Brief Intervention for Teen Pregnancy Prevention

Overview

Although the Academy of Pediatrics and the Society for Adolescent Health and Medicine recommend that teen health providers screen for sexual risk behaviors and provide education and counseling to those at risk, there are currently no specific guidelines or protocols available to guide such practices, nor have there been any rigorous evaluations of efficacy. Preventing teen pregnancy through brief intervention in primary care holds the promise to have a significant public health impact and reduce health disparities by engaging, educating, and motivating the majority of teens who visit a primary care setting each year. In the current study, we seek to rigorously evaluate the impact of brief intervention vs. informational control on unprotected sexual intercourse among teens with past year unprotected sex at two primary care clinics serving predominately underserved, minority populations in New Mexico. The target population for the current study will be 1350 male and female teens, aged 13-19, from the Atrisco Center for Family and Community Health and the Albuquerque Job Corps Wellness Center. Extensive formative work involving the study population will be conducted prior to the trial to refine the motivational interviewing-based brief intervention. Eligible youth will be randomly assigned to brief intervention or an informational control condition, in addition to regularly offered medically-based contraception consultation and prescription services. Follow-ups at 3- and 9- months will compare rates of unprotected sex and acceptance of long-acting reversible contraceptives. Brief education and counseling interventions could be feasibly implemented during the greater than eight preventive and acute primary care visits that the average US adolescent attends during their teen years. Such an approach could conserve valuable resources required by more intensive interventions for nonresponsive teens with greater need. Furthermore, social determinants of health, such as poverty and race, that may reduce access to more extensive psychosocial interventions, are less likely to prevent access to primary care, increasing health equity.

Full Title of Study: “Prevention of Teen Pregnancy Through Screening and Brief Intervention in Primary Care”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: Double (Care Provider, Outcomes Assessor)
  • Study Primary Completion Date: January 2020

Interventions

  • Behavioral: Teens Exploring and Managing Prevention Options (TEMPO)

Arms, Groups and Cohorts

  • Experimental: Brief Motivational Interviewing
    • Principles and skills of motivational interviewing will be used with participants assigned to brief intervention. These participants will receive feedback that they are at risk for unintended pregnancy. They will receive information on the likelihood of pregnancy given their self-reported frequency of unprotected sex. They will be given information regarding negative consequences associated with teen pregnancy. They will be provided with information on the chances of pregnancy with abstinence, condom use, oral contraceptives, and Long Acting Reversible Contraceptives (LARC). Following information exchange, participants who are high in readiness to change will engage in action planning, whereby a specific plan for reducing risk for unintended pregnancy will be collaboratively developed with the interventionist. Patients who are low in readiness to change will complete a motivational interviewing-based roadmap activity that is designed to strategically evoke motivational speech.
  • No Intervention: Control

Clinical Trial Outcome Measures

Primary Measures

  • Proportion of participants endorsing unprotected sex at 3 month follow up
    • Time Frame: 3-Month Endpoint
    • All participants
  • Proportion of participants endorsing acceptance of Long Acting Reversible Contraception (LARC) at 3 month follow up
    • Time Frame: 3-Month Endpoint
    • Among female participants

Secondary Measures

  • Proportion of participants endorsing unprotected sex at 9 month follow up
    • Time Frame: 9-Month Endpoint
    • All participants
  • Proportion of participants endorsing acceptance of Long Acting Reversible Contraception (LARC) at 9 month follow up
    • Time Frame: 9-Month Endpoint
    • Among female participants

Participating in This Clinical Trial

Inclusion Criteria

  • Aged 13-19
  • Self-reported past year unprotected sex
  • Can read and speak English
  • Willing to be contacted for follow-up

Exclusion Criteria

  • Current use of long-acting reversible contraceptives
  • Self-reported pregnancy or pregnancy discovered during optional medical contraception consultation
  • Expressed suicidality
  • Obvious cognitive impairment
  • Inability to provide informed consent

Gender Eligibility: All

Minimum Age: 13 Years

Maximum Age: 19 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of New Mexico
  • Collaborator
    • Department of Health and Human Services
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Jennifer E Hettema, PhD, Principal Investigator, The University of New Mexico
  • Overall Contact(s)
    • Jennifer E Hettema, PhD, 505-272-2165, jhettema@salud.unm.edu

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