Emotion regulation in adolescence is associated with health risk behaviors, including sex and substance use, and early onset of these behaviors represents a risk factor for negative health outcomes throughout life. Thus, interventions appropriate for early adolescence, when these behaviors commonly begin, are critical for prevention efforts. Our research team has developed and tested a novel, engaging, and efficacious intervention that addresses emotion regulation, a theoretically important and under-researched factor associated with risk. Our efficacy trial of this intervention, Project TRAC, showed that an intervention strategy using emotion regulation was significantly more successful than an active comparison condition on the primary target, delaying onset of sexual activity over a two and a half year follow-up, as well as on other risk behaviors, such as condom use, fighting, and partner violence. While efficacious, the current face-to-face, small group format of the program is a difficult model to sustain and implement on a larger scale. With a long-term goal toward dissemination, this two-year project will translate the emotion regulation components of this successful program for tablet-based delivery to enable it to reach a large audience in a format that can be related to a variety of health behavior education topics (e.g., sexual health, violence, substance use). For the proposed project, the Rhode Island Hospital/ Brown University research team will collaborate with Klein Buendel, a health communications technology company, to translate the emotion regulation content of Project TRAC for tablet computers. This translation, using well-established theoretical frameworks, will be approached in consultation with members of the target population (early adolescents) and experts in the field. After the intervention has been translated to a tablet form, ten adolescents will test the program to assess acceptability and usability. Finally, a small pilot study (n=100) will assess feasibility of the translated intervention and compare it to a waitlist control group. The project is novel in its focus on emotion regulation to address early adolescent risk and in teaching emotion regulation through tablet-based gaming that could be modified and enhanced through educational material targeting specific risk behaviors. It represents a continued collaboration between an experienced research team, an experienced health communications firm, and local urban school districts. Information gained in this project will improve our understanding of strategies for teaching emotion regulation and, if successful, lead to the next steps of translating the health education components and testing the full digital TRAC intervention?s efficacy. By addressing emotion regulation through a mechanism that can be widely used (an intervention program for tablets), this project aims to take an important step toward translating this efficacious intervention strategy. This project represents an innovative progression in adolescent risk prevention; its implementation in school settings has great potential for sustainability and relevance for early adolescents everywhere.

Public Health Relevance

The proposed research will fill a gap in the existing literature by translating the emotion regulation content of an efficacious intervention (Project TRAC) for tablet delivery and testing this program with early teens to examine its appropriateness, usability, acceptability, and feasibility. In this way, we hope to create an intervention with fewer barriers to wide implementation than the current small-group format. The long term goal of creating a digital emotion regulation intervention that can be integrated with health education modules targeting risk behaviors is consistent with several of the objectives of Healthy People 2020, including indicators FP 9.3 and 9.4 to ?increase the proportion of adolescents aged 15 years and under who have never had sexual intercourse,? IVP 34 to ?reduce physical fighting among adolescents,? IVP 39.1 to ?reduce physical violence by current and former intimate partners,? and SA-2 to ?increase the proportion of adolescents never using substances.?

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Exploratory/Developmental Grants (R21)
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Psychosocial Development, Risk and Prevention Study Section (PDRP)
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Lee, Karen
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Rhode Island Hospital
United States
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