Evaluating the Preliminary Efficacy of the TRUST Intervention on Alone-Time and Communication During Well-Adolescent Visits: Quasi-Experimental Study
Bibliographic record
Abstract
BACKGROUND: Alone time with health care providers is critical for adolescents, and several professional organizations recommend it. Alone time with providers promotes better utilization of health services, empowers adolescents to manage their health, and facilitates discussions on sensitive issues. However, only 40% of adolescents have private conversations with clinicians during visits. The advancement of mobile health technology provides an excellent opportunity to deliver effective interventions to promote adolescent-provider alone time with adolescents, parents, and providers. OBJECTIVE: This pilot study aims to explore the preliminary efficacy of a technology-based intervention designed to increase alone time with providers during well-adolescent visits and its impact on trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support before and after the intervention. METHODS: A pre- and postintervention design was used. Participants were recruited through local clinics. After obtaining consent, participants accessed a study website to complete a baseline survey, independently interact with 4 educational modules on a website or cellphone, and complete a post-test survey 1 month after their well-adolescent visits. The surveys assessed alone time with providers, trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support. Mixed model analysis and effect sizes were used to evaluate changes in these outcomes from pre- to postintervention. RESULTS: Thirty-two dyads (38 adolescents and 32 mothers) participated in this pilot study. About 86% (n=33) of adolescents and 87% (n=28) of mothers completed the pre- and post-test assessments and the intervention. 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% (n=2) to 18.5% (n=5). Over 90% (n=26) of adolescents reported feeling comfortable in one-on-one interactions with providers postintervention. Mixed model analysis revealed significant improvements among adolescents in parental monitoring (z=2.93, P<.001), sexual risk communication (z=3.11, P<.001), parent-adolescent communication (z=3.11, P<.001), open family communication (z=2.00, P=.04), and parental support (z=2.87, P<.001). For mothers, significant improvements were found in parental monitoring (z=2.45, P<.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 well-adolescent visits 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, sexual and reproductive health, and may strengthen overall satisfaction with health care. TRIAL REGISTRATION: ClinicalTrials.gov NCT07064070; https://clinicaltrials.gov/study/NCT07064070.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".