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Evaluating the Role of Family Context Within a Randomized Adolescent HIV-Risk Prevention Trial

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Abstract

Project STYLE is a multi-site 3-arm RCT comparing family-based, adolescent-only, and general health promotion interventions with 721 adolescents in mental health treatment. This study reports 12-month outcomes for family context and sexual risk behaviors, and explores the role of baseline family context in modifying treatment response. Using the full sample, there were sustained benefits for parent-reported sexual communication (d = 0.28), and adolescent-reported parental monitoring (d = 0.24), with minimal differences in risk behaviors. Latent profile analysis identified four family context classes: struggling (n = 177), authoritative (n = 183), authoritarian (n = 175), and permissive (n = 181). The authoritarian and permissive classes were also distinguished by disagreement between parent and adolescent report of family context. Classes differed in terms of baseline mental health burden and baseline sexual risk behavior. Classes showed different patterns of treatment effects, with the struggling class showing consistent benefit for both family context and sexual risk. In contrast, the authoritarian class showed a mixed response for family context and increased sexual risk.

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Acknowledgements

This research was supported by a National Institute of Mental Health Grant R01MH 63008 to Rhode Island Hospital and by a National Institute of Allergy and Infectious Diseases Grant P30 AI042853 to the Lifespan/Tufts/Brown Center for AIDS Research. The trial is registered as NCT00496691 on clinicaltrials.gov. Dr. Barker’s time was supported by a K23 award from the National Institute of Mental Health (K23MH102131).

Funding

This study was funded by the following grants: National Institute of Mental Health (R01MH 63008); National Institute of Allergy and Infectious Diseases (P30AI042853); and National Institute of Mental Health (K23MH102131).

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Authors and Affiliations

  1. Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA

    David H. Barker, Wendy Hadley & Larry K. Brown

  2. Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA

    David H. Barker, Wendy Hadley & Larry K. Brown

  3. Office of Medical Education, The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Heather McGee

  4. School of Public Health, University of Illinois at Chicago, Chicago, IL, USA

    Geri R. Donenberg

  5. New York University College of Global Public Health, New York, NY, USA

    Ralph J. DiClemente

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  1. David H. Barker
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  2. Wendy Hadley
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  3. Heather McGee
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  4. Geri R. Donenberg
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  5. Ralph J. DiClemente
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Correspondence to David H. Barker.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all parents/caregivers and assent was obtained from all participants under the age of 18.

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Barker, D.H., Hadley, W., McGee, H. et al. Evaluating the Role of Family Context Within a Randomized Adolescent HIV-Risk Prevention Trial. AIDS Behav 23, 1195–1209 (2019). https://doi.org/10.1007/s10461-019-02400-3

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