Denne siden ble automatisk oversatt og nøyaktigheten av oversettelsen er ikke garantert. Vennligst referer til engelsk versjon for en kildetekst.

Engineering an Online STI Prevention Program: CSE2

3. juli 2019 oppdatert av: Linda Collins, Penn State University

The Intersection of Alcohol and Sex: Engineering an Online STI Prevention Program

The overall objective of the proposed research is to reduce the incidence of sexually transmitted infections (STIs) among college students. The investigators propose to accomplish this by using the innovative, engineering-inspired multiphase optimization strategy (MOST) to develop a highly effective, appealing, economical, and readily scalable internet-delivered behavioral intervention targeting the intersection of alcohol use and sexual risk behavior. The rate of STIs on college campuses is alarming: one in four college students is diagnosed with an STI at least once during their college experience. Sexual activity when drinking alcohol is highly prevalent among college students. Alcohol use is known to contribute to the sexual risk behaviors that are most responsible for the transmission of STIs, namely unprotected sex, contact with numerous partners, and "hook-ups" (casual sexual encounters). Few interventions have been developed that explicitly target the intersection of alcohol use and sexual risk behaviors, and none have been optimized. In order to reduce the incidence of STI transmission among this and other high-risk groups, a new approach is needed. MOST is a comprehensive methodological framework that brings the power of engineering principles to bear on optimization of behavioral interventions. MOST enables researchers to experimentally test the individual components in an intervention to determine their effectiveness, indicating which components need to be revised and re-tested. Given the high rates of alcohol use and sex among college students, the college setting provides an ideal opportunity for intervening on alcohol use and sexual risk behaviors. The proposed study will include a diverse population of college students on 4 campuses which will increase the generalizability of the findings. The specific aims are to (1) develop and pilot test an initial set of online intervention components targeting the link between alcohol use and sexual risk behaviors, (2) use the MOST approach to build an optimized preventive intervention, and (3) evaluate the effectiveness of the newly optimized preventive intervention using a fully powered randomized controlled trial (RCT). This work will result in a new, more potent behavioral intervention that will reduce the incidence of STIs among college students in the US, and will lay the groundwork for a new generation of highly effective STI prevention interventions aimed at other subpopulations at risk.

Studieoversikt

Status

Fullført

Intervensjon / Behandling

Detaljert beskrivelse

As part of the MOST approach, the investigators will conduct a series of screening experiments to build an optimized intervention. The current study is the second (of two) screening experiments. The first screening experiment corresponds to clinicaltrials.gov ID # NCT02897804.

Studietype

Intervensjonell

Registrering (Faktiske)

2946

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • California
      • Fresno, California, Forente stater, 93740
        • Fresno State University
    • North Dakota
      • Fargo, North Dakota, Forente stater, 58108
        • North Dakota State University
    • Tennessee
      • Murfreesboro, Tennessee, Forente stater, 37132
        • Middle Tennessee State University
    • Texas
      • College Station, Texas, Forente stater, 77843
        • Texas A&M University

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 30 år (Voksen)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Currently enrolled at an American college or university
  • A first-year student or first-year transfer student
  • 18 years of age or older
  • Have not gone through previous versions of itMatters before

Exclusion Criteria:

  • Not a first-year student or transfer student
  • Younger than 18 years of age
  • Have gone through previous versions of itMatters

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Faktoriell oppgave
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Kunnskap alene
Deltakerne vil ha tilgang til kunnskapsmodulen i en periode på inntil 3 uker.
Increase knowledge relate d STIs, STI risk, alcohol impairment, condom use skills, alcohol use behavior tracking skills, testing & treatment services.
Eksperimentell: Self-efficacy alene
Deltakerne vil ha tilgang til kunnskapsmodulen pluss self-efficacy-modulen i en periode på inntil 3 uker.
Increase self-efficacy to us e protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Forbudsnormer alene
Deltakerne vil ha tilgang til kunnskapsmodulen pluss påbudsnormmodulen i en periode på inntil 3 uker.
Correct misperceptions regarding approval of alcohol misuse & sexual risk taking.
Eksperimentell: Beskrivende normer og self-efficacy
Deltakerne vil ha tilgang til kunnskapsmodulen pluss de beskrivende normene og self-efficacy-modulene i en periode på inntil 3 uker.
Korriger feiloppfatninger av utbredelsen av alkoholindusert seksuell risikoatferd, alkoholbruk/misbruk og seksuell risikoatferd og øk selveffektiviteten for å bruke beskyttende atferdsstrategier (f.eks. ferdigheter i kondomforhandling) for å redusere ubeskyttet sex.
Eksperimentell: Beskrivende normer og opplevd nytte
Deltakerne vil ha tilgang til kunnskapsmodulen pluss de beskrivende normer og opplevde fordelsmoduler i en periode på inntil 3 uker.
Korriger feiloppfatninger av utbredelsen av alkoholindusert seksuell risikoatferd, alkoholbruk/misbruk og seksuell risikoatferd og øk opplevde fordeler ved å bruke beskyttende atferdsstrategier for å redusere de negative konsekvensene av å delta i seksuell atferd under påvirkning av alkohol.
Eksperimentell: Beskrivende normer og påbudsnormer
Deltakerne vil ha tilgang til kunnskapsmodulen pluss modulene beskrivende normer og påbudsnormer i en periode på inntil 3 uker.
Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors and correct misperceptions regarding approval of alcohol misuse & sexual risk taking.
Eksperimentell: Forventninger alene
Deltakerne vil ha tilgang til kunnskapsmodulen pluss forventningsmodulen i en periode på inntil 3 uker.
Reduser forventningen om at alkohol er nødvendig for å ha et godt seksuelt møte.
Eksperimentell: Forventninger og selvtillit
Deltakerne vil ha tilgang til kunnskapsmodulen pluss forventnings- og egeneffektivitetsmodulene i en periode på opptil 3 uker.
Reduser forventningen om at alkohol er nødvendig for å ha et godt seksuelt møte og øke selveffektiviteten for å bruke beskyttende atferdsstrategier (f.eks. ferdigheter for å forhandle kondom) for å redusere ubeskyttet sex.
Eksperimentell: Forventninger og opplevde fordeler
Deltakerne vil ha tilgang til kunnskapsmodulen pluss modulene forventninger og opplevde fordeler i en periode på inntil 3 uker.
Decrease the expectation that alcohol is needed to have good sexual encounter and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.
Eksperimentell: Forventninger og påbudsnormer
Deltakerne vil ha tilgang til kunnskapsmodulen pluss modulene forventninger og påbudsnormer i en periode på inntil 3 uker.
Reduser forventningen om at alkohol er nødvendig for å ha et godt seksuelt møte og korrigere misoppfatninger om godkjenning av alkoholmisbruk og seksuell risikotaking.
Eksperimentell: Forventninger, påbudsnormer og fordeler
Deltakerne vil ha tilgang til kunnskapsmodulen pluss forventninger, påbudsnormer og opplevde fordelsmoduler i en periode på opptil 3 uker.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.
Eksperimentell: Forventninger, påbudsnormer, fordeler, effektivitet
Deltakerne vil ha tilgang til kunnskapsmodulen pluss forventninger, påbudsnormer, opplevde fordeler og self-efficacy-moduler i en periode på opptil 3 uker.
Reduser forventningen om at alkohol er nødvendig for å ha et godt seksuelt møte; korrigere misoppfatninger angående godkjenning av alkoholmisbruk og seksuell risikotaking; øke opplevde fordeler ved å bruke beskyttende atferdsstrategier for å redusere de negative konsekvensene av å delta i seksuell atferd under påvirkning av alkohol; og øke selveffektiviteten til å bruke beskyttende atferdsstrategier (f.eks. ferdigheter for å forhandle kondomer) for å redusere ubeskyttet sex.
Eksperimentell: Forventninger og beskrivende normer
Deltakerne vil ha tilgang til kunnskapsmodulen pluss modulene forventninger og beskrivende normer i en periode på inntil 3 uker.
Reduser forventningen om at alkohol er nødvendig for å ha et godt seksuelt møte og korrigere feiloppfatninger av utbredelsen av alkoholindusert seksuell risikoatferd, alkoholbruk/misbruk og seksuell risikoatferd.
Eksperimentell: Perceived benefits alone
Participants will have access to the knowledge module plus the perceived benefits module for a period up to 3 weeks. *Also referred to as 'benefits' in other arm descriptions**
Øk opplevde fordeler ved å bruke beskyttende atferdsstrategier for å redusere de negative konsekvensene av å engasjere seg i seksuell atferd under påvirkning av alkohol.
Eksperimentell: Benefits and self-efficacy
Participants will have access to the knowledge module plus perceived benefits and self-efficacy modules for a period up to 3 weeks.
Increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Injunctive norms and self-efficacy
Participants will have access to the knowledge module plus injunctive norms and self-efficacy modules for a period up to 3 weeks.
Korriger feiloppfatninger angående godkjenning av alkoholmisbruk og seksuell risikotaking, og øk selveffektiviteten for å bruke beskyttende atferdsstrategier (f.eks. ferdigheter for å forhandle kondom) for å redusere ubeskyttet sex.
Eksperimentell: Injunctive norms and benefits
Participants will have access to the knowledge module plus injunctive norms and perceived benefits modules for a period up to 3 weeks.
Correct misperceptions regarding approval of alcohol misuse & sexual risk taking and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Injunctive norms, benefits, self-efficacy
Participants will have access to the knowledge module plus the injunctive norms, perceived benefits, and self-efficacy modules for a period up to 3 weeks.
Correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Descriptive norms alone
Participants will have access to the knowledge module plus the descriptive norms modules for a period up to 3 weeks.
Korriger feiloppfatninger av utbredelsen av alkoholindusert seksuell risikoatferd, alkoholbruk/misbruk og seksuell risikoatferd.
Eksperimentell: Descriptive norms, benefits, self-efficacy
Participants will have access to the knowledge module plus the descriptive norms, perceived benefits, and self-efficacy modules for a period up to 3 weeks.
Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Descriptive and injunctive norms, self-efficacy
Participants will have access to the knowledge module plus the injunctive norms and self-efficacy modules for a period up to 3 weeks.
orrect misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Descriptive and injunctive norms, and benefits
Participants will have access to the knowledge module plus the descriptive norms, injunctive norms, and perceived benefits modules for a period up to 3 weeks.
Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.
Eksperimentell: Descriptive & injunctive norms, benefits, efficacy
Participants will have access to the knowledge module plus the descriptive norms, injunctive norms, perceived benefits, and self-efficacy modules for a period up to 3 weeks.
Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and Increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Expectancies, benefits, self-efficacy
Participants will have access to the knowledge module plus the expectancies, perceived benefits, and self-efficacy modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Expectancies, injunctive norms, self-efficacy
Participants will have access to the knowledge module plus the expectancies, injunctive norms, and self-efficacy modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Expectancies, descriptive norms, self-efficacy
Participants will have access to the knowledge module plus the expectancies, descriptive norms, and self-efficacy modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Expectancies, descriptive norms, benefits
Participants will have access to the knowledge module plus the expectancies, descriptive norms, and perceived benefits modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.
Eksperimentell: Expectancies, descriptive norms, benefits, efficacy
Participants will have access to the knowledge module plus the expectancies, descriptive norms, perceived benefits, and self-efficacy modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Expectancies, descriptive and injunctive norms
Participants will have access to the knowledge module plus the expectancies , descriptive norms, and injunctive norms modules for a period up to 3 weeks.
Reduser forventningen om at alkohol er nødvendig for å ha et godt seksuelt møte; korrigere feiloppfatninger av utbredelsen av alkoholindusert seksuell risikoatferd, alkoholbruk/misbruk og seksuell risikoatferd; og korrigere misoppfatninger angående godkjenning av alkoholmisbruk og seksuell risikotaking.
Eksperimentell: Expectancies, descriptive & injunctive norms, efficacy
Participants will have access to the knowledge module plus the expectancies , descriptive norms, injunctive norms, and self-efficacy modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Eksperimentell: Expectancies, descriptive & injunctive norms, benefits
Participants will have access to the knowledge module plus the expectancies, descriptive norms, injunctive norms, and perceived benefits modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.
Eksperimentell: Expectancies, descriptive & injunctive, benefits, efficacy
Participants will have access to the knowledge module plus the expectancies, descriptive norms, injunctive norms, perceived benefits, and self-efficacy modules for a period up to 3 weeks.
Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Descriptive norms about the intersection of alcohol and sex collected via an online questionnaire.
Tidsramme: This measure will be assessed immediately following the 3-week intervention.
This scale consists of 6 items and will be created as a weighted scale score. Analyses will report the mean and standard deviation and expected mean values from a regression analysis. The scale will reflect the average perceived prevalence of the alcohol and sex behaviors.
This measure will be assessed immediately following the 3-week intervention.
Injunctive norms about the intersection of alcohol and sex collected via an online questionnaire.
Tidsramme: his measure will be assessed immediately following the 3-week intervention.
This scale consists of 6 items and will be created as a weighted scale score. Analyses will report the mean and standard deviation and expected mean values from a regression analysis. The scale will reflect the average perceived approval of the alcohol and sex behaviors, ranging from strongly disapprove to strongly approve.
his measure will be assessed immediately following the 3-week intervention.
Expectancies about the intersection of alcohol use and sex collected via an online questionnaire.
Tidsramme: This measure will be assessed immediately following the 3-week intervention.
This scale consists of 10 items and will be created as a weighted scale score. Analyses will report the mean and standard deviation and expected mean values from a regression analysis. The scale will reflect the average number of drinks expected to experience the 10 different outcomes.
This measure will be assessed immediately following the 3-week intervention.
Perceived benefits about using protective behavioral strategies collected via an online questionnaire.
Tidsramme: This measure will be assessed immediately following the 3-week intervention.
This scale consists of 11 items and will be created as a weighted scale score. Analyses will report the mean and standard deviation and expected mean values from a regression analysis. The scale will reflect the average likelihood of contracting an STI using the listed behaviors.
This measure will be assessed immediately following the 3-week intervention.
Self-efficacy to use protective behavioral strategies collected via an online questionnaire.
Tidsramme: This measure will be assessed immediately following the 3-week intervention.
This scale consists of 9 items and will be created as a weighted scale score. Analyses will report the mean and standard deviation and expected mean values from a regression analysis. The scale will reflect the average level of confidence is using protective behavioral strategies to reduce the risk of contracting and STI, ranging from not at all confident to extremely confident.
This measure will be assessed immediately following the 3-week intervention.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Binge drinking behavior collected via an online questionnaire.
Tidsramme: This measure will be assessed 1 month following the completion of the intervention.
This item asks how many times in the past two weeks a male has 5 or more drinks in a 2-hour period (or females 4 or more drinks in a 2-hour period). This variable will be collapsed into 1 or more times versus other and reported as a prevalence of this behavior and used as a dichotomous outcome in regression analyses.
This measure will be assessed 1 month following the completion of the intervention.
Unprotected sex behavior at most recent sex collected via an online questionnaire.
Tidsramme: This measure will be assessed 1 month following the completion of the intervention.
This item asks whether or not a condom was used for oral, anal or vaginal sex. This variable will be collapsed into a dichotomous variable with unprotected anal or vaginal sex versus other and reported as a prevalence of this behavior and used as a dichotomous outcome in regression analyses.
This measure will be assessed 1 month following the completion of the intervention.
Penetrative sex at most recent hookup collected via an online questionnaire.
Tidsramme: This measure will be assessed 1 month following the completion of the intervention.
This item asks whether or not the most recent hookup included vaginal or anal sex. This variable will be collapsed into a dichotomous variable with penetrative sex versus other and reported as a prevalence of this behavior and used as a dichotomous outcome in regression analyses.
This measure will be assessed 1 month following the completion of the intervention.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

18. september 2017

Primær fullføring (Faktiske)

31. desember 2017

Studiet fullført (Faktiske)

31. desember 2017

Datoer for studieregistrering

Først innsendt

17. januar 2018

Først innsendt som oppfylte QC-kriteriene

17. januar 2018

Først lagt ut (Faktiske)

24. januar 2018

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. juli 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. juli 2019

Sist bekreftet

1. juli 2019

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • R01AA022931-2
  • R01AA022931 (U.S. NIH-stipend/kontrakt)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Kliniske studier på Opplevde fordeler alene

Abonnere