Youth Drug Abuse Prevention in Kazakhstan
Condition: Drug Use
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      This pilot study will adapt and test the feasibility and estimate the effect size parameters
      of Kazakhstani Family Together (KFT), a family-based multi-media intervention designed to
      reduce sexual and drug-related risks for HIV infection among at-risk 14-17 year old females
      and males living in communities highly affected by heroin trade and use in Almaty,
      Kazakhstan.
    

Detailed description: 
      The purpose of this study is to adapt an evidence-based HIV and substance use prevention
      intervention for most at-risk adolescents and their caregivers (parents or other adult family
      members) from drug-risk communities in Kazakhstan. Located on major drug trafficking routes
      (between Afghanistan, the world's largest opium producer, and Russia), Central Asia and
      Kazakhstan, in particular, face one of the fastest growing rates of HIV infection in the
      world disproportionately affecting young people ages 15-29. Youth exposed to drugs at home
      and in the community are particularly at risk.

      The country's HIV prevention efforts for youth are limited to a knowledge-based approach,
      which does not equip at-risk youth with skills required to deal with situations of risk
      exposure. Parents or other caregivers, who represent a significant protective force in a
      family-oriented culture of Central Asia, are largely excluded from youth prevention efforts
      in Kazakhstan.

      KFT is a family-based multi-media intervention designed to reduce sexual and drug-related
      risks for HIV infection among at-risk adolescents. To address the dual risk of HIV and
      substance use, the proposed intervention combines empirically tested skills-based and family
      involvement approaches and utilizes multi-media computer technology to develop an engaging
      and potentially cost-effective tool with high fidelity and easy scalability. During each of
      the sessions, youth and caregivers will participate in interactive computer activities to
      learn skills and have conversations focused on risky behaviors.

      During the development stage, the US and Kazakhstani investigative team will conduct
      formative research and will work closely with the local Community Collaborative Board to
      adapt the intervention to the cultural context of at-risk families in Kazakhstan.

      Further, the KFT intervention will be tested in a pilot Randomized Controlled Trial with 248
      adolescents and 248 of their caregivers. Intervention arm adolescent-caregiver pairs will
      receive three 45-minute interactive multi-media sessions with avatars customized to
      participants' gender that will focus on risk reduction self-efficacy, resistance to peer
      pressure, and caregiver-adolescent communication, support and monitoring. Adolescents from
      both intervention and control arms will receive the usual care services available for at-risk
      youth, which includes health education sessions on HIV and drug use delivered by peer
      educators and outreach workers.
    

Intervention name(s): Kazakhstani Family Together; Usual Care Alone
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Adolescent-caregiver pairs will receive three 45-minute interactive multi-media sessions with avatars customized to participants' gender that will focus on risk reduction self-efficacy, resistance to peer pressure, decision-making skills and caregiver-adolescent communication, support and monitoring to strengthen youth's relationships with caregivers and reduce youth's risks of drug use and sexual risk behaviors. Through the multimedia tool, participants will confront a series of sexual risks and substance use related situations and will practice their listening, empathy, assertiveness, refusal, and other interpersonal skills. Each caregiver-youth pair will work jointly and engage in discussions, exercises, and behavioral rehearsal as directed by the program.; Adolescents from both study arms will receive the usual care, a health education program about how to prevent drug use and HIV/STIs (sexually transmitted infections). The health education curriculum is delivered in a group format by trained peer educators and outreach workers. The curriculum consists of three 45-minute sessions that include lectures and interactive quizzes about drugs and HIV. These three sessions include information on the following topics:
Facts and Myth about HIV. HIV/STIs modes of transmission;
Prevention of HIV. Abstinence and Safe Sex. Attitudes and values about sexuality, sexual risk behaviors, and condom use;
Knowledge, attitudes and beliefs about drinking and drug use. Risks and consequences of drug use.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Kazakhstan; Central Asia; HIV prevention; Adolescents; Sexual risk behaviors; Drug abuse prevention; Multi-media intervention; Drug use