Project Summary This R21 application proposes the development and pilot evaluation of a clinically-based, technology- augmented secondary prevention intervention for adolescent victims of cyber-bullying. Approximately 25% of adolescents (age 13-17) report past-year cyber-victimization. Cyber-victimization correlates with numerous negative long-term psychosocial effects, including suicidality, depression, and substance use. Pediatricians currently provide in-clinic preventive interventions to adolescents on a variety of topics. They have been encouraged to screen and counsel adolescents on cyber-victimization; however, no effective cyber- victimization prevention interventions exist for the clinical setting. Brief in-person interventions and longitudinal text-message interventions are acceptable, feasible, and effective at changing adolescent behaviors, including those related to occurrence of physical victimization. Drawing on prior work, this application proposes using a rigorous two-step process to develop an intervention consisting of a brief in-clinic cyber-victimization prevention session, followed by an eight-week tailored, two-way text-messaging program. The two-part intervention will focus on (a) enhancing participants' self-efficacy and resetting norms regarding cyber- victimization and (b) improving participants' emotional regulation and cognitive restructuring in the face of cyber-victimization. In Aim 1, the novel intervention will be developed based on social cognitive learning theory, prior work by the research team, semi-structured interviews with adolescents, and an iterative refinement process during a series of open pilot tests. In Aim 2, the feasibility and acceptability of the novel in- clinic + text-message intervention will be assessed through a pilot randomized controlled trial (n=50). Additionally, the study team will establish the feasibility of an innovative method for measuring cyber- victimization, downloading participants' anonymized social interactions directly from their phones using a previously-piloted computer program, and developing preliminary coding schemes to identify victimization. If the intervention is shown feasible and effective, this study is expected to inform a future large scale effectiveness study to embed a technology-augmented intervention in the clinical setting. The proposed intervention would have broad public health implications, giving clinicians a much-needed tool to reduce cyber- victimization and its consequences in adolescents, addressing both NICHD Vision Themes and critical adolescent objectives of Healthy People 2020.

Project Narrative Cyber-victimization is common among adolescents and is associated with multiple negative consequences with large public health implications. Although the American Academy of Pediatrics, Healthy People 2020, and NICHD call for reductions in adolescent victimization, no cyber-victimization prevention interventions exist that are appropriate for the clinical setting. This grant will use a two-part strategy to develop an innovative technology-augmented cyber-victimization prevention intervention for adolescents identified during a pediatric well-child visit.