title: 2GETHER - The Dual Protection Project: Design and rationale of a randomized controlled trial to increase dual protection strategy selection and adherence among African American adolescent females.
abstract: 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.
  
  
  
  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.
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: yhy4@cdc.gov.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Ewing
authors.affiliation: Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Kottke
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Joan Marie
authors.initials: JM
authors.lastname: Kraft
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.affiliation: Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.affiliation: Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Peggy
authors.initials: P
authors.lastname: Goedken
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wiener
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
mesh_terms: D000293:Adolescent; D001741:Black or African American; D017280:Condoms; D003267:Contraception; D003376:Counseling; D005260:Female; D005845:Georgia / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D053208:Kaplan-Meier Estimate; D062405:Motivational Interviewing; D019212:Multimedia; D010349:Patient Compliance; D010353:Patient Education as Topic; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D020377:Self Efficacy; D012746:Sexual Abstinence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
keywords: Adolescents; Contraception; Dual protection; Reproductive health; Sexually transmitted infections; Unintended pregnancy