Research
Healthy Adolescent Transitions (HAT) was a research project granted to OhioHealth by HHS, Family and Youth Service Bureau, within the Personal Responsibility Education Innovative Strategies (PREIS) funding stream.
Research Questions
Because a primary goal of the PREIS program is adolescent pregnancy prevention, the primary research question was whether the HAT intervention group participants would have lower rates of rapid repeat pregnancy for the 18-month period post-enrollment relative to those study participants in the usual care control condition. Secondary research questions involved outcomes related to contraception and the three adulthood preparation subjects covered by HAT—financial literacy, educational/career attainment, and healthy life skills. The long-term objective for this work is the development of a comprehensive program to facilitate reproductive and other life goals for the high-risk group of low-income, adolescent mothers.
Study Design
Three hundred adolescent mothers with Medicaid coverage were recruited for a two-group randomized trial—156 for the HAT intervention and 155 for the usual care control condition. Baseline, post-intervention (3 month), short-term follow-up (12 months), and long-term follow-up (18 month) surveys were administered to assess pregnancy prevention and other adult preparatory subjects. Medical records were reviewed as a secondary data source to overcome the social desirability and attrition biases associated with self-report surveys.
The HAT intervention was a 3-month program with an intended dose of 12 weekly sessions lasting approximately 60 to 90 minutes each. The program was delivered by a team of two interventionists—a registered nurse and a bachelor’s level social worker—who met with an individual adolescent. Depending upon the content of a particular session, sometimes only a nurse would participate, sometimes only a social worker would participate, and sometimes both professionals would interact simultaneously with the adolescent. For example, within the healthy eating during pregnancy domain, nurses could emphasize MyPlate and recommendations from the American College of Obstetricians and Gynecologists, while social workers strategize with the participant to obtain SNAP, WIC and food resources.
Most sessions were designed to occur in the adolescent’s home, but interactions could occur by telephone or in a private area of a community setting. Participants chose how often they wished to interact with the nurse and/or social worker. However, encounters could not extend past the 3-month duration of the HAT program.
During the first interaction with the adolescent, the nurse/social worker team provided a brief overview of seven HAT content areas—contraception/pregnancy prevention, HPV vaccinations, medical home, nutrition/healthy eating, educational/career attainment, financial literacy and nicotine cessation. To be consistent with the theoretical framework of behavioral economics (BE), the curriculum was flexible for each adolescent. In other words, they were allowed to select which content area(s) they wished to discuss further.
Strategies from behavioral economics (BE) were used within each content area to aid in improving individual decision making and promote the participant’s goals around that topic.
