CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females

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Project Summary/Abstract Parent Grant: Adolescent young women involved with juvenile justice settings engage in multiple health risk behaviors that place them at risk for HIV/STIs and pregnancy affected by alcohol and marijuana. This study aims to test the efficacy of CHOICES-TEEN (CT) in reducing the risks of substance-exposed pregnancy (SEP) and HIV/STIs among juvenile justice-involved young women. Proposed Diversity Supplement: While a substantive portion of justice- involved adolescent young women have been exposed to parental incarceration, and these adolescents were at higher risk of substance use and sexual risk behaviors, extant interventions for at-risk adolescents demonstrate limited effects on those with parental incarceration experiences. This diversity supplement aims to determine the efficacy of CT for adolescent young women with parental incarceration experiences by additional quantitative analyses of data collected by the parent grant and collection and analysis of qualitative interview data from a subsample with parental incarceration experiences following completion of the final 9-month assessment. Specifically, Aim 1 will utilize multilevel logistic regression analyses and latent growth curve modeling to determine the potential differential efficacy of CT in reducing the risks of SEP and HIV/STIs among adolescent young women who have experienced parental incarceration. In Aim 2, multilevel Bayesian structural equation modeling will be employed to evaluate the mediating treatment effects of the mechanisms of action for CT by parental incarceration. In Aim 3, qualitative interviews will be conducted with 20 adolescent young women in the intervention arm to explore their lived experiences of parental incarceration that may impact the efficacy and acceptability of CT and collect their suggestions for adaptations. The proposed diversity supplement research serves as a natural extension of the parent grant while offering a novel opportunity for a promising new investigator to initiate a new line of prevention research focused on adolescents with parental incarceration experiences and receive mentorship from a strong team of experienced researchers. This diversity supplement will help the candidate gain skills and experience in intervention research, complex quantitative analysis of clinical trial data, qualitative research, and manuscript preparation. Moreover, data from this study will inform a K01 application on developing new or adapted interventions (such as CT) for adolescents with parental incarceration experiences, with the long-term goal of testing its efficacy in a larger R01 study. This diversity supplement will significantly contribute to the candidate’s trajectory to becoming an independent NIH researcher.