Adapting and testing an evidence based digitally delivered healthy relationship and violence prevention intervention with Native American adolescents

About This Grant

Dating violence (DV) is common among U.S. high school age adolescents and has significant and lifelong negative health consequences, including suicide behaviors. Native American (NA) adolescents are at increased risk for violence victimization and/or perpetration in their dating violence, given their high rates of violence exposure in their homes and communities. Key challenges for dating violence prevention are the lack of services, fear of stigma and discrimination, and limited trust in and access to skilled professionals. The Fort Peck Reservation is home to the Assiniboine and Sioux Tribes in rural Montana. The reservation community reports high rates of violence and suicide behavior with underfunded and limited health and social service, especially for adolescents. The wide range of negative health and social outcomes associated with violence experienced by reservation-based NA adolescents underscores the call for innovative and targeted behavioral health interventions using appropriate technology. myPlan Teen, is an evidence-based healthy relationship and dating violence prevention intervention for adolescents and is delivered through a secure and confidential web based and mobile app. myPlan Teen provides adolescents with immediate access to information about healthy and unhealthy behaviors, safety strategies tailored to their situation with links to youth friendly resources, to reduce confusion, feelings of isolation and stigma associated with unhealthy relationships. In our CDC funded randomized control trial (RCT) with a national sample of 609 adolescents aged 15-17, we found adolescents randomized to myPlan Teen had a significant increase in use and helpfulness of safety behaviors compared to control group (adolescent health website). Further adolescents who used myPlan Teen reported a significant reduction in physical/sexual violence perpetration and suicide behaviors compared to control group. To advance the relevance and use of myPlan Teen with NA adolescents, our interdisciplinary team in partnership with Tribal Health leaders and Youth Advisory Board (YAB) will adapt myPlan Teen by integrating culturally relevant content, including tribal identity and communal mastery for NA adolescents to build healthy relationships, develop safety skills and access culturally relevant resources. Following the adaptation process, the team will evaluate the effectiveness of the culturally adapted myPlan Teen app on health and safety outcomes with 550 NA adolescents. In addition, we will examine the mechanisms by which myPlan Teen improves health and safety outcomes. The study will advance violence prevention interventions with NA adolescents and inform future processes to adapt and disseminate a digital intervention with adolescents nationally.