PROJECT SUMMARY/ABSTRACT The primary goal of this proposal is to help further Dr. Jarvis’ development into an independent investigator in the area of adolescent relationship abuse (ARA). With her clinical background in pediatric emergency medicine and clinical and research experiences in the areas of interpersonal violence and ARA, she is ideally positioned to succeed through the CDC K01 Career Mentored Development Award mechanism. This mixed methods study will apply an iterative intervention mapping (IM) framework to adapt an ARA evidence-based intervention. This study of adolescents presenting to a pediatric ED has 3 specific aims, as follows: 1) Using an iterative IM process, we will engage stakeholders, including adolescents, to adapt Real Talk, an existing evidence-based ARA perpetration reduction program, to focus on ARA prevention (healthy relationship promotion) and victim/survivor services within the pediatric ED setting; 2) To measure the feasibility and acceptability of an adolescent centered ARA intervention adapted for the ED through a small pilot randomized controlled trial of adolescents; and 3) To measure the preliminary effectiveness (increased ARA knowledge, increased relationship self-efficacy, and decreased self-reported ARA victimization) of the adapted Real Talk brief ARA intervention. Primary prevention programs are needed to educate adolescents about healthy dating relationship behaviors, and secondary prevention programs are needed to address risk behaviors associated with ARA victimization. Collectively, these aims help enhance the development of ED-based interventions to allow more adolescents to benefit from ARA services in order to improve adolescent health. Dr. Jarvis has identified excellent mentors on her research team to help accomplish the outlined aims. The primary institutional mentor is Dr. Monika Goyal MD, MSCE, an NIH-funded expert in the development of technology- enhanced interventions to improve adolescent sexual health outcomes and reduce disparities. Dr. Elizabeth Miller MD, PhD, an NIH-funded expert in qualitative methods and stakeholder engaged intervention mapping, ARA, and sexual exploitation at the Children’s Hospital of Pittsburgh will serve as co-mentor. Dr. Jarvis’ institutional senior advisory committee will consist of Drs. James Chamberlain, MD (NIH-funded health services researcher and clinical trialist), Pam Hinds RN, PhD (qualitative methods expert), and James Bost PhD (biostatistician and study methods expert). Their career mentorship will help her ensure success during and especially beyond this award. Dr. Jarvis will participate in coursework and focused workshops/hands-on training designed to promote investigator independence. In summary, this proposal sets forth aims that are significant, innovative and feasible, and will provide Dr. Jarvis with the tools and mentorship to develop into an independent investigator working to become a proficient public health researcher and advocate for adolescents in the topic of ARA.

PROJECT NARRATIVE Adolescent relationship abuse (ARA) affects millions of adolescents annually and is defined as intimate partner violence, cyber abuse, or reproductive coercion. Adolescents experiencing ARA often access the emergency department (ED) for care. The objective of this mixed methods study of adolescents presenting to a pediatric ED is to adapt, using a stakeholder-engaged iterative intervention mapping process, an evidence-based ED ARA intervention called “Real Talk” (that focuses on abuse perpetration reduction using motivational interviewing and was shown to reduce dating abuse perpetration) to focus on ARA prevention (healthy relationship promotion) and ARA victim/survivor services; through a small pilot randomized controlled trial of adolescents we will measure feasibility, acceptability, and preliminary effectiveness (increased ARA knowledge, increased relationship self-efficacy, and decreased self-reported ARA victimization) of the adapted Real Talk brief ARA intervention.