Engagement Strategies for Adolescent Violence Prevention

Recruiting at 5 trial locations

Overseen By Katy Clark

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Incomplete screening, Late start, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

240 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to determine the preliminary efficacy (via a micro-randomized trial \[MRT\] design) of augmenting Enhanced-Replicating Effective Program (E-REP) with engagement strategies to increase and sustain reach by healthcare providers (e.g., nurses, social workers) during implementation of the SafERteens program across multiple healthcare settings.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Engagement Strategies for Adolescent Violence Prevention?

The study on a two-week psychosocial intervention showed that such interventions can reduce future aggression and incarceration in aggressive juvenile offenders, suggesting that structured programs like SafERteens may be effective in violence prevention. Additionally, higher intervention dosage was linked to positive changes in parenting practices in a family-focused violence prevention program, indicating that consistent engagement in similar interventions could be beneficial. ^{1 2 3 4 5}

How does the Engagement Strategies for Adolescent Violence Prevention treatment differ from other treatments for violence prevention?

This treatment is unique because it uses a Narrative Engagement Framework (NEF), which focuses on personal stories to engage adolescents in violence prevention. Unlike traditional methods, this approach emphasizes the active involvement of youth in creating and sharing narratives, potentially making the prevention efforts more relatable and effective. ^{2 6 7 8 9}

Research Team

Patrick Carter, M.D.

Principal Investigator

University of Michigan

Eligibility Criteria

This trial is for healthcare providers like nurses and social workers at certain study sites who are involved in screening or delivering the SafERteens program. Providers starting work more than 9 months after implementation or those not expected to complete these tasks in their roles cannot participate.

Inclusion Criteria

Employed at study site

I am willing to participate in the SafERteens program.

Exclusion Criteria

Would not be expected to complete screening and/or intervention delivery

Would not begin screening and/or delivering SafERteens within the first 9 months of cohort implementation

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Implementation of the SafERteens program with engagement strategies to increase and sustain reach by healthcare providers

52 weeks

Weekly and monthly interventions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Commitment
• Narrative Persuasion
• Personalized Feedback
• Reciprocity

Trial Overview The study aims to test if adding engagement strategies (like narrative persuasion, reciprocity, personalized feedback, commitment) can improve the reach of the SafERteens violence prevention program when implemented by healthcare providers across various settings.

Participant Groups

Group I: Reciprocity (randomized weekly, 1 of 4 options) Experimental Treatment 1 Intervention

The reciprocity engagement strategy (ES) will be operationalized as an unsolicited $5 gift card with the SafERteens Logo. Randomized weekly.

Group II: Personalized feedback (randomized monthly, 1 of 2 options) Experimental Treatment 1 Intervention

The feedback ES will be operationalized as a visual graphic of their personal performance screening and/or delivering SafERteens in relation to the mean of the provider group and/or towards a pre-set standard (i.e., screening 75% of adolescents; delivery rate of 75% of eligible youth). Personalized feedback or none will be randomized on a monthly basis.

Group III: Narrative Persuasion (randomized weekly, 1 of 4 options) Experimental Treatment 1 Intervention

Narrative persuasion will be youth or provider testimonial about violence in their community and/or how SafERteens helped their development and reduced violence. Randomized weekly.

Group IV: Commitment (randomized weekly, 1 of 4 options) Experimental Treatment 1 Intervention

Commitment will be operationalized as a pledge committing to screening and/or delivering SafERteens (depending on role). Randomized weekly.

Group V: Engagement Strategy Control (randomized weekly, 1 of 4 options) Active Control 1 Intervention

The control condition will involve no ES for the weekly Engagement Strategies. Randomized weekly.

Group VI: Personalized feedback control (randomized monthly, 1 of 2 options) Active Control 1 Intervention

The control condition will involve no personalized feedback. Randomized monthly

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

Findings from Research

In a study involving 334 families participating in a selective family-focused violence prevention program, higher intervention dosage was linked to more positive changes in targeted parenting characteristics, indicating that the amount of intervention received is crucial for effectiveness.

While parent and child satisfaction and alliance with the provider improved during the program, these factors did not significantly influence attendance, suggesting that focusing on increasing dosage may be more beneficial than enhancing engagement or alliance in structured interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation and process effects on prevention outcomes for middle school students. The Multisite Violence Prevention Project, .[2019]

In a preliminary study involving 48 adolescents, both motivational interviewing (MI) and motivational interviewing with normative feedback (MI+NF) led to a significant increase in days of abstinence from substance use, with an average increase of about 10% at follow-up.

While 55% of participants in the MI group engaged in treatment compared to 41.7% in the MI+NF group, the difference was not statistically significant, suggesting that further research is needed to understand the role of normative feedback in enhancing treatment engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational Interviewing With and Without Normative Feedback for Adolescents With Substance Use Problems: A Preliminary Study. Smith, DC., Ureche, DJ., Davis, JP., et al.[2019]

A 2-week intervention targeting psychosocial factors significantly reduced aggression in clinically aggressive juvenile offenders (n=71) compared to a control group, with many participants no longer meeting clinical criteria for aggression after the intervention.

The intervention group was nearly 4 times less likely to report incarceration at the 12-month follow-up, highlighting its effectiveness in preventing future incarceration among the most aggressive youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Two-Week Psychosocial Intervention Reduces Future Aggression and Incarceration in Clinically Aggressive Juvenile Offenders. Kendall, AD., Emerson, EM., Hartmann, WE., et al.[2019]

In a study involving 48 adolescents with substance use problems, the addition of normative feedback to motivational interviewing did not significantly improve their readiness to change compared to motivational interviewing alone.

Both treatment groups reported high satisfaction and quality ratings for motivational interviewing, indicating that normative feedback may not be a necessary component for effective treatment in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Normative Feedback and Adolescent Readiness to Change: A Small Randomized Trial. Smith, DC., Davis, JP., Ureche, DJ., et al.[2019]

In a 6-week study involving 11 therapists and 4 leaders from community mental health agencies, both financial and social incentives were found to be feasible and acceptable for improving adherence to cognitive-behavioral therapy (CBT) among therapists.

Preliminary results suggested that financial incentives might lead to better adherence to CBT compared to social incentives, indicating a potential direction for future research to enhance the implementation of evidence-based practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and acceptability of two incentive-based implementation strategies for mental health therapists implementing cognitive-behavioral therapy: a pilot study to inform a randomized controlled trial. Beidas, RS., Becker-Haimes, EM., Adams, DR., et al.[2023]

The Narrative Engagement Framework (NEF) emphasizes the unique power of personal stories in prevention efforts, particularly in engaging youth in meaningful ways.

The NEF is exemplified through the 'keepin' it REAL' drug prevention curriculum, highlighting how narrative interventions can effectively communicate prevention messages to adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Narrative means to preventative ends: a narrative engagement framework for designing prevention interventions. Miller-Day, M., Hecht, ML.[2022]

Youth-led prevention programs, like the Youth Voices in Prevention (Youth VIP) leadership retreats, show potential in reducing sexual harassment and improving bystander behaviors, especially in smaller, focused retreats during the school year.

However, larger initial retreats may lead to unintended increases in both victimization and perpetration, indicating that the structure and focus of these programs significantly impact their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Impact of a Youth-Led Sexual Violence Prevention Program: Youth Leadership Retreat Outcomes. Edwards, KM., Banyard, VL., Waterman, EA., et al.[2023]

In a study involving 310 youth participants, self-reported engagement with a media literacy e-learning program significantly predicted increased self-efficacy to counter-argue against substance use, suggesting that engagement is crucial for effective prevention outcomes.

Program analytics indicated that higher engagement dosage was associated with lower injunctive and descriptive norms regarding substance use, highlighting the potential of using technology to enhance prevention curricula beyond traditional classroom settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of Engagement in Effective, Digital Prevention Interventions: the Function of Engagement in the REAL Media Substance Use Prevention Curriculum. Greene, K., Choi, HJ., Glenn, SD., et al.[2022]

The Risk Reduction Therapy for Adolescents (RRTA) was evaluated in a study involving 105 drug court-involved youth, where it aimed to address both substance use disorders and sexual risk behaviors over a 12-month period.

Despite the comprehensive approach of RRTA, the study did not find robust effects compared to usual services, suggesting that existing interventions in the juvenile drug court may have overshadowed the potential benefits of RRTA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents. Letourneau, EJ., McCart, MR., Sheidow, AJ., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Implementation and process effects on prevention outcomes for middle school students. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Motivational Interviewing With and Without Normative Feedback for Adolescents With Substance Use Problems: A Preliminary Study. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

A Two-Week Psychosocial Intervention Reduces Future Aggression and Incarceration in Clinically Aggressive Juvenile Offenders. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Normative Feedback and Adolescent Readiness to Change: A Small Randomized Trial. [2019]

5. England pubmed.ncbi.nlm.nih.gov

Feasibility and acceptability of two incentive-based implementation strategies for mental health therapists implementing cognitive-behavioral therapy: a pilot study to inform a randomized controlled trial. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Narrative means to preventative ends: a narrative engagement framework for designing prevention interventions. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Evaluating the Impact of a Youth-Led Sexual Violence Prevention Program: Youth Leadership Retreat Outcomes. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

The Role of Engagement in Effective, Digital Prevention Interventions: the Function of Engagement in the REAL Media Substance Use Prevention Curriculum. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents. [2022]