Developing an Adolescent Relationship Abuse Prevention Intervention for Hispanic Immigrant Families

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Adolescent relationship abuse (ARA), defined as physical, psychological, sexual abuse, or stalking in the context of a teen dating relationship, is pervasive and associated with myriad negative health outcomes for youth. Parental monitoring of adolescents’ interpersonal relationships and activities is a powerful and modifiable protective factor to prevent ARA. However, for Hispanic immigrant families, parent-adolescent acculturation gaps (i.e., differences in acculturation) may create challenges in using parental monitoring as an ARA prevention tool. Less is known about which specific acculturation gaps are related to decreased parental monitoring and increased ARA. Furthermore, few parent-adolescent ARA prevention interventions exist, especially ones culturally tailored for Hispanic immigrant families. The goal of this mentored career development award is to identify specific acculturation gaps that create the most challenges to achieving optimal parental monitoring and address these acculturation gaps through development of a parent-adolescent ARA prevention intervention for Hispanic immigrant families. Dating Matters for Parents (DMP), a Centers for Disease Control developed ARA prevention intervention for middle school aged youth and their parents, will be used as a foundation for intervention development. Guided by an experienced, multidisciplinary mentorship team and with strong institutional support, Dr. Ragavan, who is the PI and an early career physician-scientist, will build upon a upon a descriptive research background to gain critical new skills in: 1) assessment of parent- adolescent interaction and the development of parent-adolescent relationships; 2) theory-based, stakeholder- involved intervention development; 3) clinical trial design and analysis; and 4) leadership and team management. These career goals are tightly linked to three research aims. In Aim 1, Dr. Ragavan will use observation-based techniques to examine, in a sample of 50 Hispanic parent-adolescent dyads, which acculturation gaps are related to parental monitoring and ARA and thus most important to target during intervention development. Informed by Aim 1 results and guided by a stakeholder advisory committee, in Aim 2 Dr. Ragavan will use the Method for Program Adaptation through Community Engagement framework to develop a novel parent-adolescent ARA prevention intervention for Hispanic immigrant families (called Juntos [“Together”]). In Aim 3, Dr. Ragavan will conduct a pilot two-armed randomized clinical trial of Juntos among middle school aged Hispanic adolescents and a first-generation immigrant parent. Primary outcomes of the pilot RCT include feasibility and acceptability; a secondary exploratory outcome will be descriptively assessing candidate outcomes for inclusion in the fully powered trial. By completing this K23, Dr. Ragavan will have the training, experience, and preliminary data needed to become an independent physician-scientist leading studies aligned with NICHD’s strategic priority of “exploring prevention and treatment strategies to address the leading causes of trauma and injury in children and adolescents.”