Developing an Adolescent Relationship Abuse Prevention Intervention for Hispanic Immigrant Families

青少年关系虐待（ARA），定义为身体，心理，性虐待，或跟踪，在 青少年约会关系的背景下，是普遍存在的，并与无数的负面健康结果， 青年父母对青少年的人际关系和活动的监控是一个强有力的， 可改变的保护因子，以防止ARA。然而，对于西班牙裔移民家庭来说， 文化适应差距（即，文化适应的差异）可能会在使用父母监控作为 ARA预防工具。关于哪些特定的文化适应差距与父母的减少有关， 监测和增加ARA。此外，几乎没有父母-青少年ARA预防干预措施， 尤其是那些为西班牙裔移民家庭量身定制的文化。这个职业生涯的目标是 发展奖旨在确定对实现目标造成最大挑战的具体文化适应差距 最佳的父母监督，并通过发展父母-青少年 ARA预防干预西班牙裔移民家庭。父母约会事宜（Dating Matters for Parents，简称DPM），一个 疾病控制中心为中学生及其父母制定了ARA预防干预措施， 作为干预发展的基础。由经验丰富的多学科导师指导 Ragavan博士是PI，也是一名早期职业医生-科学家， 将建立在一个描述性的研究背景，以获得关键的新技能：1）父母的评估， 青少年互动和父母-青少年关系的发展; 2）以理论为基础，利益相关者- 参与干预开发; 3）临床试验设计和分析;以及4）领导和团队 管理这些职业目标与三个研究目标密切相关。在目标1中，Ragavan博士将使用 基于观察的技术来检查，在50个西班牙裔父母-青少年二人组的样本中， 文化适应差距与父母的监督和ARA有关，因此在 干预发展。在目标2中，以目标1的成果为依据，并在利益攸关方咨询委员会的指导下 博士Ragavan将使用通过社区参与框架进行项目适应的方法， 为西班牙裔移民家庭开发一种新的父母-青少年ARA预防干预措施（称为Juntos ["一起"]）。在目标3中，Ragavan博士将进行Juntos的试验性双臂随机临床试验， 中学年龄的西班牙裔青少年和第一代移民父母。主要成果 试点随机对照试验包括可行性和可接受性;次要探索性结局将进行描述性评估 候选结果纳入完全把握度试验。通过完成K23，Ragavan博士将拥有 培训，经验和初步数据需要成为一个独立的医生，科学家领导 研究符合NICHD的战略优先事项"探索预防和治疗策略，以解决 儿童和青少年创伤和伤害的主要原因。"

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.”