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首页> 外文期刊>JMIR mHealth and uHealth >Pilot Study of a Multilevel Mobile Health App for Substance Use, Sexual Risk Behaviors, and Testing for Sexually Transmitted Infections and HIV Among Youth: Randomized Controlled Trial
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Pilot Study of a Multilevel Mobile Health App for Substance Use, Sexual Risk Behaviors, and Testing for Sexually Transmitted Infections and HIV Among Youth: Randomized Controlled Trial

机译：用于物质使用，性风险行为和性病感染和艾滋病毒的多级移动健康应用程序的试验研究：随机对照试验

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Background Preventing and reducing substance use disorders, sexually transmitted infections (STIs)/HIV, and teen pregnancy, and the associated risk behaviors (ie, substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among the youth. Mobile health (mHealth) apps may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated efficacy in reducing substance use or sexual risk behaviors or improving the uptake of STI/HIV testing among the youth, particularly in clinic settings. Objective This small-scale study aimed to examine the feasibility of conducting a pilot randomized controlled trial (RCT). We evaluated the effects of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, on the potential mechanisms by which behavior change occurs, namely clinician-youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy. We also assessed the ability to measure targeted outcomes of past 30-day substance use (ie, alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use before sex, as well as the uptake of STI/HIV testing. Methods Employing community-based participatory research principles, 50 youths aged 13 to 21 years were recruited from a youth-centered community health clinic in Southeast Michigan, randomized sequentially to either S4E or enhanced usual practice, and assessed at baseline, immediately postintervention, and 30 days postintervention. S4E consists of 3 modules, including alcohol and drug use, tobacco, and STI/HIV. Results Relative to youth in the enhanced usual practice group, S4E participants demonstrated higher youth-clinician risk communication (mean 3.22, SD 1.67) and increases in prevention knowledge (? score mean 0.36, SD 0.51) and self-efficacy (? score mean 0.16, SD 0.47). In addition, youth in the S4E group showed reductions in the proportions of past 30-day overall substance use (Cohen h =0.71, 95% CI 0.15 to 1.27), as well as past 30-day alcohol (Cohen h =0.71, 95% CI 0.15 to 1.27), tobacco (Cohen h =0.17, 95% CI ?0.39 to 0.73), and drug use (Cohen h =1.28, 95% CI 0.72 to 1.84). The results also suggest a reduction in the proportion of youths who reported past 30-day condomless sex (Cohen h =0.18, 95% CI ?0.38 to 0.74) and alcohol use before sex (Cohen h =0.44, 95% CI ?0.12 to 1.00). Finally, the findings also demonstrated an increase in the proportion of youths who reported STI/HIV testing over time (Cohen h =0.16, 95% CI ?0.39 to 0.72). Conclusions The findings suggest the feasibility of a small-scale pilot RCT. S4E demonstrated shifts in the hypothesized direction, reducing substance use, sexual risk behaviors, and improving the uptake of STI/HIV testing among youth in a clinic setting. The findings suggest that a larger RCT may be warranted.
机译：背景技术防止和减少物质使用障碍，性传播感染（STIS）/艾滋病毒，青少年怀孕，以及青年中的相关风险行为（即物质使用和性风险行为）仍然是美国的公共卫生优先事项。同样重要的是改善青年之间的STI / HIV测试的摄取。移动健康（MHealth）应用程序可能是改善这些公共卫生问题的解决方案;然而，很少有MHE健康的预防性干预措施已经证明了降低物质使用或性风险行为或改善青年之间STI / HIV测试的摄取，特别是在临床环境中的疗效。目的这一小型研究旨在审查进行试用随机对照试验（RCT）的可行性。我们评估了讲故事4赋权（S4E）的影响，相对于增强的通常实践，对行为变化发生的潜在机制，即临床医生 - 青年风险沟通，预防知识和物质使用以及性风险拒绝自我效能。我们还评估了衡量过去30天物质使用的有针对性结果的能力（即酒精，烟草和其他药物使用），牙齿性性别和酒精或吸毒，以及STI / HIV测试的吸收。采用基于社区的参与性研究原则的方法，从东南密歇根州的青少年社区健康诊所招募了50岁至21岁的青少年，以S4E随机分配到S4E或常规实践，并在基线中进行评估，立即进行后立即，30初期临时。 S4E由3个模块组成，包括酒精和吸毒，烟草和STI / HIV。结果相对于青少年在增强的通常练习集团中，S4E参与者展示了更高的青年临床医生风险通信（平均3.22，SD 1.67），并增加预防知识（？评分意味着0.36，SD 0.51）和自我效能（？得分意味着0.16 ，sd 0.47）。此外，S4E组中的青年表明，在过去30天的总体物质使用的比例（COHEN H = 0.71,95％CI 0.15至1.27）中显示出减少，以及过去的30天醇（COHEN H = 0.71,95 ％CI 0.15至1.27），烟草（COHEN H = 0.17,95％CI→0.39至0.73），药物用途（COHEN H = 1.28,95％CI 0.72至1.84）。结果还提出了报告过去30天通用性（COHEN H = 0.18,95％CI〜0.38至0.74）和酒精使用（COHEN H = 0.44，95％CI〜0.12）的酒精使用的比例减少了1.00）。最后，调查结果还表明，随着时间的推移报告STI / HIV测试的青少年比例（COHEN H = 0.16,95％CI？0.39至0.72）。结论研究结果表明小规模飞行员RCT的可行性。 S4E在假设方向，降低物质使用，性风险行为以及改善诊所环境中的青年中STI / HIV测试的吸收的变化。调查结果表明，可能需要较大的RCT。

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