COMPUTER-ASSISTED MOTIVATIONAL INTERVENTION Plus (CAMI Plus)

 

 

OVERVIEW

 

The Computer-Assisted Motivational Intervention-Plus (CAMI-Plus) seeks to prevent rapid subsequent births among adolescent mothers. The program begins approximately six weeks after birth and continues quarterly for two year. Participants receive motivational interviewing with a counselor to help increase motivations to use contraception and not become pregnant. Participants also receive home visitations. An evaluation performed two years after the birth of the first child found a reduction in repeat births among adolescents in the CAMI-Plus intervention group compared with the usual care control.

 

 

DESCRIPTION OF PROGRAM

 

Target population: Pregnant adolescents, aged 12 to 18.

 

The Computer-Assisted Motivational Intervention-Plus (CAMI-Plus) seeks to prevent rapid repeat births (subsequent births less than two years after the first birth) among pregnant adolescents. The program begins approximately six weeks after birth and continues quarterly for two years to prevent a subsequent birth during this time frame (approximately nine sessions). This program is based on the transtheoretical stages of chance 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 (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.

 

Additionally, participants receive bi-weekly or monthly home visitation sessions, which include parent training and case management. Home visitation sessions are delivered through use of a curriculum, which is based on social cognitive theory and developed specifically for African-American adolescent mothers.

 

Another arm of this intervention was developed, CAMI, which did not include home visitations. The CAMI 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 150 adolescent females between 12 and 18 years of age who were more than 23 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.  Approximately 42 per cent of the study sample had dropped out of school and 61 per cent live with their mothers.  About 74 per cent were still with their baby’s fathers.  Eleven per cent had had a prior birth and 31 per cent had had a prior pregnancy.

 

Approach: After completing the baseline interview, participants were randomly assigned to the CAMI-Plus intervention group (n=82), the CAMI-only group (n=87), or the usual care control group (n=68). The primary outcome assessed was repeat birth occurring two years after the birth of the first child or earlier. 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: Adolescents who participated in the CAMI-Plus intervention group were less likely to have a rapid repeat birth than Adolescents in the usual care control group (ES=.29).

 

 

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: Home-based, Community-based

 

Measured outcomes: Teen Pregnancy and Reproductive Health

 

 

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

 

 

Program information last updated 9/24/10.

 

 

 

		© Child Trends 2003