An Emotion Regulation Intervention for Early Adolescent Risk Prevention
Condition: Risk Behavior; Risk Reduction; Emotion Regulation
Study type: Interventional

Summary: 
      This study will take a group-based intervention for adolescents that reduced sexual risk
      behavior and create a computer-based version, which is a format that adolescents like and
      that is more cost-effective. The intervention focuses on teaching adolescents skills for
      managing their emotions when they are making decisions that could put them at risk (like
      whether to have sex or drink alcohol). The investigators are hoping to learn whether a
      computer version of the program will be useful in helping adolescents learn about emotional
      competence and reducing risky behaviors. The investigators will make a version of the
      intervention as games on tablet computers in a partnership with a technology company, Klein
      Buendel. The research team will begin by getting advice from adolescents and experts (in
      separate groups) about how to convey the ideas from the group program into computer games.
      Klein Buendel will then create the games. Then, about 10 adolescents will be asked to try out
      the program and give us feedback about things to change. Klein Buendel will make those
      changes. Then the investigators will ask about 100 adolescents to volunteer to be randomly
      placed in one of two groups. One group will do the computer program right away; the other
      will wait for three months. Both groups will be asked to answer questions and do computer
      tasks when the team meets them, one month later, and three months later. The investigators
      will compare the groups to see if the group that received the computer intervention reports
      being more emotionally competent than the group that has not yet done the computer
      intervention. The research team will also ask them about their risk behaviors. If this is
      useful, it may be a good way to enhance health education taught in schools.
    

Detailed description: 
      Emotion regulation in adolescence is associated with health risk behaviors, including sex and
      substance use, and early onset of these behaviors represents a risk factor for negative
      health outcomes throughout life. Thus, interventions appropriate for early adolescence, when
      these behaviors commonly begin, are critical for prevention efforts. The research team has
      developed and tested a novel, engaging, and efficacious intervention that addresses emotion
      regulation, a theoretically important and under-researched factor associated with risk. The
      efficacy trial of this intervention, Project TRAC, showed that an intervention strategy using
      emotion regulation was significantly more successful than an active comparison condition on
      the primary target, delaying onset of sexual activity over a two and a half year follow-up,
      as well as on other risk behaviors, such as condom use, fighting, and partner violence. While
      efficacious, the current face-to-face, small group format of the program is a difficult model
      to sustain and implement on a larger scale. With a long-term goal toward dissemination, this
      two-year project will translate the emotion regulation components of this successful program
      for tablet-based delivery to enable it to reach a large audience in a format that can be
      related to a variety of health behavior education topics (e.g., sexual health, violence,
      substance use). For the proposed project, the Rhode Island Hospital/ Brown University
      research team will collaborate with Klein Buendel, a health communications technology
      company, to translate the emotion regulation content of Project TRAC for tablet computers.
      This translation, using well-established theoretical frameworks, will be approached in
      consultation with members of the target population (early adolescents) and experts in the
      field. After the intervention has been translated to a tablet form, ten adolescents will test
      the program to assess acceptability and usability. Finally, a small pilot study (n=100) will
      assess feasibility of the translated intervention and compare it to a waitlist control group.
    

Intervention name(s): Tablet TRAC Emotion Regulation Intervention
Intervention type(s): Behavioral
Intervention description(s): The intervention focuses on developmentally appropriate strategies for emotion regulation during difficult situations, particularly those related to risk, using 3 primary groups of strategies identified during qualitative work in Project TRAC (R34 MH078750): 1) getting away (physically or cognitively) from triggers for strong emotions, 2) releasing emotional energy in healthy ways (physically or verbally) or 3) changing cognitions and appraisals about emotional triggers. Using strategies effective in TRAC, teens will engage in games to practice and apply strategies to risk scenarios, as well as personalize content learned.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will be randomized to complete a computerized intervention or a wait list control.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Adolescent risk behavior; digital; early adolescence; emotion regulation; prevention