Adapting a sexual health and alcohol intervention for young adults and community dissemination

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Background: High-risk alcohol use and related sexual behavior (i.e., multiple partners, casual sex, sex without condoms/contraception) that may contribute to sexually transmitted infections (STIs) or unintended pregnancies during young adulthood is a significant public health concern. Moreover, women have magnified susceptibility and severity to alcohol-related sexual consequences compared to men due to biological and social vulnerabilities. Our prior research has shown a web-based brief intervention to be efficacious among an inclusive, national sample of young adults for reducing short-term alcohol and sexual behavior outcomes. Needed next steps for this intervention is to integrate effective contraceptive use as a behavioral outcome to support prevention of unintended pregnancies, extend the impact of the outcomes beyond 1-month, strengthen motivations for protective behavioral strategies, and disseminate the intervention to community-based settings for broader use. This two-aim study elicits preferences for adapting and disseminating the STARR intervention in a community-based setting.

Methods: For Aim 1, we are conducting focus groups with young adults (n=40) who have used alcohol and ineffective contraception/condom use in Texas to determine preferences for the intervention content adaptation and intervention dissemination approaches. We have stratified focus groups by biological sex and will compare focus group themes. In Aim 2, we are conducting interviews with community stakeholders (n=12) to determine the feasibility for community-based dissemination approaches. All audio-recordings from the focus groups and interviews are transcribed and thematic analysis will be conducted.

Results: Recruitment started in January 2022 and as of May 2022, 454 participants have been screened for eligibility and less than 5% met the eligibility criteria. Eleven participants have participated in the focus groups. After review of the recruitment process, we are adjusting the eligibility criteria to be less stringent (e.g., people in a monogamous relationship less than 6 months, women either using ineffective contraceptive use or inconsistent condom use). We recruited twelve participants to participate in the community stakeholder interviews representing social, substance use, sexual health, and health services.

Discussion: The expected outcome is establishing the content for an adapted, extended delivery of the alcohol and sexual health intervention with an emphasis on pregnancy and STI prevention. Findings will be grounded in community needs and preferences for dissemination to reach young adults.

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