Bradley/Hasbro Children's Research Center of Rhode Island Hospital, and the Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
J Am Acad Child Adolesc Psychiatry. 2011 Oct;50(10):1065-74. doi: 10.1016/j.jaac.2011.06.018. Epub 2011 Aug 27.
To evaluate the effectiveness of Safe Thinking and Affect Regulation (STAR), a 14-session HIV-prevention program for adolescents at alternative/therapeutic schools. Because these youth frequently have difficulties with emotions and cognitions, it was designed to improve sexuality-specific affect management and cognitive monitoring, as well as HIV-related knowledge and attitudes. It was hypothesized that STAR would lead to a decrease in sexual risk and improved HIV knowledge and attitudes.
Fourteen schools were randomly assigned by year either to the STAR intervention or a brief educational program. Schools received the alternate intervention the following year. A total of 185 adolescents in 29 cohorts (groups) participated in the interventions. Assessment of sexual behavior, knowledge and attitudes with audio computer-assisted self-interviews occurred at 3, 6, and 9 months post intervention.
Hierarchical linear model (HLM) analyses found that adolescents in the STAR intervention reported a significantly greater decrease (p < .05) in the Sexual Risk Index than youth in the control group over the 6 months post intervention and similar improvements in the HIV Knowledge Scale and the Condom Use Self Efficacy Scale. There were no group differences between 6 and 9 months post intervention.
This STAR intervention for youth in alternative schools was associated with decreased sexual risk for 6 months after the intervention. These data suggest that intervention strategies that target cognitions and affect within a sexual context might be usefully applied to improving sexual behavior but may need to be reinforced over time. Clinical trial registration information--HIV, Abuse, and Psychiatric Disorders Among Youth; http://clinicaltrials.gov; NCT00603369.
评估针对替代/治疗学校青少年的为期 14 节的艾滋病毒预防项目 Safe Thinking 和情感调节（STAR）的有效性。由于这些年轻人经常在情绪和认知方面存在困难，因此该项目旨在提高与性行为相关的情感管理和认知监控能力，以及与艾滋病毒相关的知识和态度。假设 STAR 将降低性风险并改善艾滋病毒知识和态度。
按年份将 14 所学校随机分为 STAR 干预组或简短教育计划组。次年，学校接受替代干预。共有 185 名青少年参加了 29 个组的干预。在干预后 3、6 和 9 个月，使用音频计算机辅助自我访谈评估性行为、知识和态度。
分层线性模型（HLM）分析发现，与对照组相比，STAR 干预组青少年在干预后 6 个月内报告的性风险指数显著下降（p <.05），并且在艾滋病毒知识量表和 condom 使用自我效能量表方面也有类似的改善。在干预后 6 至 9 个月，两组之间没有差异。
针对替代学校青少年的 STAR 干预措施与干预后 6 个月的性风险降低相关。这些数据表明，针对性行为背景下的认知和情感的干预策略可能有助于改善性行为，但可能需要随着时间的推移进行强化。临床试验注册信息 - 艾滋病毒、滥用和青少年精神障碍；http://clinicaltrials.gov；NCT00603369。
