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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores new methods to help healthcare providers, such as nurses and social workers, engage more effectively in preventing violence among teens. It examines how strategies like providing feedback or sharing stories can enhance the delivery of the SafERteens program. The trial includes several groups and tests strategies such as offering a small gift or requesting a pledge (Commitment) to support the program. It suits healthcare professionals already involved in screening or delivering SafERteens at their workplace. As an unphased trial, this study offers a unique opportunity to contribute to innovative strategies that could enhance efforts in teen violence prevention.

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 prior data suggests that these engagement strategies are safe for adolescents?

Past studies have shown that SafERteens effectively reduces youth violence for up to a year after the program. The program is safe and manageable, featuring short therapy sessions that help change attitudes and behaviors. Research shows that the Narrative Persuasion strategy, which uses stories, can strongly influence attitudes and behaviors related to violence. Although specific safety data for Narrative Persuasion isn't detailed, its use in similar programs suggests it should be safe.

Commitment strategies, which involve making promises to take certain actions, are generally low-risk and have been used successfully to prevent violence. Personalized Feedback, where participants receive customized information about their progress, has been used safely in the SafERteens program to change behavior without negative effects. Overall, these strategies in the trial are considered safe based on past research and their non-invasive nature. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the new engagement strategies for adolescent violence prevention because they focus on psychological and behavioral interventions rather than traditional therapeutic or pharmaceutical methods. These strategies use unique approaches like narrative persuasion, where real stories from peers or providers help youth connect with the impact of violence prevention. Additionally, techniques like commitment, where participants make pledges to engage with prevention programs, and personalized feedback, which visually shows personal performance compared to peers, offer dynamic and personalized ways to engage adolescents. These innovative methods aim to directly influence behavior and attitudes, potentially leading to more effective and lasting outcomes in preventing youth violence.

What evidence suggests that this trial's engagement strategies could be effective for adolescent violence prevention?

Research shows that the SafERteens program helps reduce violent behavior in teenagers. One study found that teens who participated in the program reported less aggression towards others and fewer violence-related problems. This trial tests various engagement strategies to enhance the program's effectiveness. One arm uses narrative persuasion, involving storytelling to change young people's views, especially in schools. Another arm focuses on making commitments, like taking pledges, which studies have shown can greatly reduce violence, with some programs seeing a 39% drop in youth-related violent crime. Additionally, personalized feedback, which compares a person's performance to others, is being tested for its potential to boost participation and reduce aggression. These findings suggest that the strategies tested in this trial could make the SafERteens program even more effective. ^{5 6 7 8 9}

Who Is on the Research Team?

Patrick Carter, M.D.

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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 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]

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]

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 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]

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]

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]

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