The project seeks to describe the process and test the outcomes of psychoeducational interventions to lower sexual health risks and improve psychosocial adaptation in 260 young adults with a chronic disease, genital herpes. A general population of young adults with genital herpes, aged 18 to 35, who respond to newspaper advertisements will be recruited. Sexual health risk status and baseline psychosocial adaptation will be measured at an induction interview and at 3 and 6 months by self-administer questionnaires. Following induction into the study, subjects will be randomly assigned to an experimental group or a control group. Subjects in the experimental group will receive three 90-minute nurse-led psychoeducational sessions two weeks apart, stating within two weeks of induction. The study will implement a triangulation of research methods: 1) analysis of quantitative data from 220 subjects in a randomized clinical experiment of psychoeducational interventions will test the outcomes, sexual health risk reduction and psychosocial adaptation; and 2) analysis of qualitative data from unstructured interviews of 40 additional subjects (20 experimental and 20 control) and videotapes of the 20 experimental subjects receiving psychoeducational interventions will describe a psychosocial process, that is, the interaction between the psychoeducational intervention and the client to produce the outcomes. The first specific aim is to implement a longitudinal, quasi-experimental study to test the immediate and long-term effects of psychoeducational interventions by nurses from community-based agencies on decreasing the sexual health risks and improving the psychosocial adaptation of young adults with genital herpes. A repeated measures design will be used to compare outcomes of the dependent variables of sexual health risks (knowledge of and attitudes toward genital herpes; attitudes toward condom use; sexual health risk behaviors) and psychosocial adaptation (self- concealment; self-disclosure; self-concept; anxiety; depression, psychopathology, quality of life, and responses to genital herpes). Descriptive statistics will be used to describe the sample and variables. Within and between group differences will be tested using repeated measures analysis of variance. Path analysis will be used to assess the interactive nature of the dependent variables. A second specific aim is a qualitative evaluation of the psychoeducational interventions. Data will be collected by conducting unstructured interviews with 40 subjects (20 experimental and 20 control) and videotaping all sessions of the two groups in which the subjects participate. Analysis will use constant comparative methods of grounded theory.
