An RCT of Dating Matters: Effects on Teen Dating Violence and Relationship Behaviors.
ABSTRACT: INTRODUCTION:Teen dating violence is a serious public health problem with few effective prevention strategies. This study examines whether the Dating Matters comprehensive prevention model, compared with a standard of care intervention, prevented negative relationship behaviors and promoted positive relationship behaviors. STUDY DESIGN:This longitudinal, cluster-RCT compared the effectiveness of Dating Matters with standard of care across middle school. Standard of care was an evidence-based teen dating violence prevention curriculum (Safe Dates) implemented in eighth grade. SETTING/PARTICIPANTS:Forty-six middle schools in high-risk urban neighborhoods in four U.S. cities were randomized. Schools lost to follow-up were replaced with new schools, which were independently randomized (71% school retention). Students were surveyed in fall and spring of sixth, seventh, and eighth grades (2012-2016). The analysis sample includes students from schools implementing Dating Matters or standard of care for >2 years who started sixth grade in the fall of 2012 or 2013 and had dated (N=2,349 students, mean age 12 years, 49% female, and 55% black, non-Hispanic, 28% Hispanic, 17% other). INTERVENTION:Dating Matters is a comprehensive, multicomponent prevention model including classroom-delivered programs for sixth to eighth graders, training for parents of sixth to eighth graders, educator training, a youth communications program, and local health department activities to assess capacity and track teen dating violence-related policy and data. MAIN OUTCOME MEASURES:Self-reported teen dating violence perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills were examined as outcomes. Imputation and analyses were conducted in 2017. RESULTS:Latent panel models demonstrated significant program effects for three of four outcomes; Dating Matters students reported 8.43% lower teen dating violence perpetration, 9.78% lower teen dating violence victimization, and 5.52% lower use of negative conflict resolution strategies, on average across time points and cohorts, than standard of care students. There were no significant effects on positive relationship behaviors. CONCLUSIONS:Dating Matters demonstrates comparative effectiveness, through middle school, for reducing unhealthy relationship behaviors, such as teen dating violence and use of negative conflict resolution strategies, relative to the standard of care intervention. TRIAL REGISTRATION:This study is registered at www.clinicaltrials.gov NCT01672541.
Project description:Few comprehensive primary prevention approaches for youth have been evaluated for effects on multiple types of violence. Dating Matters®: Strategies to Promote Healthy Teen Relationships (Dating Matters) is a comprehensive teen dating violence (TDV) prevention model designed by the Centers for Disease Control and Prevention and evaluated using a longitudinal stratified cluster-randomized controlled trial to determine effectiveness for preventing TDV and promoting healthy relationship behaviors among middle school students. In this study, we examine the prevention effects on secondary outcomes, including victimization and perpetration of physical violence, bullying, and cyberbullying. This study examined the effectiveness of Dating Matters compared to a standard-of-care TDV prevention program in 46 middle schools in four high-risk urban communities across the USA. The analytic sample (N?=?3301; 53% female; 50% Black, non-Hispanic; and 31% Hispanic) consisted of 6th-8th grade students who had an opportunity for exposure to Dating Matters in all three grades or the standard-of-care in 8th grade only. Results demonstrated that both male and female students attending schools implementing Dating Matters reported 11% less bullying perpetration and 11% less physical violence perpetration than students in comparison schools. Female Dating Matters students reported 9% less cyberbullying victimization and 10% less cyberbullying perpetration relative to the standard-of-care. When compared to an existing evidence-based intervention for TDV, Dating Matters demonstrated protective effects on physical violence, bullying, and cyberbullying for most groups of students. The Dating Matters comprehensive prevention model holds promise for reducing multiple forms of violence among middle school-aged youth. ClinicalTrials.gov Identifier: NCT01672541.
Project description:Sexual violence (SV), including sexual harassment (SH), is a significant public health problem affecting adolescent health and well-being. This study extends prior research by evaluating the effectiveness of a comprehensive teen dating violence prevention model, Dating Matters, on SV and SH perpetration and victimization, inclusive of any victim-perpetrator relationship, among middle school students. Dating Matters includes classroom-delivered programs for youth in 6th, 7th, and 8th grades; community-based programs for parents; a youth communications program; training for educators; and community-level activities. Middle schools in four urban areas in the USA were randomly assigned to receive Dating Matters (DM, N?=?22) or a standard-of-care intervention (SC, N?=?24) over four consecutive school years (2012-2016). The analytic sample included two cohorts who entered the study in 6th grade and completed 8th grade by the end of the study allowing for full exposure to Dating Matters (DM: N?=?1662; SC: N?=?1639; 53% female; 50% black, non-Hispanic; 6 waves of data collection for each cohort). Structural equation modeling was employed with multiple imputation to account for missing data. Dating Matters was associated with significant reductions in SV and SH perpetration and victimization scores in most-but not all-sex/cohort groups by the end of 8th grade relative to an evidence-based TDV prevention program. On average, students receiving Dating Matters scored 6% lower on SV perpetration, 3% lower on SV victimization, 4% lower on SH perpetration, and 8% lower on SH victimization by the end of middle school than students receiving an evidence-based violence prevention program. Overall, Dating Matters shows promise for reducing SV and SH, occurring both within and outside dating relationships, through middle school. Clinicaltrials.gov Identifier: NCT01672541.
Project description:OBJECTIVE:Teen dating violence is a serious public health problem. A cluster-randomized trial was conducted to assess the efficacy of Teen Choices, a 3-session online program that delivers assessments and individualized guidance matched to dating history, dating violence experiences, and stage of readiness for using healthy relationship skills. For high risk victims of dating violence, the program addresses readiness to keep oneself safe in relationships. METHOD:Twenty high schools were randomly assigned to the Teen Choices condition (n=2,000) or a Comparison condition (n=1,901). Emotional and physical dating violence victimization and perpetration were assessed at 6 and 12 months in the subset of participants (total n=2,605) who reported a past-year history of dating violence at baseline, and/or who dated during the study. RESULTS:The Teen Choices program was associated with significantly reduced odds of all four types of dating violence (adjusted ORs ranging from .45 to .63 at 12 months follow-up). For three of the four violence outcomes, participants with a past-year history of that type of violence benefited significantly more from the intervention than students without a past-year history. CONCLUSIONS:The Teen Choices program provides an effective and practicable strategy for intervention for teen dating violence prevention.
Project description:Prior research has demonstrated the scope and impact of adverse childhood experiences (ACEs) on health and wellbeing. Less is known about the trajectories from exposure to ACEs, such as witnessing family conflict and violence in the community, to teen dating violence perpetration, and the protective factors that buffer the association between early exposure to ACEs and later teen dating violence perpetration. Students (n?=?1611) completed self-report surveys six times during middle and high school from 2008 to 2013. In early middle school, the sub-sample was 50.2% female and racially/ethnically diverse: 47.7% Black, 36.4% White, 3.4% Hispanic, 1.7% Asian/Pacific Islander, and 10.8% other. Youth were, on average, 12.7 years old. Latent transition analysis was used to assess how trajectories of exposure to parental conflict and community violence during middle school transition into classes of teen dating violence perpetration (e.g., sexual, physical, threatening, relational, and verbal) in high school. Protective factors were then analyzed as moderators of the transition probabilities. Three class trajectories of ACEs during middle school were identified: decreasing family conflict and increasing community violence (n?=?103; 6.4%), stable low family conflict and stable low community violence (n?=?1027; 63.7%), stable high family conflict and stable high community violence (n?=?481; 29.9%). A three class solution for teen dating violence perpetration in high school was found: high all teen dating violence class (n?=?113; 7.0%), physical and verbal only teen dating violence class (n?=?335; 20.8%), and low all teen dating violence class (n?=?1163; 72.2%). Social support, empathy, school belonging and parental monitoring buffered some transitions from ACEs exposure trajectory classes to teen dating violence perpetration classes. Comprehensive prevention strategies that address multiple forms of violence while bolstering protective factors across the social ecology may buffer negative effects of exposure to violence in adolescence.
Project description:Adolescent interpersonal violence victimization is an adverse childhood experience and a serious public health problem for youths, their families, and communities. Violence victimization includes dating violence, sexual violence, and bullying. Youth Risk Behavior Survey data for 2019 were used to examine physical and sexual dating violence; sexual violence by anyone; and bullying victimization, whether on school property or electronic, of U.S. high school students by sex, race/ethnicity, and sexual identity. In addition, this report explores frequency of dating violence and frequency of sexual violence among students who reported these forms of victimization and presents composites of dating violence and bullying. Findings reveal that 8.2% of students reported physical dating violence; 8.2% reported sexual dating violence; 10.8% reported sexual violence by anyone, of which 50% of cases were by a perpetrator other than a dating partner; 19.5% reported bullying on school property; and 15.7% reported electronic bullying victimization during the previous 12 months. Approximately one in eight students reported any dating violence, and one in four reported any bullying victimization. Female students; lesbian, gay, and bisexual students; and students not sure of their sexual identity reported the highest prevalence estimates across all five violence victimization types, any and both forms of dating violence, and any bullying victimization. Non-Hispanic white students reported the highest prevalence of bullying victimization. Among students experiencing physical or sexual dating violence or sexual violence by anyone, the most common frequency reported was one time during the previous year; higher frequency was more prevalent among male students compared with female students. These findings provide a contextual understanding of the prevalence of interpersonal violence of U.S. high school students, highlighting those with highest prevalence. Findings can be used by public health professionals to guide prevention efforts with youths in schools and communities.
Project description:The aim of this research was to know the factors associated with teen dating violence and victimization because violence in teenagers' relationships is increasing in recent years, constituting a serious social problem. For this purpose, we analyzed teen dating violence and explored the variables (sexist attitudes, personal adjustment, clinical maladjustment, and resilience) related to teen dating violence and victimization using multinomial logistic models. The sample was composed of 268 school teenagers aged 12 to 17 from the Basque Country (Spain). Results showed that sex, age, sexism, and self-esteem predicted teen dating violence and that sex and social problems predicted victimization. Associations between the wide range of variables and types of perpetration and victimization (verbal-emotional, relational, and physical) were also explored. These results could be taken into consideration for future prevention programs.
Project description:Bystander-based violence prevention interventions have shown efficacy to reduce dating violence and sexual violence acceptance at the individual level yet no large randomized controlled trial (RCT) has evaluated this effect at the high-school level and over time. This rigorous cluster-randomized controlled trial addresses this gap by evaluating intervention effectiveness at both school and individual levels. Kentucky high schools were randomized to intervention or control conditions. In intervention schools educators provided school-wide 'Green Dot' presentations and bystander training with student popular opinion leaders. Each spring from 2010 to 2014; 73,044 students completed anonymous surveys with no missing data on relevant outcomes. Dating violence and sexual violence acceptance were the primary outcomes for this analysis. At the school level, slopes from linear mixed models using averaged school-level dating violence acceptance (condition-time, p < 0.001) and sexual violence acceptance (condition-time interaction, p < 0.001) differed indicating a significant reduction in the violence acceptance in the intervention relative to control schools over time and specifically in years 3 and 4 when 'Green Dot' was fully implemented. Analyses based on student's self-reported receipt of 'Green Dot' training by condition confirmed the school level finding of significant reductions in both dating violence and sexual violence acceptance in years 3 and 4 for both males and females. In this RCT we find evidence that the bystander-based violence prevention intervention 'Green Dot' works, as hypothesized and as implemented, to reduce acceptance of dating violence and sexual violence at the school and individual levels.
Project description:Sexual minority youth (SMY) report more substance use and experience more physical and sexual dating violence victimization than heterosexual youth; however, few studies have explored the relationship between substance use and disparities in teen dating violence and victimization (TDVV) using national-level estimates, and examined if these relationships vary by sexual minority subgroups. Data from the nationally representative 2015 and 2017 national Youth Risk Behavior Surveys were used to examine differences in TDVV and substance use by sexual identity, and to determine if substance use was associated with TDVV disparities between SMY and heterosexual high school students who dated 12 months prior to the survey (n?=?18,704). Sex-stratified logistic regression models generated prevalence ratios adjusted for demographic characteristics and substance use behaviors to determine if substance use mediated the relationship between sexual identity and TDVV. Compared with their heterosexual peers, SMY experienced higher rates of TDVV and were more likely to report using most types of substances, although differences were more pronounced among female students compared with male students. Disparities in TDVV were reduced for male gay and bisexual students as well as for female bisexual students once substance use was entered into the model, suggesting that there is a relationship between substance use and some of gay and bisexual students' risk for experiences of TDVV. Comprehensive efforts for violence prevention among sexual minority students may benefit from incorporating substance use prevention, given its relationship to disparities in TDVV.
Project description:PURPOSE:Sexual violence (SV), teen dating violence (TDV), and substance use are significant public health concerns among U.S. adolescents. This study examined whether latent classes of baseline alcohol and prescription drug misuse longitudinally predict SV and TDV victimization and perpetration (i.e., verbal,relational, physical/threatening, and sexual) 1 year later. METHODS:Students from six Midwestern high schools (n?=?1,875; grades 9-11) completed surveys across two consecutive spring semesters. Latent class analysis was used to identify classes of individuals according to four substance use variables. A latent class regression and a manual three-step auxiliary approach were used to assess concurrent and distal relationships between identified classes and SV and TDV victimization and perpetration. RESULTS:Three classes of substance use were identified: low/no use (41% of sample), alcohol only use (45%), and alcohol and prescription drug misuse (APD) (14%). Youth in the APD class experienced greater SV and TDV victimization and perpetration than the alcohol only class at baseline. At Time 2 (one year later), youth in the baseline APD class experienced significantly higher SV and TDV victimization and perpetration outcomes than youth in the alcohol only class with the exception of sexual and physical TDV perpetration. CONCLUSIONS:The misuse of both alcohol and prescription drugs emerged as a significant risk factor for later SV and TDV among adolescents. As such, it would be beneficial if future research continued to assess the nature of these associations and incorporate prescription drug use and misuse into heath education,substance use, and violence prevention programs.
Project description:BACKGROUND:The Good School Toolkit, a complex behavioural intervention designed by Raising Voices a Ugandan NGO, reduced past week physical violence from school staff to primary students by an average of 42% in a recent randomised controlled trial. This process evaluation quantitatively examines what was implemented across the twenty-one intervention schools, variations in school prevalence of violence after the intervention, factors that influence exposure to the intervention and factors associated with students' experience of physical violence from staff at study endline. METHODS:Implementation measures were captured prospectively in the twenty-one intervention schools over four school terms from 2012 to 2014 and Toolkit exposure captured in the student (n = 1921) and staff (n = 286) endline cross-sectional surveys in 2014. Implementation measures and the prevalence of violence are summarised across schools and are assessed for correlation using Spearman's Rank Correlation Coefficient. Regression models are used to explore individual factors associated with Toolkit exposure and with physical violence at endline. RESULTS:School prevalence of past week physical violence from staff against students ranged from 7% to 65% across schools at endline. Schools with higher mean levels of teacher Toolkit exposure had larger decreases in violence during the study. Students in schools categorised as implementing a 'low' number of program school-led activities reported less exposure to the Toolkit. Higher student Toolkit exposure was associated with decreased odds of experiencing physical violence from staff (OR: 0.76, 95%CI: 0.67-0.86, p-value< 0.001). Girls, students reporting poorer mental health and students in a lower grade were less exposed to the toolkit. After the intervention, and when adjusting for individual Toolkit exposure, some students remained at increased risk of experiencing violence from staff, including, girls, students reporting poorer mental health, students who experienced other violence and those reporting difficulty with self-care. CONCLUSIONS:Our results suggest that increasing students and teachers exposure to the Good School Toolkit within schools has the potential to bring about further reductions in violence. Effectiveness of the Toolkit may be increased by further targeting and supporting teachers' engagement with girls and students with mental health difficulties. TRIAL REGISTRATION:The trial is registered at clinicaltrials.gov , NCT01678846, August 24th 2012.