title: The Respecting the Circle of Life trial for American Indian adolescents: rationale, design, methods, and baseline characteristics.
abstract: This paper describes the rationale, design, methods, and baseline results of a randomized controlled trial to evaluate the impact of an adapted evidence-based intervention (EBI), "Respecting the Circle of Life" (RCL) to reduce behavioral risks for HIV/AIDS among American Indian (AI) adolescents. A participatory approach shaped intervention adaptation and study design. A total of 267 participants (aged 13-19) were randomized by peer groups of the same sex to receive the RCL intervention or a control condition. Self-report assessments were administered at four intervals. The sample was predominately female (57%), had low HIV knowledge prevention scores, early sexual initiation (mean 14.6 years), and 56% reported intention to use a condom at next sex. Baseline characteristics were evenly distributed between groups with the exception of age and extrinsic reward scores. This is the first rigorous evaluation of an adapted EBI for HIV/AIDS prevention among AI adolescents, an at-risk and understudied population.
authors.affiliation: a Department of International Health, Johns Hopkins Center for American Indian Health , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Tingey
authors.forename: Britta
authors.initials: B
authors.lastname: Mullany
authors.forename: Rachel
authors.initials: R
authors.lastname: Chambers
authors.forename: Ranelda
authors.initials: R
authors.lastname: Hastings
authors.forename: Allison
authors.initials: A
authors.lastname: Barlow
authors.forename: Anne
authors.initials: A
authors.lastname: Rompalo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017280:Condoms / Q000706:statistics & numerical data*; D065246:Culturally Competent Care; D055317:Evidence-Based Practice; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology*; D015206:Southwestern United States / Q000453:epidemiology
keywords: American Indian; HIV/AIDS; adolescents; evidence-based intervention; paraprofessional interventionists; randomized controlled trial