AIDS and Behavior

, Volume 23, Issue 5, pp 1195–1209 | Cite as

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

  • David H. BarkerEmail author
  • Wendy Hadley
  • Heather McGee
  • Geri R. Donenberg
  • Ralph J. DiClemente
  • Larry K. Brown
Original Paper


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.


Adolescents Sexual risk Family context Mental health Treatment modifiers 



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 Dr. Barker’s time was supported by a K23 award from the National Institute of Mental Health (K23MH102131).


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).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

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

Supplementary material

10461_2019_2400_MOESM1_ESM.docx (285 kb)
Supplementary material 1 (DOCX 284 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychiatryRhode Island HospitalProvidenceUSA
  2. 2.Department of Psychiatry and Human BehaviorThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Office of Medical EducationThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  4. 4.School of Public HealthUniversity of Illinois at ChicagoChicagoUSA
  5. 5.New York University College of Global Public HealthNew YorkUSA

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