of the proposed activity suitable for dissemination to the public (noproprietary/confidential information). It should be a self-contained description of the project and contain a statement of objectives and methods to beemployed. 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 hasbeen adapted to include victimization and other risk-related issues in another country with women of differentcultures, 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 Americanfemales continue to increase. In addition, these statistics coincide with high rates of gang-related activitiesand high rates of school dropout. Furthermore, data from the Women's CoOp EBI showed that 46% of theAfrican 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 activeAfrican American adolescent females between 15 and 17 years old who have dropped out of school andreport 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 adolescentfemales; and to conduct an experimental phase. We will involve an expert panel (e.g., parents, serviceproviders, health educators, consultants) and community stakeholders who are members of a long-standingCommunity Advisory Board (e.g., previous women's CoOp members, health experts, and adolescents fromthe target population) to advise and help direct the adaptation process. In the experimental stage, we willconduct a small randomized controlled trial to compare this culturally, age-, and gender-targeted adaptedintervention (vs. an equal-attention nutrition intervention condition) in a study with 400 adolescent femalesrecruited 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 tospecifically address the needs of young out-of-school adolescent females (15 to 17 years old) with regard toknowledge about STIs, HIV and sexuality, health consequences of substance abuse, relationships withmales, 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 aboutHIV risk behaviors, and competency in active refusal, negotiation, and condom skills).

Public Health Relevance

Similar to national data, North Carolina state-level data indicate that the African American community, in particular young African America women, is disproportionately affected by HIV and AIDS. The proposed project will adapt an evidence-based HIV prevention intervention, the Women's CoOp, for sexually active African American adolescent females aged 15 to 17 who have dropped out of school. To address the urgent needs of this high-risk population, the newly adapted Teen-Focused HIV prevention intervention will address knowledge about HIV and sexually transmitted infections (STIs);health consequences of substance abuse;healthy relationships with males;condom communication with partners;positive social supports;HIV, STI and pregnancy risk-reduction;and violence prevention methods.

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Research Triangle Institute
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Wechsberg, Wendee M; Browne, Felicia A; Zule, William A et al. (2017) Efficacy of the Young Women's CoOp: An HIV Risk-Reduction Intervention for Substance-Using African-American Female Adolescents in the South. J Child Adolesc Subst Abuse 26:205-218
Wechsberg, Wendee M; Doherty, Irene A; Browne, Felicia A et al. (2015) Gang membership and marijuana use among African American female adolescents in North Carolina. Subst Abuse Rehabil 6:141-50
Wechsberg, Wendee M; Browne, Felicia A; Ellerson, Rachel Middlesteadt et al. (2010) Adapting the evidence-based Women's CoOp intervention to prevent human immunodeficiency virus infection in North Carolina and international settings. N C Med J 71:477-81