Choices-Teen: A Bundled Risk Reduction Intervention for Juvenile Justice Females

Study Overview
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Brief Summary
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This pilot study will: 1) demonstrate the feasibility of delivering CHOICES-TEEN with master's level mental health professionals within a juvenile justice setting; 2) determine acceptance of CHOICES-TEEN as measured by client adherence, retention, and treatment satisfaction; and 3) assess client improvement at 3-month follow-up (e.g., reduction of risk of HIV, nicotine-exposed pregnancy, and alcohol-exposed pregnancy).

Detailed Description
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The overall objective of this study is to assess the feasibility and promise of an adapted CHOICES preconception intervention (CHOICES-TEEN) in reducing the risk of HIV, nicotine-exposed pregnancy (NEP), and alcohol-exposed pregnancy (AEP) in adolescent females on intensive community probation. The current study posits that a two-session CHOICES intervention adapted to target multiple bundled health risks-AEP, NEP, and HIV-will be feasible, acceptable, and promising in reducing these risks among females on community-based juvenile probation. This study will: Aim 1: Modify the efficacious CHOICES preconception intervention to target the prevention of HIV, AEP, and NEP. The result will be a two session individual intervention (CHOICES-TEEN) and accompanying therapy manual based on the Transtheoretical Model (TTM) and Motivational Interviewing. Aim 2: Conduct a one-arm feasibility trial with females in the juvenile justice system to assess the promise of CHOICES-TEEN. This pilot study will: 1) demonstrate the feasibility of delivering CHOICES-TEEN with master's level mental health professionals within a juvenile justice setting; 2) determine acceptance of CHOICES-TEEN as measured by client adherence, retention, and treatment satisfaction; and 3) assess client improvement at 3-month follow-up (e.g., reduction of risk of HIV, NEP, and AEP). This study will inform subsequent Stage II/III behavioral intervention studies and contribute to a missing, fundamental element in the knowledge base - further understanding of the feasibility of targeting bundled health risks in high-risk adolescents, and the potential promise of a gender-specific intervention for this population.

Official Title
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Choices-Teen: A Bundled Risk Reduction Intervention for Juvenile Justice Females

Conditions
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HIV, Alcohol Use, Smoking, Contraception

Intervention / Treatment
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* Behavioral: Choices-Teen


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have had vaginal intercourse with a male in the last 90 days Inconsistent/ineffective contraception use Inconsistent/ineffective condom use Drinking at risk levels Smoking Available for the follow-up period Exclusion Criteria: Pregnant Infertile Insufficient locator information Language other than English

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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Female

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: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Choices-Teen Intervention<br>A three session intervention with two counseling sessions with a master's level therapist and a counseling session with a physician. The counseling with the master's level therapist utilizes a motivational interviewing approach to encourage changes in alcohol use, contraceptive use, smoking and HIV risk behaviors. This part of the intervention (a) provides norms-based-but personalized-feedback; (b) encourages participating in the smoking cessation program; (c) increases motivation to change each of the target behaviors; (d) decreases temptation to engage in risk behaviors; (e) increases confidence to avoid risk behaviors; and (f) develops a personalized, tailored change plan. The physician session provides individualized contraception and HIV risk reduction counseling. | Behavioral: Choices-Teen<br>* Choices-Teen participants in this condition will receive two brief motivational-interviewing-based counseling sessions, and one counseling session with a physician.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk of alcohol-exposed pregnancy | Timeline Followback Interview | 3 months | 
| Risk of nicotine-exposed pregnancy | Timeline Followback Interview | 3 months | 
| HIV risk | Timeline Followback Interview | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Excessive alcohol consumption | AUDIT Scale | 3 months | 
| Psychological distress and symptoms | Brief Symptom Inventory -18 | 3 months | 
| Pros and cons of engaging in health risk behaviors (alcohol, smoking, HIV) | Decisional Balance Scale | 3 months | 
| Experiential and behavioral processes of change for health risk behaviors (alcohol, smoking, HIV) | Processes of Change Questionnaire | 3 months | 
| Temptation to engage in health risk behaviors (alcohol, smoking, HIV) | Temptation Scale | 3 months | 
| Confidence/self-efficacy to not engage in health risk behaviors (alcohol, smoking, HIV) | Confidence Scale | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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alcohol-exposed pregnancy, nicotine-exposed pregnancy, tobacco-exposed pregnancy, alcohol, contraception, smoking, pregnancy, HIV, prevention