Adapting the Women's CoOp for At-Risk Teens

Research Triangle Institute, Durham NC

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Abstract

PROJECT SUMMARY/ABSTRACT DESCRIPTION: See instructions. This must contain a summary of the proposed activity suitable for dissemination to the public (no proprietary/confidential information). It should be a self-contained description of the project and contain a statement of objectives and methods to be employed. It should be informative to other persons working in the same or related fields. DO NOT EXCEED THE SPACE PROVIDED. The original Women's CoOp EBI prevention intervention reduced risk behaviors and empowered inner- city African American substance abusing women to better their life circumstances. Although this EBI has been adapted to include victimization and other risk-related issues in another country with women of different cultures, it has not been adapted with young adolescent females in North Carolina, where it was originated. In North Carolina, the rate of STIs among young women and the overall HIV rate among African American females continue to increase. In addition, these statistics coincide with high rates of gang-related activities and high rates of school dropout. Furthermore, data from the Women's CoOp EBI showed that 46% of the African American female participants did not graduate from high school and initiated sex by age 15. Therefore, it is opportune to propose an adaptation of an EBI prevention intervention for sexually active African American adolescent females between 15 and 17 years old who have dropped out of school and report any use of alcohol or other drugs, in addition to addressing environmental and developmental issues. We propose a multistage project to first determine how best to adapt the EBI to address cultural context, risk determinants, risk behaviors, and other environmental factors that affect risk behavior of adolescent females;and to conduct an experimental phase. We will involve an expert panel (e.g., parents, service providers, health educators, consultants) and community stakeholders who are members of a long-standing Community Advisory Board (e.g., previous women's CoOp members, health experts, and adolescents from the target population) to advise and help direct the adaptation process. In the experimental stage, we will conduct a small randomized controlled trial to compare this culturally, age-, and gender-targeted adapted intervention (vs. an equal-attention nutrition intervention condition) in a study with 400 adolescent females recruited from two urban communities in North Carolina, with 3- and 6-month follow-up assessments. The proposed specific aims of this 5-year study are: Aim 1. Adapt the Women's CoOp intervention to specifically address the needs of young out-of-school adolescent females (15 to 17 years old) with regard to knowledge about STIs, HIV and sexuality, health consequences of substance abuse, relationships with males, condom communication and social support, and HIV risk-reduction and violence prevention methods; Aim 2. Evaluate the efficacy of the culturally, age-, and gender-focused intervention relative to an equal- attention control nutrition intervention in terms of changes in behaviors (e.g., condom use, substance use, violence prevention);Aim 3. Identify the mechanisms-through both qualitative and quantitative methods- that influence the intervention outcomes (e.g., age, relationships with males, changes in knowledge about HIV risk behaviors, and competency in active refusal, negotiation, and condom skills).