An intervention to reduce risk factors for adolescent pregnancy

项目摘要 我们将评估Girls Investment的初步效果，这是一种创新的储蓄干预措施，旨在减少 经济、社会和健康行为风险与不成比例的高怀孕率有关 美国拉丁裔青少年。美国青少年怀孕预防的推荐模式侧重于 修改社会规范(例如，支持早育的规范)以及性健康知识和 技能建设；然而，这种努力不太可能有效地减少经济风险因素(例如，金融风险 依赖男性伴侣，对未来职业和教育成就的期望较低)。女孩投资 涉及多学科概念模型，适用于 处理与青少年有关的社会和经济风险的公共卫生和经济学学科 怀孕了。参与者将获得一个储蓄账户(通过我们的合作银行)，其中100美元存入 通过移动应用程序完成性别和生活技能培训的每个模块的递增。女孩们 投资将在居住在经济适用区的拉美裔青少年的社区样本中进行评估 圣地亚哥县被剥夺公民权的社区青少年怀孕率很高。青少年 在圣地亚哥和其他美墨边境地区，怀孕是一个令人担忧的问题，相比而言，这些地区的怀孕率更高 到美国其他地区或墨西哥的其他地方。与其他种族/民族相比， 墨西哥人的怀孕率最高。在加利福尼亚州，拉美裔占总人口的39%， 30%的拉丁裔人在20岁生日之前生育。15-19岁的拉丁裔青少年将通过 加州城市高地和国家城市的社区抽样。符合条件和感兴趣的女孩将招募其中一名 他们的同性朋友是他们社交网络的一部分，与他们一起参与干预。 朋友必须符合资格标准，但可以是任何种族/民族。一半的二元组将是随机的 接受女孩投资，其余被分配到等待名单控制条件(n=每臂50对；总计= 200个女孩)。为了评估可行性和保真度，我们将跟踪(通过数据日志和基于应用程序的数据) 招聘、保留和干预完成。深度访谈Girls Invest参与者和焦点 有关键利益相关者的团体将告知Girls Invest的可接受性和可扩展性。参与者将完成一份 调查问卷在基线和6个月的跟踪，以评估中期改善的证据 结果。回归分析将评估治疗对中间结果的影响。我们假设 在后续研究中，与对照参与者相比，女孩投资参与者的经济脆弱性将会降低 (例如，减少对男性伴侣的经济依赖，改善对未来职业和教育的期望 成就)，降低了怀孕的社会风险(例如，打算推迟怀孕)，并有所改善 避孕药使用的优先顺序、知识和态度。研究结果将为全面的 女孩投资的功效试验。

Project Summary We will assess the preliminary effects of Girls Invest, an innovative savings intervention that aims to reduce economic, social, and health behavior risks associated with disproportionately high rates of pregnancy among US Latina adolescents. Recommended models of adolescent pregnancy prevention in the US focus on modifying social norms (e.g., norms supporting early childbearing), as well as sexual health knowledge and skill-building; however, such efforts are not likely effective in reducing economic risk factors (e.g., financial reliance on male partners, low expectations for future career and educational achievements). Girls Invest involves a multidisciplinary conceptual model adapting the most effective prevention strategies from the disciplines of public health and economics to address social and economic risks associated with adolescent pregnancy. Participants receive a savings account (via our collaborating bank) with $100 deposited in increments based on completion of each module of a gender and life skills training via a mobile “app.” Girls Invest will be evaluated among a community sample of Latina adolescents residing in economically disenfranchised neighborhoods in San Diego County with high rates of adolescent pregnancy. Adolescent pregnancy is a concern in San Diego and other US-Mexico border regions, where rates are higher compared to the rest of the US or elsewhere in Mexico. Compared to other racial/ethnic groups, Latina adolescents of Mexican origin have the highest pregnancy rates. In California, where Latinos constitute 39% of the population, 30% of all Latinas give birth prior to their 20th birthday. Latina adolescents ages 15-19 will be recruited via community-based sampling in City Heights and National City, CA. Eligible and interested girls will recruit one of their same-gender friends who are part of their social network to participate in the intervention with them. Friends must meet eligibility criteria, except can be of any race/ethnicity. Half of the dyads will be randomized to receive Girls Invest and the remaining assigned to a wait-list control condition (n= 50 dyads per arm; total = 200 girls). To assess feasibility and fidelity, we will track (via data logs and app-based data) all aspects of recruitment, retention, and intervention completion. In-depth interviews with Girls Invest participants and focus groups with key stakeholders will inform acceptability and scalability of Girls Invest. Participants will complete a questionnaire at baseline and 6 months follow-up to assess evidence of improvements in intermediate outcomes. Regression analyses will assess treatment effects on intermediate outcomes. We hypothesize that at follow-up, compared to control participants, Girls Invest participants will have reduced economic vulnerability (e.g., reduced financial reliance on male partners, improved expectations for future career and educational achievements), decreased social risks for pregnancy (e.g., intentions to delay pregnancy), and improved prioritization, knowledge of, and attitudes supportive of contraceptive use. Study findings will inform a full-scale efficacy trial of Girls Invest.