Development and Testing of a Jamaican Mother-daughter HIV Risk-reduction Program

NCT03411577 | Completed

• 1 other identifier: R01NR010478
• Study Type: interventional
• Target: 662
• Locations: 0 countries
• Sites: N/A

Brief Summary

Caribbean nations, including Jamaica, exhibit HIV rates that are second only to sub-Saharan Africa. Jamaican young women and adolescent girls are at particularly high risk due to a number of cultural factors, gender norms, partnering with older male partners, and lack of knowledge and skills related to sexual refusal and HIV prevention. U.S. studies have shown that mothers may act as a key influence of their daughters' sexual risk beliefs and behaviors. However, no such studies have documented these effects outside of the U.S. and no studies have evaluated HIV risk-reduction interventions with Jamaican adolescent girls and their mothers. Hence, the purpose of this study is to partner with the University of the West Indies, Jamaican community based organizations (CBOs) and families in order to develop and test a culture-specific mother-daughter HIV risk-reduction intervention in a randomized field experiment. Specifically, the investigative team will evaluate whether a culture-specific, theory-based, skill-building intervention with Jamaican adolescent girls and their mothers can directly and/or indirectly reduce these girls' HIV risk-associated sexual behaviors. Jamaican girls, ages 13 - 17, and their mothers/female guardians will be recruited from CBOs and randomly assigned to either: (a) a mother-daughter HIV risk-reduction intervention condition or (b) a "no intervention" waitlist control condition. The HIV risk-reduction intervention includes 12 1-hour modules scheduled over 2 days and implemented by trained adult Jamaican women (nurses and CBO staff). The mother component is designed to increase those parenting behaviors (e.g., monitoring and parent-teen sexual risk communication \[PTSRC\]) associated with reduced adolescent sexual risk-taking; the teen component is designed to improve girls' beliefs and skills related to abstinence, sexual negotiation and condom use. A "waitlist" control condition is being employed as the proposed project is a pilot study of the HIV risk-reduction intervention. Primary outcomes include mothers'/daughters' reports of parenting behaviors (monitoring and PTSRC) and daughters' self-reports of sexual risk behaviors (sexual intercourse, unprotected sex, condom use, number of partners). Secondary outcomes include daughters' STI rates, mothers' beliefs regarding parenting behaviors and daughters beliefs regarding sexual risk behaviors.

Conditions

Parent-Child Relations; HIV Prevention; Adolescent Behavior

Outcome Measures

Primary Outcomes (1)

• Change in adolescent girls' baseline self-reported frequency of condom use at 3 and 6 months

  Questionnaire - self-reported single item asking frequency of condom use during past 3 months; scores range from 1 - 5; higher scores indicate greater frequency of condom use

  Assessed at baseline, 3- and 6-months; reported for past 3 months

Secondary Outcomes (6)

• Adolescent girls' clinically documented STIs

  Assessed at baseline and 6-month follow-up

• Change in adolescent girls' baseline self-reported condom use intentions at 3 and 6 months

  Assessed at baseline, 3- and 6-months; reported for next 3 months

• Change in adolescent girls' baseline HIV knowledge scale scores at 3 and 6 months

  Assessed at baseline and 3- and 6-month follow-up

• Changes in mothers' baseline HIV knowledge scale scores at 3 and 6 months

  Assessed at baseline and 3- and 6-month follow-up

• Change in mothers' baseline parental monitoring scale scores at 3 and 6 months

  Assessed at baseline and 3- and 6-month follow-up; reported for past 3 months

Study Arms (2)

Behavioral Intervention

EXPERIMENTAL

The adolescent HIV/STI risk-reduction intervention aims to: (a) increase knowledge of HIV risk and prevention; (b) strengthen behavioral beliefs regarding abstinence and safer sex; (c) increase self-efficacy and intentions to avoid unsafe sex; and (d) increase sexual communication and refusal skills. The mother component includes much of the same prevention knowledge and addresses parent-teen sexual risk communication, monitoring, and sexual role modeling. Interventions are held on two consecutive Saturdays for 6 hours each day. Mothers' groups meet separately from daughters' groups, although the groups will come together for the last module of each day.

Other: Behavioral Intervention

Control Group

NO INTERVENTION

The control / comparison group is essentially a "no intervention / wait-list" control group. However, during pilot testing, participants expressed a strong desire to engage in some type of health activity. As a result, the control group members, both mothers and daughters, participated in a brief educational activity on reducing risk for cardiovascular disease. The educational activity was limited to a few hours on one Saturday. Participants returned the following week to complete post-test questionnaires along with the participants in the experimental group.

Interventions

Behavioral Intervention OTHER

Behavioral Intervention

Eligibility Criteria

• Age: 13 Years - 17 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• age between 13- to 17-years, inclusive
• resident of one of the three parishes in and around Kingston, Jamaica (the study area)
• plan to reside in the "study area" for the next 12 months
• able to read, write and understand English
• unmarried and
• agrees to participate and
• mother or primary female guardian also agrees to participate.
• age greater than 18
• resident of one of the three parishes in and around Kingston, Jamaica (the study area)
• plan to reside in the "study area" for the next 12 months
• able to read, write and understand English and
• agrees to participate

You may not qualify if:

• adolescent and/or mother who is/are disruptive and/or otherwise unable to participate in small group intervention activities
• adolescent who is married

Sponsors & Collaborators

• Boston College: lead
• University of the West Indies, Mona Campus, Kingston, Jamaica: collaborator
• University of Pennsylvania: collaborator
• New York University: collaborator

Related Publications (8)

• Hutchinson MK, Smith TK, Waldron N, Kahwa E, Hewitt HH, Hamilton PI, Kang SY. Validation of the Jamaican Maternal Sexual Role Modelling Questionnaire. West Indian Med J. 2012 Dec;61(9):897-902. doi: 10.7727/wimj.2011.198.

  PMID: 24020230 BACKGROUND

• Waldron, N., Hutchinson, M.K., Hewitt, H., Kahwa, E., & Hamilton, P. (2012). Cross-cultural psychometric assessment of the parent-teen sexual risk communication scale in Jamaica. Open Journal of Preventive Medicine, 2(2), 205-213

  BACKGROUND

• Hutchinson MK, Wood EB. Reconceptualizing adolescent sexual risk in a parent-based expansion of the Theory of Planned Behavior. J Nurs Scholarsh. 2007;39(2):141-6. doi: 10.1111/j.1547-5069.2007.00159.x.

  PMID: 17535314 BACKGROUND

• Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.

  BACKGROUND

• Hutchinson MK. The Parent-Teen Sexual Risk Communication Scale (PTSRC-III): instrument development and psychometrics. Nurs Res. 2007 Jan-Feb;56(1):1-8. doi: 10.1097/00006199-200701000-00001.

  PMID: 17179868 BACKGROUND

• Hutchinson MK, Jemmott LS, Wood EB, Hewitt H, Kahwa E, Waldron N, Bonaparte B. Culture-specific factors contributing to HIV risk among Jamaican adolescents. J Assoc Nurses AIDS Care. 2007 Mar-Apr;18(2):35-47. doi: 10.1016/j.jana.2007.01.008.

  PMID: 17403495 RESULT

• Kang SY, Hutchinson MK, Waldron N. Characteristics related to sexual experience and condom use among Jamaican female adolescents. J Health Care Poor Underserved. 2013 Feb;24(1):220-32. doi: 10.1353/hpu.2013.0023.

  PMID: 23377730 RESULT

• Hutchinson MK, Kahwa E, Waldron N, Hepburn Brown C, Hamilton PI, Hewitt HH, Aiken J, Cederbaum J, Alter E, Sweet Jemmott L. Jamaican mothers' influences of adolescent girls' sexual beliefs and behaviors. J Nurs Scholarsh. 2012 Mar;44(1):27-35. doi: 10.1111/j.1547-5069.2011.01431.x. Epub 2012 Feb 16.

  PMID: 22339731 RESULT

MeSH Terms

Conditions

Adolescent Behavior

Interventions

Behavior Therapy

Condition Hierarchy (Ancestors)

Behavior

Intervention Hierarchy (Ancestors)

Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Mary K Hutchinson, PhD

  Boston College

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Data collectors were unaware of group assignment of participants.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Mother-daughter dyads were randomly assigned to either HIV risk-reduction intervention group or control group

Study Record Dates

• First Submitted: January 3, 2018
• First Posted: January 26, 2018
• Study Start: September 29, 2007
• Primary Completion: July 28, 2011
• Study Completion: June 30, 2012
• Last Updated: January 26, 2018

Record last verified: 2018-01