COMPUTER-ASSISTED MOTIVATIONAL INTERVENTION (CAMI)

OVERVIEW

The Computer-assisted Motivational Intervention (CAMI) seeks to prevent rapid subsequent births among adolescent mothers. The program begins approximately six weeks after birth and continues quarterly for two years. Participants receive motivational interviewing with a counselor to help increase motivations to use contraception and not become pregnant. An evaluation performed two years after the birth of the first child found no impact on repeat births among adolescents in the CAMI intervention group compared with the usual care control group.

DESCRIPTION OF PROGRAM

Target population: Pregnant adolescents.

The Computer-assisted Motivational Intervention (CAMI) seeks to prevent subsequent births less than two years after the first birth among adolescent mothers. The program begins approximately six weeks after birth and continues quarterly for two years (approximately nine sessions). This program is based on the transtheoretical stages of change model. Using a laptop computer, participants answer a series of questions about their current sexual relationships along with their intentions and behaviors towards contraceptive use and condom use. A computer algorithm produces each participant’s stage of change (of the transtheoretical model) for contraceptive use and condom use, which then ranks their risk for pregnancy and sexually transmitted infections. Based on these findings, a 20-minute individualized motivational interviewing session then takes place with a counselor. These sessions allow the counselor to help increase participant’s motivation to use contraception and not become pregnant two years after giving birth. Counselors are African-American paraprofessional women residing in the same communities as participants. Counselors receive up to two-and-a-half days of training on the transtheoretical stages of change model, motivational interviewing, and the protocols.

Another arm of this intervention was developed, CAMI-Plus, which also included home visitations. The CAMI-Plus program, along with the evaluation findings, is reviewed in a separate LINKS write-up.

EVALUATION(S) OF PROGRAM

Barnet B, Liu J, DeVoe M, Duggan AK, Gold MA, Pecukonis E. (2009). Motivational Intervention to Reduce Rapid Subsequent Births to Adolescent Mothers: A Community-based Randomized Trial. Annals of Family Medicine, 7(5): 436-445.

Evaluated population: A total of 155 adolescent girls between 12 and 18 years of age who were more than 24 weeks pregnant were recruited for the study. Participants were recruited from five prenatal care clinics serving low-income, predominately African-American communities located in Baltimore, MD.

Approach: After completing the baseline interview, participants were randomly assigned to the CAMI intervention group (n=87) or the usual care control group (n=68). The primary outcome assessed was repeat birth at two years after the birth of the first child. Repeat births were measured through collecting birth certificate records. Participants were also assessed on demographic characteristics, living arrangements, relationship with baby’s father, future intentions towards contraception use and pregnancy, sexual decision-making competence, depressive symptoms, substance use, and social support. Interviews were conducted at baseline as well as 24 months postpartum.

Results: There was no difference in having a rapid repeat birth between women in the CAMI intervention group and women in the control group.

SOURCES FOR MORE INFORMATION

References

Barnet B, Liu J, DeVoe M, Duggan AK, Gold MA, Pecukonis E. (2009). Motivational Intervention to Reduce Rapid Subsequent Births to Adolescent Mothers: A Community-based Randomized Trial. Annals of Family Medicine, 7(5): 436-445.

SUMMARY & CATEGORIZATION

Program categorized in this guide according to the following:

Evaluated participant age: Adolescents (12-17), Youth (16+)

Program component: Community-based

Measured outcomes: Teen Pregnancy and Reproductive Health

KEYWORDS: Adolescents (12-17), Youth (16+), Female Only, Black/African, Adolescent Mothers, Reproductive Health, Teen Pregnancy, Sexual Activity, Condom Use and Contraception, Community-based

Program information last updated 9/24/10.