Technology-based health behavior intervention with at-risk teens in shelters

摘要 第一阶段可行性研究的目的是评估4- 周时间4U青少年健康干预（T4 U）的干预，以改善谁住在青少年的健康 亲密伴侣暴力（IPV）。父母IPV被550万美国人见证 青春期的青少年这些青少年特别容易受到负面健康行为（物质或 吸烟、不健康饮食、性冒险、青少年约会暴力）。经历IPV的女性及其 儿童经常在家庭暴力庇护所寻求帮助。许多DVS提供同行或专业咨询 帮助妇女处理IPV的后果;然而，为儿童提供的咨询服务往往 由于资源有限而缺乏。T4 U干预包括三个部分：（a）四个基于计算机的， 与非专业卫生工作者（LHW）进行实时动机访谈（MI）;（B）在线书面健康 信息;以及（c）在线每日跟踪健康行为。预期干预结果是 与物质使用、烟草使用、饮食失调、性冒险有关的行为（由青少年选择），或 青少年约会暴力拟议研究的具体目标是：（a）评估提供 T4 U在庇护所的干预，证明了青少年愿意参加四个基于计算机的MI 会话（出席）和受试者满意度;（B）获得T4 U干预的初步疗效以供使用 与收容所中的青少年一起，激励他们改变选定的行为，并改变从基线到结束的行为 与注意力控制组相比，在4个阶段的干预和基线后8周;以及（c）获得 关于T4 U干预组件的定性干预后反馈（MI会话、健康信息、健康 行为活动跟踪系统）和AC组件（AC会话、休闲时间消息、休闲时间 活动跟踪系统）以及T4 U和AC中的更改建议。 使用准实验设计，100名13-18岁的青少年与他们的母亲一起生活在DVS， 至少有一种健康风险行为的筛查呈阳性，将被招募。50个将分配给T4 U条件 50到注意力控制（AC）状态。将收集数据：（a）基线，4周T4 U后 干预或AC条件，并在基线后8周使用两种工具测量青少年的动机， 变化和他们参与健康风险行为，（B）在T4 U条件下测量花费的时间 参与与目标风险相关的健康行为，（c）在每次T4 U或AC疗程后， 对课程的满意度，以及（d）4周后的T4 U或AC条件，以测量在线 书面健康信息或休闲信息（AC组）和在线跟踪系统。T4 U的所有青少年 和AC组将被要求参与定性访谈，这些访谈将被转录和分析， 定性描述分析技术，以获得关于T4 U和AC条件的反馈。

Abstract The aim of this Phase I feasibility study is to assess the feasibility and preliminary efficacy of the 4- week Time4U Teen Health Intervention (T4U) an intervention to improve the health of teens who live in families experiencing intimate partner violence (IPV). Parental IPV is witnessed by 5.5 million American teens during adolescence. These teens are particularly vulnerable to negative health behaviors (substance or tobacco use, unhealthy eating, sexual risk-taking, teen dating violence). Women who experience IPV and their children often seek help at domestic violence shelters (DVS). Many DVS offer peer or professional counseling to assist women to deal with the consequences of IPV; however, counseling services for children are often lacking due to limited resources. The T4U intervention consists of three components: (a) four computer-based, real-time motivational interviewing (MI) sessions with a lay health worker (LHW); (b) online written health messages; and (c) online daily tracking of health behaviors. Expected intervention outcomes are change in behavior (selected by the teen) related to substance use, tobacco use, disordered eating, sexual risk taking, or teen dating violence. The specific aims of the proposed study are to: (a) Assess the feasibility of delivering the T4U intervention in shelters as evidenced by the willingness of teens to participate in four computer-based MI sessions (attendance) and subject satisfaction; (b) Obtain preliminary efficacy of the T4U intervention for use with teens in shelters to motivate change in a selected behavior and change in behavior from baseline to end of the 4-session intervention and 8 weeks after baseline compared to an attention control group; and (c) Obtain qualitative post intervention feedback on T4U intervention components (MI sessions, health messages, health behavior activity tracking system) and AC components (AC sessions, leisure time messages, leisure time activity tracking system) and suggestions for change in both T4U and AC. Using a quasi-experimental design, 100 teens between the ages of 13-18 living with their mothers in DVS, who screen positive for at least one health risk behavior, will be recruited. Fifty will be assigned to the T4U condition and 50 to the attention control (AC) condition. Data will be collected: (a) baseline, post 4-week T4U intervention or AC condition, and 8 weeks after baseline using two tools to measure teens' motivation to change and their engagement in health risk behaviors, (b) during the T4U condition to measure time spent engaging in healthy behavior related to the targeted risk, (c) after each T4U or AC session to measure satisfaction with the sessions, and (d) post 4-week T4U or AC condition to measure satisfaction with online written health messages or leisure time messages (AC group) and online tracking system. All teens in the T4U and AC groups will be asked to engage in qualitative interviews which will be transcribed and analyzed using qualitative description analysis techniques to obtain feedback on the T4U and AC conditions.