Ewing Alexander C, Kottke Melissa J, Kraft Joan Marie, Sales Jessica M, Brown Jennifer L, Goedken Peggy, Wiener Jeffrey, Kourtis Athena P
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
Contemp Clin Trials. 2017 Mar;54:1-7. doi: 10.1016/j.cct.2016.12.014. Epub 2016 Dec 19.
African American adolescent females are at elevated risk for unintended pregnancy and sexually transmitted infections (STIs). Dual protection (DP) is defined as concurrent prevention of pregnancy and STIs. This can be achieved by abstinence, consistent condom use, or the dual methods of condoms plus an effective non-barrier contraceptive. Previous clinic-based interventions showed short-term effects on increasing dual method use, but evidence of sustained effects on dual method use and decreased incident pregnancies and STIs are lacking.
METHODS/DESIGN: This manuscript describes the 2GETHER Project. 2GETHER is a randomized controlled trial of a multi-component intervention to increase dual protection use among sexually active African American females aged 14-19years not desiring pregnancy at a Title X clinic in Atlanta, GA. The intervention is clinic-based and includes a culturally tailored interactive multimedia component and counseling sessions, both to assist in selection of a DP method and to reinforce use of the DP method. The participants are randomized to the study intervention or the standard of care, and followed for 12months to evaluate how the intervention influences DP method selection and adherence, pregnancy and STI incidence, and participants' DP knowledge, intentions, and self-efficacy.
The 2GETHER Project is a novel trial to reduce unintended pregnancies and STIs among African American adolescents. The intervention is unique in the comprehensive and complementary nature of its components and its individual tailoring of provider-patient interaction. If the trial interventions are shown to be effective, then it will be reasonable to assess their scalability and applicability in other populations.
非裔美国青少年女性意外怀孕和性传播感染（STIs）的风险较高。双重保护（DP）被定义为同时预防怀孕和性传播感染。这可以通过禁欲、持续使用避孕套或采用避孕套加有效的非屏障避孕方法来实现。以往基于诊所的干预措施显示，在增加双重避孕方法使用方面有短期效果，但缺乏对双重避孕方法使用的持续影响以及意外怀孕和性传播感染发生率降低的证据。
方法/设计：本手稿描述了“一起行动”项目。“一起行动”是一项随机对照试验，针对佐治亚州亚特兰大一家第十类诊所中14 - 19岁、有性行为且不想要孩子的非裔美国女性，开展多成分干预措施以增加双重保护的使用。该干预以诊所为基础，包括一个根据文化定制的交互式多媒体组件和咨询环节，既有助于选择双重保护方法，也能强化双重保护方法的使用。参与者被随机分配到研究干预组或标准护理组，随访12个月，以评估干预如何影响双重保护方法的选择和依从性、怀孕和性传播感染发生率，以及参与者的双重保护知识、意愿和自我效能。
“一起行动”项目是一项旨在减少非裔美国青少年意外怀孕和性传播感染的新型试验。该干预措施的独特之处在于其各组成部分的全面性和互补性，以及对医患互动的个性化定制。如果试验干预措施被证明有效，那么评估它们在其他人群中的可扩展性和适用性将是合理的。
