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A Tablet-delivered Intervention to Reduce Risky Behavior in Adolescents

A Tablet-delivered Intervention to Reduce Risky Behavior in Adolescents

Klein Buendel collaborator, Dr. Christopher Houck from Rhode Island Hospital, will present findings from Project TRAC at the Society of Research on Adolescence Biennial Meeting in San Diego, California, March 19-21, 2020. His presentation will also include a demonstration of the targeted games used in the intervention.

The team initially developed and validated an Emotion Regulation (ER) intervention for reducing risk behaviors among early adolescents. Project TRAC showed that adolescents who learned about sexual health information with ER content were significantly less likely to transition to sexual activity. Despite the promise of targeting ER during early adolescence to prevent risk behaviors, discussions with community partners suggest that the original facilitator-led small-group format is difficult to sustain. Disseminating this prevention approach required a format that was less reliant on specialized training that could be easily implemented to an individual format. Therefore, through advisory panels of early adolescents and consultation from a group of experts in the field, Project TRAC was translated from a small-group format to a tablet-delivered, game-based program.

Acceptability testing took place with ten adolescents followed by 85 adolescents who participated in a small randomized pilot trial to assess the feasibility of the digital intervention as well as preliminary assessment of short-term changes in ER. Those randomized to the intervention condition completed four computerized modules that taught emotion concepts through games and instructional videos. Control participants were waitlisted to complete the intervention at the end of the study and all adolescents completed surveys at baseline and one month later.

Participants positively rated the intervention with a majority completing all four modules. Intervention participants self-reported significant improvements, including emotional awareness, perceived access to ER strategies, use of the strategies taught in the intervention, intentions to use these strategies, emotional knowledge, and perceptions that emotions are changeable. They also reported a moderate effect of poorer perceptions of abilities to manage positive emotions.

Results suggest that a tablet-based intervention providing ER training was able to affect adolescents’ use of ER behaviors, understanding of emotions, and perceptions of emotional competence. Linking ER training to specific areas of risk (sexual health, substance use, or violence prevention) in the developmental window when risk behaviors are beginning, such as early adolescence, may prevent risk behaviors for many young people. Dissemination of evidence-based interventions through tablet formats may also improve the reach of effective interventions.

This research is funded by a grant from the National Institute of Child Health and Human Development (HD089979; Dr. Christopher Houck, Principal Investigator). Other collaborators include Wendy Hadley from the University of Oregon; Crosby Modrowski and Kelsey Bala from Brown University; Brittany Wickham from Villanova University; and Dr. Valerie Myers and Tiffany Jerrod from Klein Buendel.

Project STRONG Expands into Spanish

Project STRONG Expands into Spanish

Ms. Julia Berteletti, Klein Buendel Research Program Manager, is a Co-Investigator on a new research project aimed at teaching adolescent boys, with their parents, skills on regulating their emotions and how to communicate their feelings.

Emotional regulation is the ability to successfully understand and express one’s emotions (1). The large empirical literature links violent behavior and adolescents who lack this ability. Furthermore, numerous studies show that parental involvement is crucial to offsetting dating violence risk (2).

Northeastern University, in collaboration with Klein Buendel, conducted a pilot study which was funded by the National Institute of Justice and titled “Partner Violence Prevention for Middle School Boys: A Dyadic Web-Based Intervention” (2014-MU-CX-4002). The aim of the study was to develop a web-based intervention to reduce the risk of dating violence among middle-school aged males. The engaging web program was used by parents and adolescents together, with both the parent and the child choosing an avatar, playing games together, and being prompted to discuss the content.

Results showed that families generally found the program helpful and useful (3). Adolescents randomized to the STRONG condition were less likely to report dating violence perpetration events and victimization events when compared to the control group (3). Additionally, adolescents in the STRONG condition reported an increase in a number of emotional regulation measures compared to control participants (3).

The new Project STRONG R01 study will be conducted in a larger randomized controlled trial titled “Project STRONG: A Web-Based Dating Violence Prevention Program for Parents and Middle School Boys”. The web-based program will be translated and developed in Spanish and will be tested for its ability to reduce the risk of dating violence among both English- and Spanish-speaking middle-school aged males. Again, parents and their sons will complete the program together.

The research is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (HD097126; Dr. Chris Houck and Dr. Christine Rizzo, Principal Investigators). Ms. Berteletti will be collaborating with Dr. Chris Houck of Rhode Island Hospital and Dr. Christine Rizzo of Brown University.

References

1. Houck CD, Hadley W, Barker D, Brown LK, Hancock E, Almy B. An emotion regulation intervention to reduce risk behaviors among at-risk early adolescents. Prev Sci. 2016;17(1):71-82. doi: 10.1007/s11121-015-0597-0
2. Lundgren R, Amin A. Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness. J Adolesc Health. 2015;56(1 Suppl):S42-S50. doi: 10.1016/j.jadohealth.2014.08.012
3. National Criminal Justice Reference Service; Rizzo CJ, Houck C. Summary Report: Partner Violence Prevention for Middle-School Boys: A Dyadic Web-Based Intervention Study (Project STRONG). Available at: https://www.ncjrs.gov/pdffiles1/nij/grants/252517.pdf. Published January 2019. Accessed August 21, 2019.