This 4-year competing continuation will extend the follow-up for 750 subjects enrolled in a randomized interventions trial, Project STYLE: """"""""HIV Prevention for Youth with Severe Mental Illness"""""""" (R01, MH 63008). Extending the follow-up from one year to 36 months will 1) discern the long-term impact of the Project STYLE interventions and 2) permit complex modeling of the predictors and trajectories of sexual health (delay of sex) and risk (incident STIs). Adolescents, particularly those in mental health treatment, are at risk for HIV because of sexual and substance behaviors. Parent-child communication about sexual topics and parental supervision are associated with delays in the onset of sexual activity and more responsible sexual behavior;thus, the parent project, Project STYLE, is a randomized trial that is evaluating the comparative efficacy of three interventions: a) family-based HIV prevention intervention, b) adolescent-only HIV prevention intervention, and c) general health promotion intervention. This multi-site project (Rhode Island Hospital, Emory University, and the University of Illinois at Chicago) is enrolling an ethnically/racially/geographically diverse group of 750 adolescents in outpatient mental health treatment and their parents. Subjects receive a full day group intervention on the day of randomization, return in two weeks for an individual session, participate in a half day booster session three months later, and are assessed six and 12 months after the intervention. This application offers a unique opportunity to assess this already ascertained sample at three additional points (24,30, and 36 months). This is important because few studies have examined the longer-term predictors of the delay of sex and incident STIs over 36 months using a comprehensive array of family functioning, family monitoring/communication, and trauma history. Additionally, this continuation will provide important data concerning the long-term impact of Project STYLE'S theoretically based HIV prevention programs which are designed to maintain safe sexual behaviors. The Family-Based program has increased parent/adolescent sexual communication and reduced adolescent unprotected sex after six months and extended assessment will determine whether these benefits are maintained over time. Public Health Significance: (1) Examination of the long-term impact of HIV prevention programs will guide the development of programs that are highly effective at maintaining safe adolescent behavior. (2) Understanding factors related to delay of sex and STI incidence especially among vulnerable youth with high rates of psychiatric comorbidities is important in reducing HIV infections.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Application #
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Stoff, David M
Project Start
Project End
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Budget End
Support Year
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Rhode Island Hospital
United States
Zip Code
Hadley, Wendy; Lansing, Amy; Barker, David H et al. (2018) The longitudinal impact of a family-based communication intervention on observational and self-reports of sexual communication. J Child Fam Stud 27:1098-1109
Hadley, Wendy; Brown, L K; Barker, D et al. (2016) Work It Out Together: Preliminary Efficacy of a Parent and Adolescent DVD and Workbook Intervention on Adolescent Sexual and Substance Use Attitudes and Parenting Behaviors. AIDS Behav 20:1961-72
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Brown, Larry K; Hadley, Wendy; Donenberg, Geri R et al. (2014) Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment. Psychiatr Serv 65:338-44
Hadley, Wendy; Barker, David H; Lescano, Celia M et al. (2014) Associations Between Psychiatric Impairment and Sexual Risk Behavior Among Teens in Mental Health Treatment. J HIV AIDS Soc Serv 13:198-213
Joppa, Meredith C; Rizzo, Christie J; Brown, Larry K et al. (2014) Internalizing Symptoms and Safe Sex Intentions among Adolescents in Mental Health Treatment: Personal Factors as Mediators. Child Youth Serv Rev 46:177-185
Hadley, Wendy; Stewart, Angela; Hunter, Heather L et al. (2013) Reliability and Validity of the Dyadic Observed Communication Scale (DOCS). J Child Fam Stud 22:279-287
Lang, Delia L; Rieckmann, Traci; Diclemente, Ralph J et al. (2013) Multi-level factors associated with pregnancy among urban adolescent women seeking psychological services. J Urban Health 90:212-23
Stewart, Angela J; Theodore-Oklota, Christina; Hadley, Wendy et al. (2012) Mania symptoms and HIV-risk behavior among adolescents in mental health treatment. J Clin Child Adolesc Psychol 41:803-10
Seth, Puja; Lang, Delia L; Diclemente, Ralph J et al. (2012) Gender differences in sexual risk behaviours and sexually transmissible infections among adolescents in mental health treatment. Sex Health 9:240-6

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