O1019: Adolescent Relationship Abuse Prevention in a Pediatric Emergency Department: Preliminary Findings from a Pilot RCT

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) setting.

Methods: Pilot randomized controlled trial (RCT) designed to assess feasibility, acceptability, and effectiveness of an ED-based ARA intervention in an urban PED. From February 2023 (and ongoing), 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 receive institutional resources and have opportunity to request social work consultation. The intervention group receives universal ARA education, a healthy relationship quiz (if in a relationship), and QR code access that contains local and national resources (websites with chat options, click to call phone numbers, and texting) through an electronic tablet. The intervention group also answers questions about the intervention effectiveness and QR “hits” are tracked. We calculated feasibility based on adolescent study completion. Acceptability was assessed using 4 Likert-style questions to assess the acceptability of ARA being addressed in the ED setting. Secondary outcome measures include preliminary intervention effectiveness will be further assessed through a future 1-month follow-up survey.

Results: Study enrollment is ongoing. Of 107 (intervention=50, control=57) patients currently enrolled, the mean age was 15.5 (SD +/- 1.5), the majority were female (55%), Black (56%), heterosexual (71%), identified as single (66%), and not sexually active (62%). Over one-third (36%) have experienced some form of ARA (5% physical abuse, 10% sexual abuse, 5% reproductive coercion, 33% cyber abuse). At least 18% (6 of 33 adolescents in a relationship) reported that their dating partners had access to firearms. Of the adolescents randomized to the intervention group who are currently in a relationship, the majority (13/21 (62%)) scored as “definitely 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” (91%) and that the “ED is an acceptable place” (74%)), and effectiveness (majority of adolescents in the intervention group report increased understanding about healthy and unhealthy relationships (88%) and how to help someone being hurt by a sexual partner or in an unhealthy relationship (84%)) (Table 1).

Conclusion: This ongoing pilot RCT supports feasibility and acceptability of an ED-based ARA intervention for adolescents in a PED. Over one-third of our adolescents have experienced ARA and the majority of adolescents who took the healthy relationship quiz intervention have signs of an abusive relationship. One-month follow-up surveys will continue to assess preliminary intervention effectiveness.