During its first two funding periods, our interdisciplinary research team from the University of Maryland and University of Pennsylvania has developed and is completing evaluation of a face-to-face (FTF) HIV/STD risk reduction intervention targeting African-American adolescents, """"""""Focus on Kids"""""""" (FOK), and parental monitoring intervention (imPACT). The adolescent intervention consists of a primary series of weekly 1.5 hour sessions (FOK-Basic). In an evaluation of FOK-Basic, unprotected sex was decreased six months post intervention among intervention youth compared to control youth, but these differences were no longer significant at 12 months. Following a booster at 15 months (FOK+), differences were again significant at 18 months. IMPACT is a one session intervention with a parent and his/her adolescent. Two months post- intervention there is evidence of enhanced parental monitoring by parents who received the intervention. These findings merge with a growing consensus that: 1) FTF interventions can reduce adolescent risk behavior; and 2) there is an urgent need to identify these approaches which sustain intervention impact over prolonged periods of time. In addition to having developed and evaluated the interventions, our research team has developed appropriate assessment tools and thus is well positioned to address these issues. Accordingly, for this competitive renewal, the current proposal requests funding to conduct a randomized, longitudinal effectiveness evaluation among 840 youth residing in Baltimore to determine: 1) whether one or more of the """"""""embellished"""""""" FOK risk reduction intervention approaches (FOK-Basic/ImPACT or FOK+ImPACT) compared to a standard-of-care FTF intervention (FOK-Basic) results in significantly lower rates of unprotected sexual intercourse over two years among African-American adolescents ages 13-16 years at baseline?; and, 2) whether we can identify the mechanism(s) through which the """"""""embellished"""""""" interventions exert their enhanced intervention effect. Subjects will be recruited from 24 public housing developments in Baltimore. Following completion of baseline measures, subjects will be randomly assigned (at the level of the housing developments) to one of these four study conditions. Subjects will be followed for two years (2, 6, 12, 18, and 24 months) to post-intervention.
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