, MA, Pam Drake, PhD, James Walker, Scott Martin, Teree Jerome, Suzanne Schrag, Sarah Stevens, Charlene Foster, & the CDC Division of HIV/AIDS Prevention
Focus on Youth with Informed Parents and Children Together (ImPACT) is an HIV, STD and pregnancy prevention intervention for African-American youth ages 12–15. The intervention was updated from Focus on Kids, a community-university linked research and intervention program. The goal of Focus on Youth with ImPACT is to reduce the risk of HIV infection among youth. The researchers, led by principle investigator Bonita Stanton, M.D., worked with community members from recreation centers, housing developments, schools and government agencies in settings throughout the U.S. to reach this goal. The evaluation of the combined Focus on Kids and ImPACT interventions met the necessary criteria for the interventions identified as interventions with best evidence of efficacy by the Centers for Disease Control and Prevention’s (CDC) HIV/AIDS Prevention Research Synthesis (PRS) Project. Focus on Kids alone was identified as an intervention with promising evidence. This Focus on Youth with ImPACT edition provides updated information and more tools to facilitate implementation and increase the relevance of the program for African-American youth between ages 12 and 15 who are at risk for HIV infection. ImPACT is a 90-minute HIV prevention program for parents of African-American adolescents used in combination with Focus on Youth. ImPACT is delivered to parents/guardians and youth, one family at a time, by a health educator. It consists of basic HIV information, a culturally appropriate video documentary that stresses parental monitoring and communication, a discussion with the health educator, two guided roleplays, a parent/guardian resource guide, and a condom demonstration. It was guided by parental monitoring theory and theory of parenting (passive, authoritarian and authoritative).
Focus on the Future
Investigators: Richard Crosby, PhD, Ralph J. DiClemente, PhD, Richard Charnigo, PhD, Gregory Snow, Adewale Troutman, MD
FOCUS ON THE FUTURE, a one-to-one, single session intervention, administered by a lay health advisor, is culturally appropriate for use among young (aged 18-29 years) heterosexual African American men newly diagnosed with a sexually transmitted infection (STI). Based on the behavioral skills model, this one hour long program consists of a personalized discussion, presentation of basic STI/HIV/AIDS and safer sex information, and condom use skills practice. For each individual participant, the FOCUS ON THE FUTURE health facilitator initiates a discussion about the disproportionate HIV/AIDS burden experienced by African American men (illustrated using large posters); condom negotiation skills; and any questions, problems, and concerns the men may have regarding safer sex with their partners. The health facilitator also conducts a demonstration of available condom and lubricant varieties and correct condom and lubrication use. Throughout the session, the advisor encourages the individual to feel good about using condoms, to experience condoms as being compatible with sexual pleasure, to equate condom use with an investment in his future, and to actively protect himself from obtaining a future STI. Men are encouraged to use condoms that they feel fit them well and provide them with a sense of security. Participants receive pocketsize vials of water-based lubricants as well as 12 or more condoms of their choice from a broad selection of brands and sizes. Click here to view more detailed information on this program.
Investigators: Craig W. LeCroy, MSW, PhD, & Janice Daley, MSW
Go Grrrls is a program designed to promote healthy psychosocial development in female adolescents. Building a foundation of information and skills that related to middle school females is a core feature of the program. The program is not just a pregnancy prevention program but a program about empowering adolescent females with pregnancy prevention as one core part. All of the units in the program work together to create the context and motivation for taking actions that can prevent teen pregnancy. The program has been delivered to girls in grades six through nine and is expected to occur as a series of 8 units held outside of traditional school hours. The 8-unit curriculum covers six topics related to female adolescent development: being a girl in today's society (gender role identity), establishing a positive self-image, establishing independence, making and keeping friends, when it all seems like too much (learning to obtain help and find access to resources), and planning for the future. Sessions are expected to last 90-120 minutes and occur once per week. They are made up of groups of 6-11 female adolescents, led by two group facilitators with appropriate interest, background knowledge (e.g., social work or psychology), and past experience working with young people. The sessions include didactic instruction, class discussion, group exercises, completion of worksheets, role-playing, and weekly journal assignments. The Go Grrrls program materials include a Go Grrrls curriculum guide for group leaders and a Go Grrrls workbook for use by group attendees. In addition, the program developers offer one-day trainings for group leaders on topics such as an introduction to Go Grrrls and female adolescent development, being a group leader, and advanced topics related to leading a Go Grrrls group. Click here to view more detailed information on this program.
Group Cognitive-Behavioral Treatment for Phobic/Anxious Children (GCBT)
Investigators: Wendi Silverman, PhD
GCBT is a child-focused treatment intervention with parental involvement, for children with overanxious disorder, social phobia, and avoidant disorder. The key therapeutic procedure in this intervention is exposure to anxious-phobic objects or events, with contingency management and self-control training as additional therapeutic strategies. In the group format, these strategies are generally sequenced between education and application with the parent receiving training on a specific strategy and applying it to the child, then the child receiving training and applying the strategy him or herself. A randomized clinical trial conducted in 1999 evaluated the therapeutic efficacy of this program versus a wait-list control condition. The study found that 64% of the children in GCBT were recovered at posttreatment (i.e., no longer met primary diagnoses) compared with 13% of the children in the control condition. In addition, 82% of the participants showed clinically significant improvement at posttreatment compared with only 9% in the control condition. An improvement was also observed for ratings of disorder severity and for child- and parent-completed questionnaire measures. A consistent trend for treatment gains was found at the 3-month and 6-month follow-ups. Additionally, participants who were not recovered continued to show improvement into the 12-month follow-ups. The pattern for all of the child- and parent-completed measures similarly indicated a continued reduction in degree and severity of anxious symptoms from posttreatment to the 3-month follow-up, with improvements maintained at 6 and 12 months. Click here to view more detailed information on this program.
HIV/AIDS Warriors Program
Investigators: Eric G. Bing, MD, Daniel J. Ortiz, PhD, Ricardo E. Ovalle-Bahamn, C. Phil., Karen G. Cheng, PhD, Francisco Ernesto, MD, & Cherrie B. Boyer, PhD
The HIV/AIDS Warriors Program aims to enhance HIV risk reduction knowledge, motivation, and behaviors among soldiers or other at-risk populations. The program is composed of five, 4-hour sessions delivered on consecutive days to groups of soldiers by civilian facilitators. Optional monthly booster sessions last 1-hour and reinforce the information provided by the initial program and give participants an opportunity to discuss their experiences related to the program. Program participants significantly increased their HIV/AIDS knowledge, perceived vulnerability to HIV, and condom use. Program participants also engaged in fewer unprotected sex acts with girlfriends, occasional partners, and sex workers; reduced the number of unprotected anal sex acts with live-in partners; and reduced the overall number of occasional partners and sex workers. The HIV/AIDS Warriors Program was originally designed for and implemented with soldiers in the Angolan Armed Forces. The HIV prevention messages presented in the curriculum are applicable to other non-military populations at risk of acquiring and transmitting STIs/HIV. Click here to view more detailed information on this program.