Translation of an Intervention for Violence Among Adolescents in Emergency Departments

Study Overview
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Brief Summary
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The translation study aims to refine and package intervention and training materials essential to translating an efficacious Emergency Department (ED) based Brief Intervention (BI) for violence (SafERteens) for two delivery methods: by ED staff on site or by therapist remotely. The study will take place in two phases. During the Effectiveness phase, we will determine the effectiveness of the interventions [on-site therapist delivered BI + text messages (n=133); remote therapy delivered BI + text messages (n=133)], as compared to a usual care control (brochure; n=133), on violence outcomes at 3 months. Note that tailored text messages will be delivered daily for the first month post-discharge, and three times per week in the second month post-discharge to the BI groups. During the Implementation phase, components of the RE-AIM model will be assessed over a 4-month period.

Detailed Description
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Participants who screen positive for the study during the effectiveness phase, will be randomized to either the therapy or control at a rate of 2:1. Whether the participant receives the on-site therapist or the remote therapist will depend on day of week or shift. Over the course of the study, the proportion of shifts covered by on-site verses remote therapists will be balanced for seasonality and time of day (evening vs. day time).

Official Title
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Translation of an Intervention for Violence Among Adolescents in Emergency Departments

Conditions
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Violence

Intervention / Treatment
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* Behavioral: SafERteens


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: youth (ages 14-18) presenting to the Hurley Medical Center (HMC) ED who are medically stable. Patients classified by medical staff as having unstable vital signs or Level 1 trauma (e.g., unconscious, in need of immediate lifesaving procedures such as surgery), will be approached during their inpatient stay after stabilization (4% based on prior work); access to a parent or guardian for consent among adolescents ages 14-17 (over 90% based on our prior work). Positive past 3 month violence screen criteria: Youth will be eligible for the study if they endorse on self-report computer survey past three month violence perpetration Exclusion Criteria: youth who do not understand English youth deemed unable to provide informed assent/consent by ED or research staff prisoners at time of ED presentation. youth who present to the ED as victims of sexual abuse or child abuse

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: In-person Therapy by ED Staff<br>Brief 30 minute on-on-one private motivation interviewing intervention during emergency department care delivered by ED staff in-person. | Behavioral: SafERteens<br>* A 30 minute private on-on-one brief motivational interviewing intervention given during emergency department care. The goal of the intervention was to reduce and prevention youth violence using techniques to change behavior in a respectful, non-confrontational, and non-judgmental manner. This one-on one counseling approach emphasizes individual choice and responsibility and differentiates between future goals/values and current behavior<br>|
| Experimental: Remote Therapy by Research Staff<br>Brief 30 minute on-on-one private motivation interviewing intervention during emergency department care delivered remotely (over video) by research staff. | Behavioral: SafERteens<br>* A 30 minute private on-on-one brief motivational interviewing intervention given during emergency department care. The goal of the intervention was to reduce and prevention youth violence using techniques to change behavior in a respectful, non-confrontational, and non-judgmental manner. This one-on one counseling approach emphasizes individual choice and responsibility and differentiates between future goals/values and current behavior<br>|
| No Intervention: Comparison Group<br>This group will not receive an intervention, but did receive an informational pamphlet of resources in the area (enhanced usual care). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Peer violence behaviors | as assessed with the modified Conflict Tactic Scale | Change from baseline to 3 months | 
| Violence Consequences | as assessment with a scale developed in the original SafERteens study | Change from baseline to 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-Efficacy for non-violence | As assessed with the Teen Conflict Survey | Change from baseline to 3 months | 
| Attitude towards viiolence | as assessed with the Attitudes Towards Violence Scale | Change from baseline to 3 months |