# CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females

> **NIH NIH R01** · BAYLOR UNIVERSITY · 2021 · $704,242

## Abstract

PROJECT SUMMARY/ABSTRACT
NOT-DA-19-048 Adolescent females in juvenile justice settings engage in multiple health risk behaviors that place
them at risk for HIV and pregnancy affected by alcohol and marijuana. Specifically, they engage in frequent sexual
risk behaviors, placing them at risk of pregnancy, STIs and HIV, while also using marijuana, and alcohol. With
nearly half of U.S. pregnancies being unplanned, females unaware of their pregnancy will continue to drink or use
marijuana during the early and critical weeks of gestation, which places them at risk of substance-exposed
pregnancy. The long-term goal of this proposed line of research is to develop efficient and opportunistic
interventions that reduce the risk of substance-exposed pregnancy (SEP) and HIV/STIs for justice involved female
youth. Therefore, the overall objective of this study is to test the efficacy of CHOICES-TEEN (CT) for reducing the
risks of SEP and HIV/STI in young women involved in community probation or diversion programs. CT was adapted
from the CHOICES preconception intervention and its shorter version, CHOICES-PLUS, which have a robust
history of efficacy in reducing the risk of alcohol and tobacco-exposed pregnancy with high-risk adult women. CT
utilizes Motivational Interviewing (MI), which has demonstrated significant promise with adolescents and criminal
justice populations. Our recent pilot study (R03DA034099; CHOICES-TEEN; CT-P), in which we adapted
CHOICES for teens and tested its feasibility with youth on community probation, produced promising results. CT
was modified based on this pilot work to 1) focus on marijuana (reported by 89% in CT-P study) rather than tobacco
given the low prevalence and sporadic nature of nicotine use reported by the teens; 2) add a mobile health
application to increase engagement with the daily journal and; 3) incorporate a post-CT self-regulation component
targeting behavioral processes of change (POC). This study will move the field vertically by elucidating important
factors influencing youth health behavior change, while testing an intervention designed to reduce individual and
societal costs for this high risk, underserved adolescent population. The next logical step is to conduct a rigorous
RCT to assess the efficacy of this gender-responsive, tailored bundled risk reduction intervention for young,
primarily minority, women involved in a community-based juvenile justice diversion or probation program. A stage II
behavioral intervention efficacy trial will: 1) Primary Aim: Test the efficacy of CHOICES-TEEN (CT) on reducing the
risk of substance-exposed pregnancy (SEP) and HIV/STI among high-risk female youth involved with the juvenile
justice system by reducing alcohol use, increasing marijuana cessation, reducing pregnancy risk, and increasing
condom use. Aim 2: Test the efficacy of CT, compared to SC, in increasing cognitive self-regulation abilities; Aim 3:
Test proposed intervention mediators/mechanisms of action for CT ...

## Key facts

- **NIH application ID:** 10212073
- **Project number:** 1R01DA050670-01A1
- **Recipient organization:** BAYLOR UNIVERSITY
- **Principal Investigator:** Danielle Elizabeth Parrish
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $704,242
- **Award type:** 1
- **Project period:** 2021-05-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10212073

## Citation

> US National Institutes of Health, RePORTER application 10212073, CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females (1R01DA050670-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10212073. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*