This rigorous three-arm randomized experiment will test whether an innovative parent-mediated HIV intervention, Preparing Our Sons and Daughters for Healthy Futures, reduces HIV risks among African American and other Black youth living in high-poverty urban neighborhoods. Under a prior NICHD grant, a set of three audio-CDs containing culturally relevant role-model stories were sent to families with preteen sons and daughters. Results of a randomized trial with over 800 mostly African American families indicate that parents receiving the audio-CDs reported significantly higher levels of monitoring, parent-child communication, perceived influence over youths' behaviors, and self efficacy to address adolescent sexuality and HIV risks. Adolescents in the intervention condition reported more household rules, higher levels of family support and, importantly, fewer behavioral risks related to sexual initiation than control- group youth. Extending this work, this study aims to: (1) Develop additional Healthy Futures audio-CDs to promote positive parenting practices and support youth in establishing patterns of behavior that are protective against HIV; (2) Conduct a randomized field trial in which 1500 African American/Black parents and their 6th grade sons and daughters are randomly assigned one of three conditions: (a) a multi-year audio-CD intervention, Healthy Futures; (b) an attention-controlled condition; or (c) a non-attention controlled condition; (3) Survey parents at baseline and at four follow up time-points extending from 7th into 10th grade, to test whether Healthy Futures is effective in promoting and sustaining positive parenting practices; (4) Conduct youth assessments at baseline and four time-points from 7th to 10th grade to test whether Healthy Futures delays sexual initiation, reduces risk behaviors and, at 10th grade, results in fewer STI; (5) Examine whether youth outcomes are explained by parenting practices and identify which parenting practices mediate the relationship between experimental condition and youth outcomes; (6) Examine whether intervention effects vary (i.e., are moderated) by youths' gender or level of baseline risk behaviors to better understand for whom the intervention works; (7) Examine where and how an audio-CD facilitated parent-mediated intervention (our original one-year Saving Sex for Later) is being used in diverse settings to inform dissemination strategies. Healthy Futures addresses the HIV epidemic among African Americans/Blacks in high-poverty urban communities by preparing parents to address the challenges their adolescent sons and daughters face. ? ? ?
