Effects of Dating Matters® on Sexual Violence and Sexual Harassment Outcomes among Middle School Youth: a Cluster-Randomized Controlled Trial

Outcomes Associated with Adolescent Dating and Sexual Violence Victimization: A Systematic Review of School-Based Literature

Dating and sexual violence (DSV) is a common occurrence among school aged youth and has been associated with numerous harmful long-term outcomes. The goal of this article is to better understand the range of outcomes associated with DSV during youth and adolescence. This systematic review consists of 28 school-based studies from 20 journals discussing outcomes of youth experiences of DSV. Results demonstrate significant associations between DSV victimization and mental health symptoms, substance use, sexual health, academic, and social outcomes. To better understand this issue, this article recommends that schools offer additional training for staff on recognizing DSV. Additionally, improved research is needed in this area including surveys that are inclusive of diverse student identities and include more comprehensive measures of DSV, and additional research on DSV explicitly focused on minoritized groups.

Understanding U.S. Caregivers' Perceptions of Youth's Sexting Motivations and Concerns About Their Children's Sexting Involvement: Fall ConsumerStyles Survey, 2018 and 2019

Sexting is associated with a range of negative outcomes among youth. While parents and caregivers can play a critical role in the prevention of youth risk behaviors, nationally representative research has yet to examine U.S. caregivers' perceptions of youth's sexting motivations to help inform sexting risk prevention efforts. Using 2018 and 2019 Fall ConsumerStyles online panel survey data (N = 1,034), this study estimated and examined U.S. caregivers' perceptions of youth's sexting motivations and the associations of such perceptions with concerns about their children (ages 10-17) getting and sharing sexts (sexual messages, photos, videos). Weighted percentages were calculated to describe caregivers' perceptions of youth's sexting motivations. Logistic regression analyses were performed to examine associations between caregivers' perceptions and concerns about youth's sexting. Results suggest that many caregivers perceive youth sext because they think it is harmless (72.79%), they want to be popular or boast (70.51%), they have low self-esteem (52.00%), and/or it is part of their sexual exploration process (49.05%). Fewer caregivers perceived that youth sext because they want revenge (21.80%) or to harm others (16.06%). Caregivers' concerns about their children getting and sharing sexts were related to perceiving that youth sext because of low self-esteem, sexual exploration processes, or to harm others. The perception that youth sext because they want to be popular or boast was related to concern about youth getting but not sharing sexts. Odds of concern were significantly higher among caregivers from some racial/ethnic subgroups. Findings can inform sexting prevention efforts that include caregivers.

Development and Usability of a Mobile Support Application for Sexual Violence Victims Connecting With Formal Support Organizations

The lack of awareness and accessibility about the support organizations for preventing sexual violence and assisting victims hampers the effectiveness of the social safety net. A mobile application based on a connection to support agencies was developed and evaluated for usability. A group of 15 experts and a group of 30 users evaluated usability. The developed mobile application focused on "Emergency Report," "Support Agencies and Services," and "Counseling for Support." The strength of the application was acknowledged in providing easy-to-find, reliable, useful, and necessary information, highlighting the positive usability and applicability of the mobile support application for sexual violence victims.

The Primary Prevention of Sexual Violence Against Adolescents in School and Community Settings: A Scoping Review

Sexual Violence (SV) is a public health problem with serious long-term consequences for victims. This scoping review aimed at summarizing the implementation, methodology, characteristics, and efficacy of SV prevention programs conducted in school and community settings with middle and high school students. This study also gathered recommendations for future research. Studies were searched in three databases: EBSCOHOST, SCOPUS and Web of Science. Eighty-six peer-reviewed empirical studies about SV prevention programs applied in school and community settings with samples of middle and high school students were analyzed. Most original studies (46.3%) used sexual violence outcomes, although many approached sexual violence in the context of dating violence (43.3%). Most SV prevention programs were applied in the U.S.A. although studies were identified across the globe. Prevention programs tend to reduce SV attitudes, perpetration, and victimization and to increase SV knowledge, as well as bystander attitudes and behaviors. The evidence reveals the efficacy of these programs, although future studies are needed to clarify the specificities of SV prevention. This article provides recommendations considering the measurement of SV outcomes, the role of technology, the involvement of adults and communities, the timing of interventions, sexual education, and reporting practices.

High School Follow-Up of the Dating Matters® RCT: Effects on Teen Dating Violence and Relationship Behaviors

Teen dating violence (TDV) is a significant public health problem that can have lifelong consequences. Using a longitudinal, cluster randomized controlled trial (RCT), this study examines whether the Dating Matters comprehensive prevention model, implemented in middle school, prevented TDV and negative relationship behaviors and promoted positive relationship behaviors in high school (9th-11th grades), when compared with a standard of care intervention. Dating Matters includes programs for sixth to eighth grade youth and their parents, training for school staff, a youth communications program, and policy and data activities implemented in the community. Self-report survey data were collected from students in 46 middle schools that were randomly assigned to condition within site. Students completed two surveys (fall and spring) in each middle school grade and a single survey in the spring of each high school grade. This study examined self-reported TDV perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills in the high school follow-up. While varying patterns emerged, latent panel models demonstrated significant program effects for all outcomes. Dating Matters students reported 19% reduced risk for TDV perpetration, 24% reduced risk for TDV victimization, 7% reduced risk for use of negative conflict strategies, and 3% more use of positive relationship skills, on average across time and cohort, than standard of care students. On average, Dating Matters, implemented in middle school, continued to be more effective at reducing TDV perpetration, TDV victimization, and use of negative conflict resolution strategies in high school than an evidence-based comparison program.Trial Registration: clinicaltrials.gov Identifier: NCT01672541.

The Saturation- and Dose-Dependent Effects of a Teen Sexual Harassment Prevention Program: Findings from a Randomized Controlled Trial

Using a randomized controlled trial, we investigated changes in both sexual harassment (SH) perpetration and victimization of 2104 middle school students in New York City who received divergent saturation and dosage levels of Shifting Boundaries, an SH prevention program, which was represented by the length of the program. We assessed the saturation effect of the program by comparing the outcomes across respondents from 26 schools in which there were varying percentages of students enrolled in the program. The data suggested that, overall, the program was effective in reducing sexual harassment victimization but achieved a null effect against respondents' SH perpetration and that neither the length nor the school-saturation level of the program exerted a significant effect on SH perpetration. Although the data indicated a significant difference in SH victimization between the treatment and control group, when comparing subgroups who received treatment with divergent saturation and dosage levels, no statistically significant difference was identified. Our results suggested that the program effect was not contingent on the portion of students in a school who enrolled in the program, nor was it contingent on the dosage.

Sexual Assault Among Young Adolescents in Informal Settlements in Nairobi, Kenya: Findings from the IMPower and SOS Cluster-Randomized Controlled Trial

Sexual assault is a global threat to adolescent health, but empowerment self-defense (ESD) interventions have shown promise for prevention. This study evaluated the joint implementation of a girls' ESD program and a concurrent boys' program, implemented via a cluster-randomized controlled trial in informal settlements of Nairobi, Kenya, from January 2016 to October 2018. Schools were randomized to the 12-h intervention or 2-h standard of care. Students were randomly sampled to complete surveys at baseline and again at 24 months post-intervention. A total of 3263 girls, ages 10-14, who completed both baseline and follow-up surveys were analyzed; weights were adjusted for dropout. At follow-up, 5.9% (n = 194/3263) of girls reported having been raped in the prior 12 months. Odds of reporting rape were not significantly different in the intervention versus SOC group (OR: 1.21; 95% CI (0.40, 5.21), p = 0.63). Secondary outcomes, social self-efficacy (OR: 1.08; 95% CI (0.95, 1.22), p = 0.22), emotional self-efficacy (OR 1.07; 95% CI (0.89, 1.29), p = 0.49), and academic self-efficacy (OR: 0.90; 95% CI (0.82, 1.00), p = 0.06) were not significantly different. Exploratory analyses of boys' victimization and perpetration are reported. This study improved on previous ESD studies in this setting with longitudinal follow-up of individuals and independent data collection. This study did not show an effect of the intervention on self-reported rape; findings should be interpreted cautiously due to limitations. Sexual assault rates are high in this young population, underscoring a dire need to implement and rigorously test sexual assault prevention interventions in this setting. The trial was registered with Clinical Trials.gov # NCT02771132. Version 3.1 registered on May 2017, first participant enrolled January 2017.

School-based interventions TO Prevent Dating and Relationship Violence and Gender-Based Violence: STOP-DRV-GBV systematic review

Background

Schools have a duty of care to prevent violence between students but a significant amount of dating and relationship violence and gender-based violence occurs in schools. These are important public health issues with important longitudinal consequences for young people.

Objectives

To understand functioning and effectiveness of school-based interventions for the prevention of dating and relationship violence and gender-based violence.

Review methods

We undertook a mixed-methods systematic review to synthesise different types of evidence relating to school-based interventions for the prevention of dating and relationship violence and gender-based violence to understand if, how and in what ways these interventions are effective. We searched 21 databases and 2 trial registers and undertook forwards and backwards citation chasing, author contact and other supplementary search methods. Searches identified all literature published to June 2021. All screening was undertaken in duplicate and independently, and we quality appraised all included studies.

Results

We included 247 reports (68 outcome evaluations, 137 process evaluations). Synthesis of intervention components produced an intervention typology: single-component, curricular, multicomponent, and multilevel programmes. Synthesis of intervention theories suggested that interventions aiming to increase students' sense of school belonging and sense of safety in the school building could encourage increased learning of prosocial skills and increased prosocial peer norms, and so potentially reducing dating and relationship violence and gender-based violence. Synthesis of factors affecting delivery highlighted school organisation and leaders who believed in the importance of addressing dating and relationship violence/gender-based violence, along with time and resources to deliver the interventions. The ease with which the intervention could be delivered and modified was also important. Meta-analysis found stronger evidence for intervention effectiveness in reducing dating and relationship violence than for gender-based violence, with significant long-term impacts on dating and relationship violence victimisation and perpetration, and some evidence that interventions in high-income countries could be effective for reducing victimisation and perpetration of gender-based violence in the long-term. Impacts on knowledge and attitudes were primarily short-term. Network meta-analysis did not suggest superiority of any intervention type. Moderation evidence suggested interventions reduced dating and relationship violence perpetration in boys more than girls, but reduced gender-based violence perpetration more in girls. Metaregression by intervention component did not explain heterogeneity in effectiveness, but qualitative comparative analysis suggested that reducing perpetration was important to reducing victimisation, and that perpetration could be reduced via focus on interpersonal skills, guided practice and (for gender-based violence) implementation of social structural components.

Limitations

Despite an exhaustive search, trials may have been missed and risk of publication bias was high for several analyses.

Conclusions

This is the most comprehensive systematic review of school-based interventions for dating and relationship violence and gender-based violence to date. It is clear that the prevention of dating and relationship violence and gender-based violence in schools will require longer-term investment to show benefit.

Future work

Future research is needed to understand why intervention effectiveness appears stronger for dating and relationship violence than gender-based violence.

Study registration

The study is registered as PROSPERO CRD42020190463.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR130144) and is published in full in Public Health Research; Vol. 12, No. 3. See the NIHR Funding and Awards website for further award information.

Using Cognitive Interviews to Adapt Interpersonal Violence Measures for Use With Middle School Youth

Experiences of interpersonal violence are common among youth. Starting prevention programming early (e.g., middle school) may be beneficial for primary prevention. Evaluating whether such programs are effective often requires collecting self-report data from youth, but many existing measures have been developed for high school and college-aged youth. This study aimed to assess adolescents' comprehension of self-report survey items on interpersonal violence with middle school youth. We conducted virtual cognitive interviews with 15 youth in grades 6 to 8. A content analysis was used to identify patterns and to classify the nature and type of comprehension issues youth experienced. Nearly all students found most questions clear and understandable. We identified the following comprehension issues: (1) uncertainty with how the intent of a perpetrator factored into a victim's experience (e.g., distinguishing the difference between joking and bullying, or intentional versus unintentional behavior); (2) lack of familiarity with certain expressions of sexualized violence (e.g., "sexual looks") or sex-related terminology (e.g., intercourse); and (3) narrow interpretations of question prompts (e.g., interpreting "forced" as physically forced, not psychologically coerced). Students suggested including language describing dating relationships, types of social media platforms where cyber abuse takes place, and additional examples alongside items to enhance relevance and clarity. Survey questions to measure interpersonal violence may need to be adapted for use among middle school youth. Our findings highlight potential considerations for improving the measurement of interpersonal violence in this age group.

Can Virtual Reality be Used for the Prevention of Peer Sexual Harassment in Adolescence? First Evaluation of the Virtual-PRO Program

Objective: The present study analyzed the Virtual-PRO program's efficacy in preventing peer sexual harassment by promoting the bystanders' active intervention and incorporating a virtual reality (VR) component. The impact of the program on sexist attitudes, moral disengagement, the intention to intervene as bystanders, and the involvement in sexual aggression and victimization was tested. Method: Virtual-PRO is a VR-enhanced sexual harassment curricular prevention program of six one-hour sessions. The evaluation comprised a pre-test, a post-test after the intervention, and a follow-up measure at three months. In the study, 579 Spanish adolescent students aged between 12 and 17 years (M = 14.76, SD = 0.88; 47.1% boys) were randomly grouped into experimental (n = 286) and control (n = 293) conditions. Results: The Virtual-PRO program effectively controlled participants' levels of sexism and reduced moral disengagement in the experimental group compared to the control group three months after the intervention. The program also showed positive results in changing bystander behavior, increasing the intention to intervene when the victim was not a friend. Finally, visual/verbal and online victimization decreased in the experimental group and increased in the control group. No differences were found for physical sexual victimization and sexual aggression. Conclusions: The first trial of the Virtual-PRO program is promising and highlights the use of VR as a sexual harassment prevention tool. Follow-up measures are essential to determine the impact of interventions accurately.

A Meta-Analysis of the Effects of Comprehensive Sexuality Education Programs on Children and Adolescents

Childhood and adolescence are crucial periods for developing one's awareness of sexuality. Comprehensive Sexuality Education (CSE) during these stages is essential for overall growth, fostering healthy self-concepts, and addressing diverse sexual issues among children and adolescents globally. A meta-analysis was conducted to analyze the effectiveness of CSE programs. A literature search was performed on EMBASE, PubMed, CINAHL, Cochrane Library, and PsycInfo for studies published before 14 June 2023, and based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We used the Comprehensive Meta-Analysis (CMA, V4) software version 4.0 for the analysis and interpreted the effect sizes according to Cohen's definition. Between 2011 and 2020, 21 studies on CSE were published, with the United States having the most publications (17). Of the 34 studies reviewed, 20 were randomized controlled trials. The primary population for CSE was middle/high school students (15), with the most frequent age range being 10-19 years (26). The overall effect size of CSE was significant (effect size = 1.31, p < 0.001), with cognition (effect size = 5.76, p < 0.001) being the most significant. CSE is an effective educational tool for children and adolescents with a significant impact on variables such as cognition and abstinence. It should be incremental from childhood and adolescence to adulthood.

Preventing sexual violence among high school students through norms correction and bystander intervention: A school-based cluster trial of Your Voice Your View

Risk for sexual violence begins early in the lifespan; thus, interventions are needed to decrease the risk for sexual violence among high school youth. The current study evaluates the Your Voice Your View (YVYV) sexual violence prevention program using a school-based cluster trial among 26 high schools in the Northeastern United States. YVYV, includes: 1) a series of four classroom workshops designed to engage students as allies in violence prevention through bystander intervention skills training, address risks for sexual aggression, and reduce risk for victimization; 2) a Lunch and Learn teacher training workshop; and 3) a 4-week social norms poster campaign based on normative data from the school. Schools were matched based on size and demographics and randomly assigned to the intervention group or a wait-list control group. A sample of 2685 10th grade students enrolled in the research and completed assessments at baseline, 2-month and 6-month follow-up periods. The magnitude of the difference in sexual aggression did not vary by condition at either follow-up period. The magnitude of 6-month differences in experiencing unwanted sexual intercourse varied significantly by condition (IRR = 0.33 [0.14-0.76]), demonstrating a small protective effect favoring intervention schools (Cohen's f2  = 0.012). These findings highlight the promise of multicomponent interventions grounded in bystander intervention skills training, risk reduction, and social norms theory as a promising, comprehensive approach for sexual violence prevention among youth.

Adolescent Sexting, Violence, and Sexual Behaviors: An Analysis of 2014 and 2016 Pennsylvania Youth Risk Behavior Survey Data

BACKGROUND

Sexting is common among adolescents and is associated with numerous health risk behaviors and negative psychosocial constructs. This study examined the relationships between high school students' experiences with sexual violence victimization, dating violence victimization, and engagement in risky sexual behaviors with experiences of receiving sexts.

METHODS

Cross-sectional data from the 2014 to 2016 data from Pennsylvania Youth Risk Behavior. Participants were selected using an independent 2-stage cluster sample design to produce a statewide population-based sample. The pencil and paper surveys were conducted in school. Participants included 6734 Pennsylvania high school students in grades 9-12.

RESULTS

Overall, 29.0% of Pennsylvania high school students had received a sext, which varied by sex, race/ethnicity, school grade, and sexual identity. Students who engaged in sexual risk behaviors, experienced dating violence, or experienced lifetime sexual violence outside of the dating context had a significantly higher prevalence of receiving a sext than students who did not engage in those behaviors or have those experiences.

CONCLUSIONS

Early screening and prevention efforts that include discussions about sexting behaviors may help prevent other negative outcomes, such as risky sexual behaviors and interpersonal violence. Addressing sexting in the education and health sectors may help to prevent other related harmful health and violence experiences during adolescence.

Middle School Psychological Distress and Sexual Harassment Victimization as Predictors of Dating Violence Involvement

Adolescent sexual harassment victimization is increasingly recognized as a strong risk factor for dating violence victimization and perpetration. Research on this association has focused on older adolescents and on sexual harassment at a single time point rather than chronic exposure. Furthermore, potential mechanisms, such as psychological distress, are not well understood. The goals of this study were to identify whether sexual harassment victimization and psychological distress were reciprocally related, whether chronic psychological distress and sexual harassment victimization in early adolescence were associated with higher levels of dating violence involvement measured in mid-adolescence, and whether these relationships differed between boys and girls. We used longitudinal data from 4,718 US middle school students to fit regression models for the associations between sexual harassment victimization and psychological distress. We then used data from a subset of 1,279 students followed up in high school to fit marginal structural models for sixth- to eighth-grade psychological distress and sexual harassment victimization as predictors of dating violence involvement measured in ninth grade. We found that (1) sexual harassment victimization was positively, concurrently associated with psychological distress, with a stronger association among girls than boys; (2) psychological distress was positively, prospectively associated with sexual harassment victimization among girls but not boys; (3) chronic sixth- to eighth-grade psychological distress was not significantly associated with dating violence victimization or perpetration measured in ninth grade; and (4) chronic sixth- to eighth-grade sexual harassment victimization was associated with significantly higher levels of dating violence victimization and perpetration measured in ninth grade. The results support a reciprocal relationship between distress and sexual harassment victimization for early adolescent girls, and they call for further attention to gender differences in the content and impact of sexual harassment. Furthermore, the findings indicate that preventing sexual harassment in early adolescence may be critical in reducing dating violence.

Implementing school-wide sexual assault prevention in middle schools: A qualitative analysis of school stakeholder perspectives

Sexual assault and harassment are significant problems that begin early in the lifespan. The current study sought to understand the contextual factors that influence the implementation of school-wide sexual assault prevention programs in middle schools that focus on fostering community norms change. The Consolidated Framework for Implementation Research (CFIR) is a menu of constructs arranged across 5 domains that assists stakeholders in assessing and identifying site-specific determinants of successful intervention implementation. In the present study, researchers conducted a series of 10 interviews with middle school stakeholders (i.e., principals, guidance counselors, teachers) to document characteristics inside and outside of the school environment (i.e., cultural norms, relative priority, prior interventions, implementation climate) relevant to the implementation of prevention programming, using the CFIR as a guiding framework for analysis. Whereas schools recognized the importance of implementing violence prevention programming, stakeholders reported several other competing demands (i.e., time, resources) that make it difficult to implement rigorous programming without support from an outside agency/team. Community agencies and research teams hoping to implement violence prevention in middle schools can benefit from using stakeholder interviews grounded in the CFIR model to gain a better awareness of the school- and community-specific factors that are likely to influence successful implementation of violence prevention programs in middle schools.

Stop Sexual Harassment: A study protocol for a cluster randomised controlled trial in secondary schools in Norway

Background

Sexual- and gendered harassment are normalised in many peer groups, yet their associations with mental health concerns among adolescents are well-established. School based interventions that prevent and reduce sexual and gendered harassment among younger adolescents are scarce. For schools, protecting pupils from harassment may be challenging if the behaviour is trivialised among the pupils themselves. In the current study, the school intervention "Stop Sexual Harassment" was therefore developed to help teachers and pupils detect, address and stop sexual and gendered harassment among pupils ages 13-15 in Norwegian secondary schools.

Methods

In this study the effectiveness of "Stop Sexual Harassment" is evaluated via a cluster randomised controlled trial among pupils and teachers at 38 secondary schools. Schools were randomised into intervention and control groups. Primary outcomes are sexual and gendered harassment victimisation and perpetration, which will be assessed by the administration of questionnaires to pupils and teachers at baseline, and 2-, and 7-months follow-up. A process evaluation of the intervention implementation will be conducted through focus group interviews with pupils and teachers to gain insight about their experiences with the program components and implementation of the intervention.

Discussion

If the intervention yields positive effects, large-scale implementation of the program may be offered for secondary schools. The program may thus reduce sexual and gendered harassment among young adolescents.

Clinical trial registration

clinicaltrial.gov; identifier: NCT04716400.

Evaluating the Impact of a Youth-Led Sexual Violence Prevention Program: Youth Leadership Retreat Outcomes

Involving youth in developing and implementing prevention programs to reduce sexual violence (SV) has the potential to improve prevention outcomes. However, there has been little focus on youth-led SV prevention programs, and limited evaluation research to help guide efforts. The current study examined the effectiveness of Youth Voices in Prevention (Youth VIP) leadership retreats on SV victimization and perpetration, forms of violence related to SV (e.g., bullying), SV bystander behaviors and readiness, and perceptions of norms related to SV prevention. Results identified mixed findings for program impact, with variations in outcomes that can help guide future youth-led prevention program initiatives. Youth attending a large "kick-off" leadership retreat (that was less youth-led that subsequent smaller retreats) later reported more bystander behaviors, but also reported increased perpetration and victimization, compared to non-attending youth. However, youth attending smaller, more focused leadership retreats held during the school year, reported reductions in sexual harassment perpetration and improved bystander behaviors and attitudes compared to non-attending youth. Evaluation of moderator variables suggests that program impact was generally stronger for younger participants, sexual minority youth, and non-White youth (which were largely Native American youth in this sample). Findings suggest promise for youth-led prevention work but also highlight the need for testing the impact of different training structures and modalities. Clinical trials number: NCT03207386.

Bullying as a Developmental Precursor to Sexual and Dating Violence Across Adolescence: Decade in Review

Adolescent bullying continues to be a major focus of scholarship across the globe. This article reviews research from 2010 to 2021 with a particular focus on longitudinal studies of the bully-sexual violence pathway (BSVP), where bullying serves as a precursor for sexual violence (SV) (e.g., sexual harassment, sexual coercion, and sexual assault) and teen dating violence via individual and socio-contextual mediators. Articles reviewed consisted of a total of 505, which included 17 meta-analyses and systematic reviews. Databases used for the search were Academic Search Complete, Education Full Text (H. W. Wilson), ERIC, National Criminal Justice Reference Service Abstracts, PsycINFO, PubMed (Medline), and Social Sciences Abstracts (H. W. Wilson). In total, 107 peer-reviewed articles were included in this review. Potential mechanisms underlying the BSVP include social dominance orientation, exposure to sexual education, and alcohol use. Several school-based intervention approaches have evidenced marginal success in reducing rates of bullying and SV by targeting factors undergirding both behaviors. The efficacy of international prevention approaches is summarized. Gaps in the literature are identified and future research is proposed.

How Does Green Dot Bystander Training in High School and Beyond Impact Attitudes Toward Violence and Sexism in a Prospective Cohort?

Bystander interventions are recognized as "promising" programming to reduce sexual violence. Gaps in current evaluations include limited follow-up post-training (beyond 24 months) and knowledge of additional bystander training during follow-up.In this prospective cohort study, nested in a cluster randomized controlled trial (RCT), three cohorts of high school (HS) seniors were recruited (Fall 2013-2015) and followed through Spring 2018 (n = 1,831). Training was based on their school cluster RCT assignment and receipt of additional Green Dot (GD) training after HS. Training was hypothesized to be associated with lower scores indicating less acceptance of violence or sexism.Sixty percent reported GD training after HS (68.7% of 986 in intervention and 50% of 845 in control conditions). No significant differences (p < .05) were observed by GD training for four of the five violence acceptance or sexism attitudinal measures at recruitment or final surveys. For "ambivalent sexism" alone was there a significant reduction in scale scores over time in the intervention versus control condition. Additional GD training after the RCT significantly reduced neither violence acceptance nor sexism scores over time.GD training does not appear to have a consistent longer-term impact on reducing violence acceptance and sexism.

Estimating From the Payer Perspective the Implementation Cost of Dating Matters®: A Comprehensive Teen Dating Violence Prevention Model

"Dating Matters®" is a CDC-developed comprehensive, multi-component teen dating violence (TDV) prevention model, made available to the public in 2019. A longitudinal, multi-site demonstration project found that the model significantly reduced TDV during middle school relative to an evidence-based, single-program intervention (Safe Dates; Niolon et al., 2019), when implemented across 46 middle schools in four high-risk urban areas with predominantly Black (55%) and Hispanic (28%) youth participants. Research on the costs of implementing TDV prevention strategies is limited, despite recognition within the field of prevention science that such data are critical to widespread dissemination. The current study adds to the available literature on the cost of dating violence prevention by estimating the budgetary impact from the payer perspective of implementing the comprehensive Dating Matters model, compared to Safe Dates, at four sites over four school years to inform prevention planning in communities. Total costs of implementing Dating Matters were relatively stable within sites over time but varied greatly between sites (M = $175,452 per year; range = $130,149 to $227,604). The mean per-student cost of Dating Matters was $145.40 but also ranged widely ($20.66 to $324.65) across sites and years. Variation was largely driven by staffing costs and number of students served. As expected, total and per-student costs were substantially lower at all sites for the Safe Dates program (M = $12,148; range = $2,848 to $17,840; $44.81 per student) compared to Dating Matters. This study provides an estimate from the payer perspective to demonstrate the budgetary impact of Dating Matters. These estimates can help inform implementation decisions and planning by potential funders, communities, and organizations as they seek to support and implement effective TDV prevention strategies. It also adds substantially to understanding of the additional costs associated with a move from single-program interventions to community-wide initiatives.

Evaluation of the lights4violence program: reduction in machismo and acceptance of violence among adolescents in Europe

Background

Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities.

Methods

Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12–17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1.

Results

An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (β: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (β: 0.247; p < 0.001).

Conclusion

The importance of empathy is shown in the effectiveness of interventions to reduce machismo and AV in adolescents. While the Lights4Violence program focuses on promoting healthy relationships, there were some controversial results. It is possible that some children, especially those with less empathy, may have felt “challenged” during the intervention and/or assessment. This suggests the need for the development of interventions that also consider psychological processes and integrate the promotion of positive expressions of masculinity.

Intimate Partner and Sexual Violence Prevention Among Youth: A Community Guide Systematic Review

INTRODUCTION

Intimate partner violence and sexual violence are widespread and often occur early in life. This systematic review examines the effectiveness of interventions for primary prevention of intimate partner violence and sexual violence among youth.

METHODS

Studies were identified from 2 previous systematic reviews and an updated search (January 2012-June 2016). Included studies were implemented among youth, conducted in high-income countries, and aimed to prevent or reduce the perpetration of intimate partner violence or sexual violence. In 2016-2017, Guide to Community Preventive Services (Community Guide) methods were used to assess effectiveness as determined by perpetration, victimization, or bystander action. When heterogeneity of outcomes prevented usual Community Guide methods, the team systematically applied criteria for favorability (statistically significant at p<0.05 or approaching significance at p<0.10) and consistency (75% of results in the same direction).

RESULTS

A total of 28 studies (32 arms) met inclusion and quality of execution criteria. Interventions used combinations of teaching healthy relationship skills, promoting social norms to protect against violence, or creating protective environments. Overall, 18 of 24 study arms reported favorable results on the basis of the direction of effect for decreasing perpetration; however, favorability for bystander action diminished with longer follow-up. Interventions did not demonstrate consistent results for decreasing victimization. A bridge search conducted during Fall 2020 confirmed these results.

DISCUSSION

Interventions for the primary prevention of intimate partner violence and sexual violence are effective in reducing perpetration. Increasing bystander action may require additional follow-up as effectiveness diminishes over time. Findings may inform researchers, school personnel, public health, and other decision makers about effective strategies to prevent intimate partner violence and sexual violence among youth.

Design-Based Approaches to Causal Replication Studies

Recent interest in promoting replication efforts assumes that there is well-established methodological guidance for designing and implementing these studies. However, no such consensus exists in the methodology literature. This article addresses these challenges by describing design-based approaches for planning systematic replication studies. Our general approach is derived from the Causal Replication Framework (CRF), which formalizes the assumptions under which replication success can be expected. The assumptions may be understood broadly as replication design requirements and individual study design requirements. Replication failure occurs when one or more CRF assumptions are violated. In design-based approaches to replication, CRF assumptions are systematically tested to evaluate the replicability of effects, as well as to identify sources of effect variation when replication failure is observed. The paper describes research designs for replication and demonstrates how multiple designs may be combined in systematic replication efforts, as well as how diagnostic measures may be used to assess the extent to which CRF assumptions are met in field settings.