Dating Violence and Sexual Risk Prevention for Young Mothers

年轻母亲的约会暴力和性风险预防 青少年母亲（15-19岁）比没有养育子女的同龄人更容易遭受约会暴力， 包括艾滋病毒在内的性传播感染增加了青少年母亲及其子女感染艾滋病毒的风险。 负面的健康结果。减少年轻母亲家庭家庭暴力和性风险的循证干预措施 关系有限。青少年母亲来自低收入、种族和少数民族的比例过高 因此，他们在获得预防干预措施方面面临更多障碍。拟建项目 包括3个目标：1）确定和测试增加青少年招募和参与的方法 来自家庭暴力和医院性风险预防研究中服务不足背景的母亲（15-19岁）， 2）适应日期SMART，一个循证的DV和性风险预防干预， 青少年母亲; 3）进行适应性干预的试点随机对照试验，日期 在新泽西州卡姆登市的库珀大学医院的门诊诊所里，年轻的聪明妈妈们（YM）。 卡姆登是一个城市，大多数居民是低收入，种族和/或少数民族，和青少年出生 率是全国最高的。在第一阶段，与10名医疗保健提供者进行了关键线人访谈， 由16名年轻母亲组成的焦点小组将帮助确定在何处、何时以及如何最好地与目标联系 医院门诊部的人口。在第二阶段，招募方法将通过招募两名 更多的16名青少年母亲的重点小组，以告知适应日期智能，一个7届会议，小组- 为处境危险、得不到充分服务的少女设计的干预措施。日期SMART旨在减少DV和 通过教授认知行为疗法（CBT）为基础的技能， 症状、情绪反应和人际交往能力缺陷。焦点小组的反馈将用于调整 年轻母亲的日期智能（日期智能-YM）。III期将是一项随机对照试验，日期 SMART-YM与32名青少年母亲（16名处于干预条件，16名处于对照条件）在一个 医院诊所设置，并进行了试点测试的日期智能-YM评估电池。主要结局 性风险行为从基线到干预后的变化（最后一次性交时使用避孕套， 无保护的性行为）和DV（敌对、胁迫和暴力行为的实施和受害）。 次要结果包括可行性（招聘和保留率）和可接受性（定性和定量）。 定量干预反馈）。本科生研究助理将在招聘中发挥积极作用， 干预措施的调整和实施，并将接受性风险和家庭暴力预防专家的指导， 健康差距，以及定性和定量研究方法。结果将为未来的全功率 疗效试验比较日期智能健康促进控制条件。提供CBT技能，以减少 抑郁症状、情绪反应和人际交往技能的缺陷，最终将 减少危险性行为和家庭暴力，改善青少年母亲及其子女的健康。

DATING VIOLENCE AND SEXUAL RISK PREVENTION FOR YOUNG MOTHERS Adolescent mothers (ages 15-19) are at greater risk than non-parenting peers for dating violence (DV) and sexually transmitted infections (STIs), including HIV, increasing teen mothers’ and their children’s risk for negative health outcomes. Evidence-based interventions to reduce both DV and sexual risk in young mothers’ relationships are limited. Adolescent mothers are disproportionately from low-income, racial and ethnic minority backgrounds, and thus face additional barriers to accessing prevention interventions. The proposed project includes 3 aims: 1) identifying and testing ways to increase recruitment and engagement of adolescent mothers (ages 15-19) from underserved backgrounds in DV and sexual risk prevention research at hospital- based clinics; 2) adapting Date SMART, an evidence-informed DV and sexual risk prevention intervention, for adolescent mothers; and 3) conducting a pilot randomized controlled trial of the adapted intervention, Date SMART-Young Moms (YM) in an ambulatory clinic setting at Cooper University Hospital in Camden, NJ. Camden is a city where the majority of residents are low-income, racial and/or ethnic minorities, and teen birth rate is among the highest in the state. In Phase 1, key informant interviews with 10 healthcare providers and focus groups with 16 young mothers will help identify where, when, and how to best connect with the target population in hospital-based outpatient clinics. In Phase 2, recruitment methods will be tested by recruiting two more focus groups of 16 adolescent mothers to inform the adaptation of Date SMART, a 7-session, group- based intervention designed for at-risk, underserved adolescent girls. Date SMART aims to reduce DV and sexual risk behavior by teaching cognitive behavioral therapy (CBT)-based skills to reduce depressive symptoms, emotional reactivity, and interpersonal skills deficits. Focus group feedback will be used to adapt Date SMART for young mothers (Date SMART-YM). Phase 3 will be a randomized controlled trial of Date SMART-YM with 32 adolescent mothers (16 in the intervention condition, 16 in the control condition) in a hospital clinic setting, and a pilot test of the Date SMART-YM assessment battery. Primary outcomes are changes from baseline to post-intervention in sexual risk behavior (condom use at last sex, number of unprotected sex acts) and DV (perpetration and victimization of hostile, coercive, and violent behaviors). Secondary outcomes include feasibility (recruitment and retention rates) and acceptability (qualitative and quantitative intervention feedback). Undergraduate research assistants will play an active role in recruitment, intervention adaptation, and delivery, and will receive mentoring from experts in sexual risk and DV prevention, health disparities, and qualitative and quantitative research methods. Results will inform a future fully-powered efficacy trial comparing Date SMART to a health promotion control condition. Delivering CBT skills to reduce depressive symptoms, emotional reactivity, and interpersonal skills deficits in healthcare settings will ultimately decrease sexual risk behavior and DV, and improve the health of adolescent mothers and their children.