The authors are with the Bloomberg School of Public Health, Center for American Indian Health, Johns Hopkins University, Baltimore, MD.
Am J Public Health. 2021 Oct;111(10):1874-1884. doi: 10.2105/AJPH.2021.306447. Epub 2021 Sep 16.
To evaluate the efficacy of the Respecting the Circle of Life program (RCL) among Native American youths 11 to 19 years of age residing in a rural reservation community in the southwestern United States. Between 2016 and 2018, we conducted a randomized controlled trial of the RCL program with 534 Native youths. Participants completed assessments at baseline and 9 and 12 months after the intervention. We conducted intention-to-treat analyses based on study group randomization. At 9 months, intervention participants had significantly better condom use self-efficacy (< .001), higher intentions to use condoms ( = .024) and abstain from sex ( = .008), and better contraceptive use self-efficacy ( < .001) than control participants, as well as better condom use ( = .032) and contraceptive use ( = .002) negotiation skills. At 12 months, intervention participants had significantly better sexual and reproductive health knowledge ( = .021), condom use self-efficacy ( < .001), contraceptive use self-efficacy ( < .001), and contraceptive use negotiation skills ( = .004) than control participants. Intervention participants reported significantly more communication with their parents about sexual and reproductive health than control participants at both 9 and 12 months ( = .042 and = .001, respectively). The RCL program has a significant impact on key factors associated with pregnancy prevention among Native youths and should be used as an adolescent pregnancy prevention strategy. Clinical Trials.gov identifier: NCT02904629. (. 2021;111(10): 1874-1884. https://doi.org/10.2105/AJPH.2021.306447).
评估“尊重生命圈”（RCL）项目对居住在美国西南部农村保留地的 11 至 19 岁美国原住民青年的疗效。在 2016 年至 2018 年期间，我们对 RCL 项目进行了一项随机对照试验，共有 534 名美国原住民青年参与。参与者在干预前、干预后 9 个月和 12 个月进行评估。我们根据研究组随机分组进行意向性治疗分析。在 9 个月时，干预组参与者的避孕套使用自我效能显著提高（<0.001），使用避孕套（=0.024）和禁欲（=0.008）的意愿更高，以及更好的避孕使用自我效能（<0.001），而对照组参与者的避孕套使用（=0.032）和避孕使用（=0.002）谈判技巧也更好。在 12 个月时，干预组参与者在性与生殖健康知识（=0.021）、避孕套使用自我效能（<0.001）、避孕使用自我效能（<0.001）和避孕使用谈判技巧（=0.004）方面显著优于对照组参与者。与对照组相比，干预组参与者在 9 个月和 12 个月时都报告与父母就性与生殖健康进行了更多的沟通（=0.042 和=0.001）。RCL 项目对与美国原住民青年妊娠预防相关的关键因素产生了重大影响，应作为青少年妊娠预防策略加以利用。临床试验.gov 标识符：NCT02904629。（2021；111（10）：1874-1884。https://doi.org/10.2105/AJPH.2021.306447）。
