The PREvention Program for Adolescent Relationship and Emotional Development (PREPARED): a proof-of-concept study

The bi-directional link between mental health problems and intimate partner violence (IPV) is well established, yet there is a lack of prevention approaches directly targeting both during adolescence. This study conducted a mixed-methods pilot evaluation of the Prevention Program for Adolescent Relationship and Emotional Development (PREPARED), a weekly, six-session, non-specialist delivered, prevention program to promote mental health and prevent IPV. This proof-of-concept study tested implementation outcomes and measured mental health and relationship attitude and behavior changes among adolescents in rural Kenya. PREPARED was piloted with 46 adolescents aged 14–17 (M = 15.47, SD = 1.1) over six weeks. Each session was designed to last approximately two hours, totaling 12 h. Two implementation settings were tested to reach youth enrolled in secondary school (N = 22) and youth not enrolled in school (N = 24). Young adult non-specialist providers (N = 10) were trained to deliver the intervention. Implementation outcomes were assessed at the participant and facilitator levels through surveys, tracking, and qualitative focus group discussions (FGDs). Adolescent participants completed pre-post surveys (immediately before and following the intervention) and endline FGDs to assess changes in mental health and relationship attitudes and behaviors. Participant and facilitator implementation results suggest PREPARED is feasible, acceptable, appropriate, adopted, and accessible in both school and community settings. On average, youth attended 5.5 sessions out of 6; 75% attended all 6. Providers facilitated the intervention with high fidelity (M = 97.8%). Tests of preliminary effectiveness revealed promising, though modest, changes in mental health outcomes and greater agreement with positive approaches to sexual relationships. We did not observe changes in disagreement with male-perpetrated violence in the overall sample. Among adolescents in the same dating relationship throughout the intervention (N = 20), communication in dating relationships improved and shared decision-making increased. There were no substantial changes in reported IPV victimization and perpetration immediately post-intervention. Our study supports the feasibility and acceptability of a novel non-specialist peer-provided mental health and IPV combined prevention intervention in a low-resource setting. The study also provides preliminary positive pre-post signals of change in mental health outcomes and some relationship-related processes, but no immediate change in IPV victimization and perpetration. Open Science Framework (https://doi.org/10.17605/OSF.IO/3H6XT).