Jovenes Sanos: Preventing IPV and Reproductive Coercion Among Underserved Adolescents
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Unintended Pregnancy
- Sponsor
- University of California, San Diego
- Enrollment
- 124
- Locations
- 3
- Primary Endpoint
- Recent RC
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The primary purpose of this research is to conduct a small matched cluster control trial of an intervention designed to address reproductive coercion and unintended pregnancy (ARCHES - Addressing Reproductive Coercion within Healthcare Settings) adapted to the Mexican cultural and family planning healthcare context ( renamed Jovenes Sanos) in order to provide initial data regarding acceptability, feasibility and efficacy in this high need low-and-middle-income country.
Detailed Description
The project consortium will implement the ARCHES model across two community health centers in Tijuana, Baja California, Mexico. A 2-armed pilot study of ARCHES (adapted) will be conducted with 80 female FP clients (40 intervention, 40 control) ages 16-20 drawn from 2 comparable community health centers randomly assigned to either intervention or control (i.e. standard of care). Baseline data will be collected prior to routine FP service delivery, with a short exit survey conducted immediately following the clients' FP appointment (ARCHES or standard FP counseling will be provided during this visit). Follow-up data will be collected at 3-months post-intervention. Data at each time point will be collected via a 30-minute audio computer-assisted self-interview (ACASI) in Spanish. Data will also be collected to assess qualities of program implementation (i.e., process evaluation) to ensure implementation of the program as intended as well as unforeseen barriers to implementation. Creation of procedures for data collection, review of quality control data, and interpretation of findings will occur in collaboration with the entire mentoring/training committee. In-depth interviews (IDIs) with female adolescent FP clients ages 16-20 with a recent IPV/RC (n= 20), and focus groups (FGs) (n=2; 6-8 participants per group) with FP counselors in 2 comparable urban community health centers to identify perceptions of prevalence and impact of IPV and RC among adolescent clients and barriers to identifying IPV and RC. FGs with FP counselors from the participating community health centers will be conducted (n=2; 6-8 participants per group). FP counselors from these community health centers will be purposely selected to participate based on having provided FP services for at least 10 female adolescent clients in the past 6 months. At intervention sites, FP counselors will deliver the intervention integrated into standard-of-care practice; at control sites FP counselors will deliver solely standard-of-care services. Analyses specific to participants ages 16-20 will provide findings to guide consideration of ARCHES as an effective strategy to improve the reproductive health and reduce GBV among adolescents in this region.
Investigators
Argentina Servin, MD, MPH
Assistant Professor
University of California, San Diego
Eligibility Criteria
Inclusion Criteria
- •a) Client seeking voluntary FP services at community health centers; b)Aged 16-20 years; c) Biologically female; d) Willing to complete baseline, exit, and 3-month follow-up survey; e) Able to provide informed consent; f) Literate in Spanish; g) Screened positive for recent RC; h) Reside in Tijuana and have no plans to move in the next 12 months; i) Having no cognitive impairment that may interfere with their decisions to participate in the project (using Folstein Mini-Mental Exam); j) Not have participated in the IDIs (qualitative phase).
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Recent RC
Time Frame: Change from prior 3 months (baseline) and 3-month follow-up
RC consisted of two elements, pregnancy coercion and birth control sabotage. Pregnancy coercion was assessed using via 5 dichotomous items. Birth control sabotage was assessed via 5 dichotomous items measuring experiences of partner interference with contraception to promote pregnancy.
Secondary Outcomes
- Contraception self-efficacy(Baseline and 3-month follow-up)
- Biased and coercive FP provider practices(Immediate post-intervention)
- Contraception discontinuation(Prior 6 months and 12 months)
- Knowledge of IPV services(Present, assessed at baseline, 3-month follow-up)
- Intimate Partner Violence (IPV)(Prior 3 months and prior 12 months)
- Contraception delivery(Immediate post-intervention)
- Utilization of IPV services among those reporting IPV(Prior 3 months and 6 months)