Dating Violence and Sexual Risk Prevention for Young Mothers

年轻母亲的约会暴力和性风险预防 青春期母亲(15-19岁)比没有父母的同龄人更容易遭受约会暴力(DV)和 性传播感染(STI)，包括艾滋病毒，增加了青少年母亲及其子女患上 负面的健康后果。以证据为基础的干预措施降低年轻母亲的DV和性风险 关系是有限的。青春期母亲不成比例地来自低收入、种族和少数民族 因此，在获得预防干预措施方面面临更多的障碍。拟议中的项目 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 母亲(15-19岁)来自DV和医院性风险预防研究的服务不足背景- 以诊所为基础；2)调整DATE SMART，一种循证的DV和性风险预防干预，用于 青春期母亲；以及3)进行适应性干预的先导性随机对照试验，日期 在新泽西州卡姆登的库珀大学医院的门诊环境中，聪明年轻的妈妈们(YM)。 卡姆登是一个大多数居民是低收入、种族和/或少数民族以及青少年出生的城市 这一比例是该州最高的之一。在第一阶段，与10家医疗保健提供者和 由16名年轻母亲组成的焦点小组将帮助确定在哪里、何时以及如何最好地与目标建立联系 以医院为基础的门诊的人口。在第二阶段，将通过招募两个人来测试招募方法 更多由16名青春期母亲组成的焦点小组向Date Smart介绍适应情况，这是一个由7个会议组成的小组- 为高危、未得到充分服务的青春期女孩设计的干预措施。Date Smart旨在降低DV和 通过传授基于认知行为疗法(CBT)的技能来减少抑郁的性危险行为 症状、情绪反应和人际交往技能缺陷。将使用焦点小组反馈来适应 年轻母亲的约会聪明(Date Smart-ym)。第三阶段为DATE的随机对照试验 对32名青少年母亲(16名在干预条件下，16名在对照条件下)进行了SMART-YM调查 医院诊所设置，以及DATE SMART-YM评估电池的试点测试。主要结果是 性危险行为从基线到干预后的变化(最后一次性行为使用避孕套，数量 无保护的性行为)和DV(敌对、强迫和暴力行为的实施和受害)。 次要成果包括可行性(征聘和保留率)和可接受性(质量和 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、适应和交付，并将接受性风险和DV预防方面的专家的指导， 健康差距以及定性和定量的研究方法。结果将为未来提供全面的动力 将Date Smart与健康促进控制条件进行疗效比较试验。提供CBT技能以减少 医疗保健环境中的抑郁症状、情绪反应性和人际交往技能缺陷最终将 减少性危险行为和DV，改善青春期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.