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电子健康家庭联合初级保健计划的基本原理和设计:在儿科初级保健诊所为西班牙裔青年提供药物使用、性风险行为和性传播感染预防干预。

Rationale and design for eHealth Familias Unidas Primary Care: A drug use, sexual risk behavior, and STI preventive intervention for hispanic youth in pediatric primary care clinics.

机构信息

Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.

Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.

出版信息

Contemp Clin Trials. 2019 Jan;76:64-71. doi: 10.1016/j.cct.2018.11.005. Epub 2018 Nov 17.

Abstract

Family-based behavioral interventions are efficacious and effective in preventing drug use and sexual risk behaviors; unfortunately, they have not been evaluated and disseminated in pediatric primary care practice, where they can have a significant impact. There is an increased focus on integrating parenting interventions into primary care to reduce health disparities among ethnic minorities such as Hispanics. Although Hispanic youth demonstrate higher levels of drug use and sexual risk behaviors than their non-Hispanic counterparts, few parenting interventions are available for Hispanic youth, and none have been delivered specifically to Hispanic adolescents in primary care. Therefore, this manuscript describes the rationale and design of an Internet-based, family-centered, Hispanic-specific, evidence-based prevention intervention, eHealth Familias Unidas Primary Care. Hispanic adolescents (n = 456) and their care givers will be recruited from pediatric primary care clinics in South Florida and randomized to: eHealth Familias Unidas Primary Care or prevention as usual. The intervention will be delivered by trained interns, clinic volunteers, social workers, mental health counselors, students, and nurses. Outcomes will be measured at baseline and 6, 12, 24, and 36 months post-baseline. This study will determine whether the intervention, compared to prevention as usual, is effective in reducing drug use, unprotected sex, and STI incidence in Hispanic youth through the improvement of family functioning. Additionally, we will determine the cost effectiveness of delivering eHealth Familias Unidas within primary care settings. The effectiveness of eHealth Familias Unidas Primary Care will further inform the need to integrate effective behavioral health interventions into primary care settings.

摘要

基于家庭的行为干预措施在预防药物使用和性风险行为方面是有效和有效的;不幸的是,它们尚未在儿科初级保健实践中进行评估和推广,而在儿科初级保健实践中,它们可以产生重大影响。越来越关注将育儿干预措施纳入初级保健,以减少西班牙裔等少数民族的健康差距。尽管西班牙裔青年的药物使用和性风险行为水平高于非西班牙裔同龄人,但针对西班牙裔青年的育儿干预措施很少,而且没有专门针对西班牙裔青少年在初级保健中提供的干预措施。因此,本文描述了基于互联网的、以家庭为中心的、针对西班牙裔的、基于证据的预防干预措施 eHealth Familias Unidas Primary Care 的基本原理和设计。将从南佛罗里达州的儿科初级保健诊所招募西班牙裔青少年(n=456)及其照顾者,并将他们随机分为:eHealth Familias Unidas Primary Care 或常规预防。干预措施将由经过培训的实习医生、诊所志愿者、社会工作者、心理健康顾问、学生和护士提供。结果将在基线和 6、12、24 和 36 个月时进行测量。本研究将确定与常规预防相比,该干预措施是否通过改善家庭功能,有效减少西班牙裔青年的药物使用、无保护性行为和性传播感染的发生率。此外,我们将确定在初级保健环境中提供 eHealth Familias Unidas 的成本效益。eHealth Familias Unidas Primary Care 的有效性将进一步说明需要将有效的行为健康干预措施纳入初级保健环境。

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