Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Jan 17, 2025
Date Accepted: Aug 17, 2025
Evaluating the Preliminary Efficacy of the TRUST Intervention on Alone-Time and Communication During Well-Adolescent Visits: A Quasi-Experimental Study
ABSTRACT
Background:
Alone time with providers promotes better utilization of health services, including sexual and reproductive health (SRH), empowers adolescents to manage their health, and facilitates discussions on sensitive issues. Yet only 40% of adolescents have alone time with clinicians during well-adolescent visits. Positive parental communication and monitoring are associated with improved SRH and increased alone time. The advancement of mHealth technology provides an excellent opportunity to deliver effective interventions to promote adolescent/provider alone time during well-adolescent visits (WAV).
Objective:
This pilot study aims to explore 1) the preliminary efficacy of a technology-based intervention designed to increase alone time with providers during well-adolescent visits (WAVs) and 2) its impact on trustworthiness between adolescents and mothers, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support before and after the intervention.
Methods:
After obtaining consent and assent, participants accessed a study website to complete a baseline survey, interact with four modules, and complete a post-test survey one month after WAVs. Participants completed surveys assessing alone time, trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support. Mixed model analysis and effect sizes for pre- and post-intervention outcomes were employed.
Results:
Thirty-two dyads (38 adolescents between ages 11 and 17 years old and 32 mothers) participated in this pilot study. This study found a trend toward an increase in alone time from 81.6% to 84.4%, albeit not statistically significant. Adolescents initiating alone time with providers rose from 6.45% to 18.5%. Over 90% of adolescents reported feeling comfortable in one-on-one interactions with providers post-intervention. Mixed model analysis revealed significant improvements among adolescents in parental monitoring (z=2.93, p<0.001), sexual risk communication (z=3.11, p<0.001), parent-adolescent communication (z=3.11, p<0.001), open family communication (z=2.00, p=0.04), and parental support (z=2.87, p<0.001). For mothers, significant improvements were found in parental monitoring (z=2.45, p<0.001) and problem family communication (z=2.24, p =.03).
Conclusions:
This pilot study demonstrates promising results regarding the preliminary efficacy of a technology-based intervention to increase alone time with providers during WAVs and to enhance communication and parenting practices. Improving access to alone time and strengthening communication between parents and adolescents facilitates discussions about sensitive topics, including parental monitoring and sexual and reproductive health, and may strengthen overall satisfaction with healthcare. Clinical Trial: not applicable
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