In the U.S., teen unintended pregnancy and STIs remain at epidemic levels. Rates of teen fatherhood are especially high among non-Hispanic Black and Hispanic teens. Initiatives to prevent teen pregnancy have focused primarily on female adolescents; how to effectively counsel young men to reduce their risk of fathering a teen pregnancy is unclear. We proposed to adapt, implement and rigorously evaluate an innovative computer-assisted motivational interviewing (CAMI) intervention, originally designed and implemented with girls, for use with young men, age 15-24 years old, to reduce their risk of fathering a teen pregnancy. We will use qualitative methods to modify the CAMI for use with young men. Then we will enroll 646 young men, ages 15 to 24 years, from 2 inner city high schools, a young men's clinic and from community agencies and randomize them to either a modified CAMI aimed at Teen Pregnancy Prevention (CAMI-TPP) or a CAMI aimed at diet, physical activity and tobacco use (CAMI- Fitness). The CAMI-TPP group will receive four, 30-minute MI coaching sessions over 12 weeks and one 30 minute booster at 6-months with a MI coach; sessions will be guided by a computer- generated, feedback aimed at increasing condom use, supporting female partners' contraceptive use, and completing a reproductive health visit with STI testing. The CAMI-Fitness group will receive four, 30-minute MI coaching sessions over 12 weeks and one 30 minute booster at 6-months with a MI coach; sessions will be guided by a computer-generated, feedback aimed at diet, physical activity and tobacco use. Both interventions are identical in length and timing but vary in the target behavior (pregnancy prevention versus fitness). We will track the two groups of young men through a 12 week intervention phase and a 12-month follow-up phase to assess differences in sexual and contraceptive behaviors by group.
The specific aim of the study is to evaluate the efficacy of the CAMI-TPP compared to CAMI-Fitness in reducing sexual behaviors that increase the risks of fathering an unintended teen pregnancy by increasing condom use and female partner use of moderately and highly effective reversible contraception. We hypothesize that the CAMI-TPP will increase the proportion of participants who report condom use at last intercourse as well as female partner use of contraception. We also predict that those who receive CAMI-TPP will report higher completion of a reproductive health service visit with STI and/or HIV testing over the course of study participation compared to those in the CAMI-Fitness group. If proven effective, the CAMI-TPP could be broadly implemented as a method to decrease the risk of young men fathering a teen pregnancy.
Although rates of teen fatherhood are high, especially among non-Hispanic Black and Hispanic teens, the effectiveness of counseling to alter young men's sexual and contraceptive behaviors has not been rigorously evaluated. We propose to adapt, implement and rigorously evaluate an innovative computer-assisted motivational interviewing intervention aimed at Teen Pregnancy Prevention (CAMI-TPP), originally designed and implemented with adolescent and adult women, for use with young men, 15-24 years, to reduce their risk of fathering a teen pregnancy. If proven effective, the CAMI-TPP could be broadly implemented as a method to decrease the risk of young men fathering a teen pregnancy.
