Jovenes Sanos: Preventing IPV and RC
Condition: Unintended Pregnancy; Family Planning; Intimate Partner Violence (IPV)
Study type: Interventional

Summary: 
      The primary purpose of this research is to conduct a small matched cluster control trial of
      an intervention designed to address reproductive coercion and unintended pregnancy (ARCHES -
      Addressing Reproductive Coercion within Healthcare Settings) adapted to the Mexican cultural
      and family planning healthcare context ( renamed Jovenes Sanos) in order to provide initial
      data regarding acceptability, feasibility and efficacy in this high need
      low-and-middle-income country.
    

Detailed description: 
      The project consortium will implement the ARCHES model across two community health centers in
      Tijuana, Baja California, Mexico. A 2-armed pilot study of ARCHES (adapted) will be conducted
      with 80 female FP clients (40 intervention, 40 control) ages 16-20 drawn from 2 comparable
      community health centers randomly assigned to either intervention or control (i.e. standard
      of care). Baseline data will be collected prior to routine FP service delivery, with a short
      exit survey conducted immediately following the clients' FP appointment (ARCHES or standard
      FP counseling will be provided during this visit). Follow-up data will be collected at
      3-months post-intervention. Data at each time point will be collected via a 30-minute audio
      computer-assisted self-interview (ACASI) in Spanish. Data will also be collected to assess
      qualities of program implementation (i.e., process evaluation) to ensure implementation of
      the program as intended as well as unforeseen barriers to implementation. Creation of
      procedures for data collection, review of quality control data, and interpretation of
      findings will occur in collaboration with the entire mentoring/training committee. In-depth
      interviews (IDIs) with female adolescent FP clients ages 16-20 with a recent IPV/RC (n= 20),
      and focus groups (FGs) (n=2; 6-8 participants per group) with FP counselors in 2 comparable
      urban community health centers to identify perceptions of prevalence and impact of IPV and RC
      among adolescent clients and barriers to identifying IPV and RC. FGs with FP counselors from
      the participating community health centers will be conducted (n=2; 6-8 participants per
      group). FP counselors from these community health centers will be purposely selected to
      participate based on having provided FP services for at least 10 female adolescent clients in
      the past 6 months. At intervention sites, FP counselors will deliver the intervention
      integrated into standard-of-care practice; at control sites FP counselors will deliver solely
      standard-of-care services. Analyses specific to participants ages 16-20 will provide findings
      to guide consideration of ARCHES as an effective strategy to improve the reproductive health
      and reduce GBV among adolescents in this region.
    

Intervention name(s): Jovenes Sanos
Intervention type(s): Behavioral
Intervention description(s): FP counselors in intervention clinics will a) provide counseling and education regarding risk of partner detection of FP methods, and women's and girls' strategies to use FP methods to minimize partner detection risk integrated into standard FP counseling, b) make brief inquiries to allow clients the opportunity to disclose experiences of RC and IPC (i.e., screening), c) provide method-specific counseling based on this information and the method chosen by the client, d) provide supported linkage of IPV survivors to local IPV support services (i.e. warm referral), and e) distribute palm-sized educational materials on RC and IPV, as well as IPV services.
Other intervention name(s): ARCHES
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: The Jovenes Sanos study will take place in two urban clinics in Tijuana, Mexico for all clients receiving voluntary FP counseling. The intervention study will involve a matched cluster control trial. Two clinics will serve as the intervention sites.
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Reproductive Coercion; Gender-based violence; Contraception; Clinic-based screening for IPV; Clinic-based counseling