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

摘要 这项第一阶段可行性研究的目的，是评估4项计划的可行性和初步成效。 每周时间4U青少年健康干预(T4U)一项旨在改善居住在 遭受亲密伴侣暴力(IPV)的家庭。550万美国人见证了父母的IPV 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)。体验过IPV和她们的女性 儿童经常在家庭暴力庇护所(DVS)寻求帮助。许多DV提供同伴或专业咨询 帮助妇女应对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。T4U干预由三个部分组成：(A)四个基于计算机的， 与业外保健工作者(LHW)进行实时激励性访谈(MI)；(B)在线书面健康 信息；以及(C)在线每日跟踪健康行为。预期的干预结果是 行为(由青少年选择)与物质使用、烟草使用、饮食失调、性风险或 青少年约会暴力。拟议研究的具体目的是：(A)评估交付 T4U在收容所的干预--青少年参与四种基于计算机的MI的意愿证明 会议(出席)和受试者满意度；(B)获得T4U干预使用的初步效果 让青少年在庇护所中激励选定行为的改变，以及从基线到结束的行为改变 与注意控制组比较：(C)获得 干预后对T4U干预组件(MI会话、健康消息、健康)的定性反馈 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)，并对T4U和AC的变化提出建议。 使用准实验设计，100名年龄在13-18岁之间的青少年与他们的母亲一起生活在DVS，谁 筛查阳性者至少有一种健康危险行为，将被招募。50人将被分配给T4U条件 注意控制(AC)状态为50。将收集以下数据：(A)基线，4周后T4U 干预或AC状况，并在基线后8周使用两种工具测量青少年的动机 改变和他们对健康危险行为的参与，(B)在T4U条件下测量花费的时间 从事与目标风险相关的健康行为，(C)在每次T4U或AC会议后进行测量 (D)在四周的T4U或AC状态后测量对在线的满意度 书面健康信息或休闲信息(AC组)和在线跟踪系统。T4U中的所有青少年 AC小组将被要求进行定性访谈，这些访谈将被转录并使用 定性描述分析技术，以获得关于T4U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.