Program

Sep 24, 2010

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.

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

Program
information last updated 9/24/10.

 

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