115 Preventing perinatal teen dating violence through relationship education at nurse home visiting: secondary analyses of a randomized controlled trial

Abstract

<h3>Statement of Purpose</h3> To explore the effectiveness and mechanisms of relationship education to reduce perinatal teen dating violence (PTDV) at nurse home visitation. Home visiting programs are critical to prevent PTDV. Only one randomized controlled trial (RCT) of relationship education to prevent intimate partner violence (IPV) in home visiting has been published without specific analyses for adolescent parents. <h3>Methods/Approach</h3> In 2020, we performed secondary analyses of a subsample of 63 adolescents (aged 15 to 17) among 238 first-time, low-income mothers in the Nurse Family Partnership (NFP) program in an RCT in Oregon from 2005 to 2011. In the augmented program, trained nurses provided the adapted Within My Reach curriculum where commitment was taught along with IPV screening and referral and decision-making (e.g., sliding vs. deciding) during pregnancy. These IPV interventions were not in the standard program. Mixed effects models were performed because PTDV was assessed during pregnancy, 1- and 2-year follow-ups and summed instances of victimization and/or perpetration of physical assault, sexual coercion, and physical injury. <h3>Results</h3> The augmented program was associated with reduced PTDV at 1-year follow-up significantly (ß=-2.8; 95% confidence limit -5.3, -0.3, p=0.03] but not at 2-year follow-up (ß=-1.5; -4.2, 1.2, p=0.27). In exploratory mediation analyses, mediation effects of commitment and relationship stability on PTDV were not significant (p= 0.47 and 0.64, respectively). <h3>Conclusions</h3> Exploratory analyses of this RCT showed significant short-term effects on PTDV. Large trans-disciplinary studies are needed to perform mediation analyses to delineate mechanisms of change and improve NFP program models to prevent PTDV.