BACKGROUND
Substance use, sexual assault, and sexual risk behaviors are common among adolescents and are interrelated. Nearly 1 in 5 adolescents use substances before sexual encounters, placing these young people at risk for both sexual assault and sexual risk behaviors. Primary care visits present a unique opportunity to address multiple health risk behaviors.
OBJECTIVE
<i>Teen Well Check</i> is a web-based integrated prevention program for substance use, sexual assault, and sexual risk behaviors with demonstrated usability and acceptability among patients and providers. The aim of this study was to conduct a pilot randomized controlled trial to assess feasibility.
METHODS
Adolescents (n=123) aged 14 to 18 years from diverse backgrounds were recruited from primarily Medicaid-serving pediatric primary care clinics. Participants completed a baseline survey; were randomized to receive <i>Teen Well Check</i> or an assessment-only control; and completed 1-, 3-, and 6-month follow-up surveys. Feasibility was assessed in terms of recruitment and retention rates. Preliminary changes from baseline to follow-up periods were examined separately in the <i>Teen Well Check</i> and control conditions.
RESULTS
We recruited 123 participants (<i>Teen Well Check</i>: n=61, 49.6%; control: n=62, 50.4%). Of the 61 participants assigned to the <i>Teen Well Check</i> condition, 55 (90%) completed the full program and viewed all intervention content. Of the 123 participants, 105 (85.4%) were retained across at least 1 follow-up period, and there was no difference in follow-up rates between the conditions (<i>χ<sup>2</sup><sub>1</sub></i>=0.6; <i>P</i>=.43). The completion of <i>Teen Well Check</i> took an average of 6.2 (SD 5.8) minutes. Preliminary analyses revealed that there were significant reductions in perceived peer norms (descriptive norms) for substance use before sex across follow-ups among participants in the <i>Teen Well Check</i> condition (<i>P</i>=.001 from baseline to 6 months), whereas there were significant increases among participants in the control condition (<i>P</i>=.003 from baseline to 6 months). In addition, there were nonsignificant reductions in substance misuse risk from baseline to the 6-month follow-up among participants in the <i>Teen Well Check</i> condition (<i>P</i>=.16).
CONCLUSIONS
These findings support the feasibility of <i>Teen Well Check</i> delivery within pediatric primary care clinics. A randomized clinical trial is needed to assess efficacy.
CLINICALTRIAL
ClinicalTrials.gov NCT3489434; https://www.clinicaltrials.gov/study/NCT03489434