Dating Violence and Sexual Risk Prevention for Young Mothers - DATING VIOLENCE AND SEXUAL RISK PREVENTION FOR YOUNG MOTHERS Adolescent mothers (ages 15-19) are at greater risk than non-parenting peers for dating violence (DV) and sexually transmitted infections (STIs), including HIV, increasing teen mothers’ and their children’s risk for negative health outcomes. Evidence-based interventions to reduce both DV and sexual risk in young mothers’ relationships are limited. Adolescent mothers are disproportionately from low-income, racial and ethnic minority backgrounds, and thus face additional barriers to accessing prevention interventions. The proposed project includes 3 aims: 1) identifying and testing ways to increase recruitment and engagement of adolescent mothers (ages 15-19) from underserved backgrounds in DV and sexual risk prevention research at hospital- based clinics; 2) adapting Date SMART, an evidence-informed DV and sexual risk prevention intervention, for adolescent mothers; and 3) conducting a pilot randomized controlled trial of the adapted intervention, Date SMART-Young Moms (YM) in an ambulatory clinic setting at Cooper University Hospital in Camden, NJ. Camden is a city where the majority of residents are low-income, racial and/or ethnic minorities, and teen birth rate is among the highest in the state. In Phase 1, key informant interviews with 10 healthcare providers and focus groups with 16 young mothers will help identify where, when, and how to best connect with the target population in hospital-based outpatient clinics. In Phase 2, recruitment methods will be tested by recruiting two more focus groups of 16 adolescent mothers to inform the adaptation of Date SMART, a 7-session, group- based intervention designed for at-risk, underserved adolescent girls. Date SMART aims to reduce DV and sexual risk behavior by teaching cognitive behavioral therapy (CBT)-based skills to reduce depressive symptoms, emotional reactivity, and interpersonal skills deficits. Focus group feedback will be used to adapt Date SMART for young mothers (Date SMART-YM). Phase 3 will be a randomized controlled trial of Date SMART-YM with 32 adolescent mothers (16 in the intervention condition, 16 in the control condition) in a hospital clinic setting, and a pilot test of the Date SMART-YM assessment battery. Primary outcomes are changes from baseline to post-intervention in sexual risk behavior (condom use at last sex, number of unprotected sex acts) and DV (perpetration and victimization of hostile, coercive, and violent behaviors). Secondary outcomes include feasibility (recruitment and retention rates) and acceptability (qualitative and quantitative intervention feedback). Undergraduate research assistants will play an active role in recruitment, intervention adaptation, and delivery, and will receive mentoring from experts in sexual risk and DV prevention, health disparities, and qualitative and quantitative research methods. Results will inform a future fully-powered efficacy trial comparing Date SMART to a health promotion control condition. Delivering CBT skills to reduce depressive symptoms, emotional reactivity, and interpersonal skills deficits in healthcare settings will ultimately decrease sexual risk behavior and DV, and improve the health of adolescent mothers and their children.
