Date SMART: With $443,000 NIH grant, Rowan psychologist seeks to help teen moms avoid dating violence, risky sexual behavior

Teen moms face endless obstacles. To Dr. Meredith Joppa, clinical psychologist and assistant professor in the Department of Psychology at Rowan University, the high rate of dating violence is among the most worrisome.

“Adolescent mothers are at elevated risk for dating violence, rapid repeat pregnancy, and sexually transmitted infections, including HIV,” Joppa explained. The negative health outcomes of dating violence can affect these young women--and their children who grow up surrounded by it--for a lifetime, Joppa noted.

The odds are stacked against teen moms, but Joppa and her colleagues know that more could be done to change the equation. Their evidence-based Date SMART-Young Mothers Intervention Program recently secured a $443,688 Academic Research Enhancement Award (R15 AREA) from the National Institutes of Health (NIH).

“Having the time and funding to really do this work in the most rigorous and community-informed way allows us to directly impact the lives of young moms and their families,” said Joppa, who has been studying adolescent relationships, sexual behavior and dating violence for 13 years and been working on different iterations of this project since 2011.

 What does it mean to Date SMART?

Of the few evidence-based sexual risk interventions out there for young moms, most focus narrowly on preventing HIV and other sexually transmitted infections. Date SMART, a seven-session group-based intervention developed by clinical psychologist Dr. Christie Rizzo from Northeastern University – one of Joppa’s two co-investigators on this project – is unique.

Date SMART is the only program aimed specifically at reducing dating violence, Joppa noted.

The Date SMART program works by teaching young women important cognitive behavioral therapy-based skills. In many instances, when young girls become parents themselves, they don’t yet have the skills to build healthy relationships. As they navigate the challenges of adolescent motherhood, they may never have the opportunity to develop these skills. As a result, they are more likely to be involved in dating relationships characterized by sexual risk behavior, including unprotected sex, or by hostile, coercive or violent behaviors.

In particular, Date SMART addresses three concerns that are linked to higher rates of dating violence and sexual risk behavior. The program teaches women skills to decrease depressive symptoms, regulate emotional reactivity and learn valuable new interpersonal skills. Through Date SMART, young women learn how to promote healthy relationships, particularly dating relationships.

Joppa and her colleagues aren’t trying to tell young mothers who or how they should date, but instead, empowering them to cultivate and use these skills to improve their own well-being and that of their children.

“Young moms are the true experts about their lives and relationships,” said Joppa. “We hope that by listening to and working with them, we’ll be better able to serve and support them.”

Dating violence and underserved teen mom populations

The higher-than-average risks of dating violence and sexual risk behavior disproportionately affect underserved young women. Research shows that Hispanic and non-Hispanic black adolescent girls in low-income urban areas are most likely to see negative outcomes of dating violence.

“Prevention needs to address the unique needs of predominantly racial and ethnic minority young women,” Joppa said. “We know that young moms are more likely to come from underserved backgrounds.”

Birth rates are twice as high among Hispanic and non-Hispanic black teens as they are among non-Hispanic white adolescents, Joppa noted. This makes it crucial that young women from these underserved backgrounds have access to help and intervention.

Health disparities across the United States are another troubling piece of the puzzle. Disadvantaged young mothers who most need care tend to face additional barriers to getting the help they need. In particular, adolescent mothers suffering from depression often have trouble accessing behavioral health care services.

The problem with dating violence research

Young mothers from underserved backgrounds aren’t only lacking in access to prevention programs and behavioral health services. They are also underrepresented in research, according to Joppa.

That leaves researchers like Joppa with a complex dilemma. To develop evidence-based interventions like Date SMART, they need ample research. That research must include participants representative of the populations the intervention strives to help.

So, how do researchers connect with the people who most need, and yet are least likely to participate in, this research? That’s one of the three areas Joppa intends to explore over the course of this funded project.

“If we want to support young moms in learning evidence-based skills to promote healthy relationships, the first step is for us to work with young moms themselves and learn from them,” Joppa said. “How can we adapt our research recruitment strategies to reach more young moms? How can we make it easier for them to participate in this kind of research?”

The enthusiastic response from the teen moms Joppa’s team has worked with in pilot studies makes it clear that there’s plenty of interest among this population.

“The young moms we worked with were eager to talk about their relationships and really excited about the prospect of a program that would help make their co-parenting and dating relationships happier and healthier,” said Joppa. “Like moms of all ages, they put their kids first. They told us they would love a program where they can connect with other young moms and support each other.”

Besides developing a better understanding of how to reach teen moms for both research and implementation purposes, Joppa and her team have two other important objectives.

One, they want to use what they learn from young mothers to adapt the existing Date SMART program to the unique needs of teen moms. Two, they want to launch this new version of the intervention in a pilot research study that will illustrate its effectiveness and opportunities for improvement.

Intervention takes a team approach

No one person could make a difference of the magnitude Joppa has in mind in the lives of countless young mothers. The project is, without a doubt, a team effort, she noted.

Joppa’s second co-investigator, clinical psychologist Dr. Georita Frierson from D’Youville College, brings to the project her unique expertise in health disparities and firsthand experience working with medically underserved individuals. Physician consultant Dr. Lori Feldman-Winter from Cooper University Hospital and statistical consultant Dr. David Barker from Brown University and Rhode Island Hospital are also contributing their knowledge to the project.

On the student front, the project will provide plenty of valuable research opportunities for undergraduate and graduate students. Doctoral students from Rowan’s newly accredited Ph.D. program in Clinical Psychology will serve as research coordinators. The students currently working in Joppa’s Aggression, Substance, and Sexuality Research Team (ASSeRT) lab are playing other key roles, and Joppa plans to hire undergraduate research assistants.

“Student training in research is a major goal of this type of grant,” said Joppa. “The students will be working closely with the faculty and getting mentorship in research and professional development.”