434 - Adolescent Relationship Abuse Prevention in a Pediatric Emergency Department: Preliminary Findings from a Pilot RCT

Poster Number: 434
Publication Number: 434.2811

Background: Adolescent relationship abuse (ARA) affects millions of adolescents annually and is associated with negative health outcomes. We leveraged community collaborative input for adaptation of existing evidence-based ARA interventions for the pediatric emergency department (PED).

Objective: To measure feasibility, acceptability, and preliminary effectiveness of a PED-based ARA intervention.

Design/Methods: A pilot RCT of an ED-based ARA intervention was performed from February to August 2023. Adolescents 13-18 years old completed an electronic survey evaluating acceptability attitudes, self-efficacy, recognition of ARA, importance of healthy relationship characteristics, ARA victimization, partner access to firearms, knowledge and use of ARA resources; and received institutional resources and the opportunity for social work consultation. The intervention group received universal ARA education, a healthy relationship quiz (if in a relationship), and QR code access that contained resources. The intervention group answered questions about intervention effectiveness. Feasibility was calculated based on adolescent study completion. Acceptability was assessed using 4 Likert-style questions. Secondary outcome measures include preliminary intervention effectiveness assessed through a 1-month follow-up survey.

Results: Of 224 (intervention=112, enhanced care=112) adolescents, the mean age was 15.6 (SD +/- 1.5), the majority were female (58%), Black (50%), heterosexual (67%), single (64%), and sexually inexperienced (63%). Over one-third (39%) experienced some form of ARA (3% physical abuse, 15% sexual abuse, 3% reproductive coercion, 30% cyber abuse). At least 7% (8 of 72 adolescents in a relationship) reported that their dating partners had access to firearms. Of the adolescents in the intervention group in a relationship, the majority (27/45 (60%)) scored as “definite warning signs of an abusive relationship” on the healthy relationship quiz. Preliminary intervention results demonstrate high feasibility (97% baseline study completion), acceptability (majority of study participants report “it is helpful for healthcare providers to talk about healthy and unhealthy relationships to adolescents” (90%) and the “ED is an acceptable place” (77%)), and effectiveness (adolescents in the intervention group report increased understanding about healthy and unhealthy relationships (88%) and how to help someone in an unhealthy relationship (85%)) (Table 1). Follow-up survey data analysis is ongoing.

Conclusion(s): This pilot RCT supports feasibility and acceptability of an ED-based ARA intervention for adolescents in a PED.