Adolescent Dating Violence Prevention Program for Early Adolescents: The Me & You Randomized Controlled Trial, 2014-2015

Parental monitoring and adolescent suicidality: Exploring differences by sex in the 2021 national survey on drug use and health

BACKGROUND

Suicide is the second leading cause of death for adolescents in the U.S. Existing research demonstrates an inverse relationship between perceived parental monitoring and suicidal ideation among youth. The purpose of this study is to examine the relationship between parental monitoring and suicidality by sex among adolescents with the 2021 National Survey on Drug Use and Health (NSDUH).

METHODS

Participants were n = 10,055 youth (12-17 years old; 48.18 % female). We examined the relationship between parental monitoring and two measures of suicidality (ideation; planned attempts). Models controlled for sex, age, race/ethnicity, past 30-day alcohol use, household income, and past 12-month major depressive episode. We tested for sex differences in this association via interaction models (sex ∗ perceived parental monitoring) and conducted sex-stratified models.

RESULTS

Approximately 13.1 % of participants reported suicidal ideations and 6.0 % reported planning a suicide attempt. Every unit increase in perceived parental monitoring was associated with significantly lower odds of reporting suicidal ideations (aRRR: 0.89; 95 % CI: 0.87-0.91) and planned attempts (aRRR: 0.87; 95 % CI: 0.84-0.91). In sex-stratified models, the association between perceived parental monitoring and suicidal ideations was significantly (p = .012) stronger among females (aRRR: 0.86; 95 % CI: 0.84-0.89) relative to males (aRRR: 0.92; 95 % CI: 0.88-0.97); the same was observed for planned attempts among females (aRRR: 0.84; 95 % CI: 0.80-0.88) relative to males (aRRR: 0.92; 95 % CI: 0.85-0.99).

DISCUSSION

Future research should examine dyadic assessments of both adolescent and parental appraisals of parental monitoring, and adolescent suicide prevention interventions should integrate mechanisms involving perceived parental monitoring.

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.

Attitude Is Everything: Examining Acceptance of Violence Items for Differential Item Functioning Across Heterosexual and Sexual Minority Youth

Acceptance of dating violence (ADV) is a cognitive risk factor for violence perpetration and a common target of prevention programs. However, frequently used items assessing ADV are characterized by heteronormative item wording, and limited research has evaluated the degree to which ADV items function equivalently for both heterosexual and sexual minority youth (SMY). The current study sought to determine if there are differences in the way heterosexual and SMY respond to ADV survey items. Secondary data from a total of 2,014 adolescents (Mage = 16.78) were used to examine differences in ADV. Results of differential item functioning analysis indicated nonuniform differential item functioning for two of eight ADV items, with heterosexual youth being more likely to express strong levels of agreements with (a) female-perpetrated physical violence in response to male-perpetrated violence and (b) female-perpetrated violence against males broadly, relative to SMY. Although these differences were of negligible magnitude and only resulted in minimal differences in overall expected average scores, heterosexual youth were more likely to strongly accept female-perpetrated dating violence compared to SMY. Findings highlight differences in ADV item response patterns across heterosexual and sexual minority identifying youth and provide preliminary evidence for group differences in acceptance of female-perpetrated dating violence. Implications for prevention programming based on current findings include greater focus on measure adaptation and development as well as more consensus on the necessity of preventing female-perpetrated violence.

Validation of the Adolescent Dating Violence Victim-Blaming Attitudes Scale

Dating violence (DV) is a social problem that affects adolescents worldwide. Prevalence figures show that this type of violence is starting at an increasingly younger age, which is why it is important to study attitudes toward DV, as they are an important risk factor. Victim-blaming attitudes justify this type of violence by excusing perpetrators and blaming victims. The present study aimed to validate an instrument developed to assess victim-blaming attitudes in DV cases among the adolescent population: The Adolescent Dating Violence Victim-Blaming Attitudes Scale (ADV-VBA). Two samples of high school students were recruited using a two-stage stratified sampling by conglomerates, one consisting of 758 adolescents (48% females) and the other of 160 (50% females), whose ages ranged from 12 to 18 years. We found that this instrument presented good reliability and validity evidence, showing good internal consistency, a clear one-factor latent structure, and a close relation to other related constructs, such as ambivalent sexism and perpetration and victimization of DV. We also found that items did not present differential item functioning across gender and the instrument was especially informative for assessing moderate to high levels of victim-blaming attitudes. A short five-item version is also presented for use when time and space constraints exist. Our results indicate that the ADV-VBA scale is a psychometrically sound measure to assess victim-blaming attitudes in cases of adolescent DV.

Short-Term Outcomes of a Healthy Relationship Intervention for the Prevention of Sexual Harassment and Sexual Assault in the US Military: Pilot Pretest-Postest Study

BACKGROUND

Sexual harassment (SH) and sexual assault (SA) are serious public health problems among US service members. Few SH and SA prevention interventions have been developed exclusively for the military. Code of Respect (X-CoRe) is an innovative web-based, multilevel, SA and SH intervention designed exclusively for the active-duty Air Force. The program's goal is to increase Airmen's knowledge and skills to build and maintain respectful relationships, ultimately reducing SH and SA and enhancing Airmen's overall well-being and mission readiness.

OBJECTIVE

This pilot study aimed to assess the short-term psychosocial impact (eg, knowledge, attitudes, and self-efficacy) of the web-based component of X-CoRe on a sample of junior enlisted and midlevel Airmen.

METHODS

Airmen from a military installation located in the Northeastern United States were recruited to complete the 10 web-based modules in X-CoRe (9/15, 60% male; 7/15, 54% aged 30-35 years). Participants were given pretests and posttests to measure short-term psychosocial outcomes associated with SH and SA. Descriptive statistics and paired 2-tailed t tests were conducted to assess differences from preintervention to postintervention time points.

RESULTS

After completing X-CoRe, participants had a significantly greater understanding of active consent (P=.04), confidence in their healthy relationship skills (P=.045), and confidence to intervene as bystanders (P=.01). Although not statistically significant (P>.05), mean scores in attitudes about SH, couple violence, and cyberbullying; perceptions of sexual misconduct as part of military life; and relationship skills self-efficacy with a romantic partner and friend also improved.

CONCLUSIONS

The findings from this study demonstrate X-CoRe's effectiveness in improving critical determinants of SH and SA, making it a promising intervention for SH and SA prevention. More rigorous research is needed to determine X-CoRe's impact on SH and SA victimization and the long-term impact on associated psychosocial determinants.

A Review of Evidence-Based Dating Violence Prevention Programs With Behavioral Change Outcomes for Adolescents and Young Adults

Adolescent dating violence (DV) is not only a social but also a public health problem, necessitating the development and scale-up of prevention strategies. We conducted a review of the literature to identify adolescent and young adult DV prevention programs that have shown promising behavioral outcomes. The literature search covered articles published from 1996 to 2022 and indexed in Medline, Cochrane, Scopus, PsycINFO, and Embase. The review focused on programs implemented and evaluated in the United States or Canada that included intervention and comparison groups, a baseline assessment, and at least one post-assessment conducted after the intervention exposure. Promising behavioral outcomes were defined as positive, statistically significant differences between intervention and comparison groups with respect to DV perpetration or victimization or bystander behavior in relation to DV. A total of 118 articles were screened by abstract and read in-depth. Eighteen programs that met the inclusion criteria were identified. Of these programs, one showed reductions in DV victimization, six showed reductions in DV perpetration, and nine showed behavioral reductions in both violence perpetration and victimization. The review highlighted that while multiple programs have demonstrated efficacy in preventing or reducing intimate partner violence in North American youth populations, more robust research on the replication of these programs outside researcher-controlled environments is needed. Furthermore, issues with program inclusivity, such as with sex and gender-minority individuals, should be considered in future intervention development and replication research.

Queering the Conflict in Adolescent Dating Relationships Inventory: An Examination of the Conflict in Adolescent Relationships Inventory Perpetration Scale's Measurement Invariance Across Heterosexual and Sexual Minority Youth

Teen dating violence (TDV) is a public health concern impacting more than half of U.S. adolescents aged 12 to 18. Sexual minority youth (i.e., adolescents who are not exclusively heterosexual) experience disproportionately high rates of TDV. Yet, measures of TDV such as the Conflict in Adolescent Dating Relationships Inventory (CADRI) have been developed without considering sexual identity with items and instructions frequently anchored in heterosexual romantic relationships. Examination of measurement equivalence across heterosexual and sexual minority youth has only begun recently with existing research examining the CADRI's victimization scale measurement invariance providing empirical support for invariance across heterosexual and sexual minority youth. However, no prior research has examined the measurement invariance of the CADRI perpetration scales across heterosexual and sexual minority youth. The current study fills this gap by examining the CADRI perpetration scale measurement invariance across heterosexual and sexual minority youth. Using multigroup confirmatory factor analysis responses from 1,143 adolescents (Mage = 15.88, SD = 2.49) to the CADRI perpetration items were examined across heterosexual (n = 922) and sexual minority youth (n = 218). Results confirmed the five-factor structure of the CADRI perpetration scales, providing empirical support for the appropriateness of the use of the CADRI perpetration scale's scores across heterosexual and sexual minority youth broadly. However, findings of partial scalar measurement invariance on the emotional/verbal abuse perpetration scale raise questions about the appropriateness of mean-score comparisons on this particular subscale. Areas of potential revisions of the emotional/verbal abuse perpetration scale are discussed to facilitate meaningful comparisons among heterosexual and sexual minority youth and to substantiate program evaluation results by groups.

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.

Exploring the Activities and Target Audiences of School-Based Violence Prevention Programs: Systematic Review and Intervention Component Analysis

Adolescents are at an increased risk for experiencing dating and relationship violence (DRV) and gender-based violence (GBV). School-based interventions remain an important and frequently used method for DRV/GBV prevention. A clear understanding and description of the different components of school-based interventions specific to DRV/GBV is needed to organize and advance the array of prevention efforts being utilized in school settings. We conducted an intervention component analysis to create a taxonomy for school-based interventions addressing DRV and GBV. We searched 21 databases in July 2020 and updated searches in June 2021, alongside extensive supplementary search methods. We included randomized controlled trials (RCTs) in adolescents of compulsory school-age that were implemented within the school setting which partially or wholly focused on DRV and GBV topics. Our analysis included 68 studies describing 76 different school-based interventions. Through an iterative coding process we identified 40 intervention components organized within 13 activity categories, including both student-directed components and non-student-directed components such as activities for school personnel and family members of students. We also identified components addressing higher levels of the social-ecological model including structural-social and structural-environmental aspects of DRV/GBV which prior reviews have not considered. This taxonomy of components and synthesis of intervention efficacy for DRV/GBV school-based interventions provides a framework for comparing past intervention evaluations and constructing new interventions to address these issues at multiple levels within a community.

Social Cognitive Theory-Based Interventions to Address Interpersonal Violence Among Hispanic Youth-A Systematic Review

Introduction: The prevalence of interpersonal violence among Hispanic youth is high and effective interventions are sparse yet needed to prevent and address interpersonal violence. Theory-based interventions are crucial for creating robust interventions for public health concerns, such as interpersonal violence. Methods: In our systematic literature review, we sought to examine social cognitive theory (SCT)-based Interventions addressing interpersonal violence among Hispanic youth. Searching in both English and Spanish, we used the search engines, PubMed, Google Scholar, CINAHL, Web of Science, and Lilacs, and restricted the years to 2010-2022. Results: Self-efficacy and normative beliefs were the two most commonly addressed SCT constructs in the interventions. SCT-based interventions were found to increase confidence in not engaging in negative behaviors and improve coping skills. Moreover, within the context of implementing SCT-based interventions, school-based interventions and Participatory Action Research, were foundational to the SCT-based interventions. Conclusion: Overall, SCT-based interventions were found to be effective in interpersonal violence mitigation and reduction among Hispanic youths. There was a synergistic effect between the number of SCT constructs incorporated in an intervention and the positive results of the intervention. Thus, future studies are both needed and should robustly incorporate SCT constructs to yield the best possible outcomes.

Cumulative Incidence of Physical and Sexual Dating Violence: Insights From A Long-term Longitudinal Study

Decades of inquiry on intimate partner violence show consistent results: violence is woefully common and psychologically and economically costly. Policy to prevent and effectively intervene upon such violence hinges upon comprehensive understanding of this phenomenon at a population level. The current study prospectively estimates the cumulative incidence of sexual and physical dating violence (DV) victimization/perpetration over a 12-year timeframe (2010-2021) using diverse participants assessed annually from age 15 to 26. Data are from Waves 1-13 of an ongoing longitudinal study. Since 2010 (except for 2018 and 2019), participants were assessed on past-year physical and sexual DV victimization and perpetration. Participants (n = 1,042; 56% female; Mage baseline = 15) were originally recruited from seven public high schools in southeast Texas. The sample consisted of Black/African American (30%), White (31%), Hispanic (31%), and Mixed/Other (8%) participants. Across 12 years of data collection, 27.3% experienced sexual DV victimization and 46.1% had experienced physical DV victimization by age 26. Further, 14.8% had perpetrated at least one act of sexual DV and 39.0% had perpetrated at least one act of physical DV against a partner by this age. A 12-year cumulative assessment of physical and sexual DV rendered prevalence estimates of both victimization and perpetration that exceeded commonly and consistently reported rates in the field, especially on studies that relied on lifetime or one-time specified retrospective reporting periods. These data suggest community youth are at continued and sustained risk for DV onset across the transition into emerging adulthood, necessitating early adolescent prevention and intervention efforts that endure through late adolescence, emerging adulthood, and beyond. From a research perspective, our findings point to the need for assessing DV on a repeated basis over multiple timepoints to better guage the full extent of this continued public health crisis.

Are school-based interventions to prevent dating and relationship violence and gender-based violence equally effective for all students? Systematic review and equity analysis of moderation analyses in randomised trials

School-based interventions for the prevention of dating and relationship violence (DRV) and gender-based violence (GBV) take advantage of universal opportunities for intervention. Information on differential effectiveness of interventions is important to assess if they ameliorate or worsen social gradients in specific outcomes. This is especially important in DRV and GBV prevention given the gendered context of these behaviours and their common aetiologies in patriarchal gender norms, and social acceptance in school contexts of sexual harassment, such as catcalling or unwanted groping. We undertook a systematic review of moderation analyses in randomised trials of school-based interventions for DRV and GBV prevention. We searched 21 databases and used supplementary search methods without regard to publication type, language or year of publication, and synthesised moderation tests relating to equity-relevant characteristics (principally sex and prior history of the outcome) for DRV and GBV perpetration and victimisation. Across 23 included outcome evaluations, programme effects on DRV victimisation were not moderated by gender or prior experience of DRV victimisation, but DRV perpetration outcomes were greater for boys, particularly for emotional and physical DRV perpetration. Findings for GBV outcomes were counterintuitive. Our findings suggest that practitioners should carefully monitor local intervention effectiveness and equity to ensure that interventions are working as intended. However, one of the most surprising findings from our analysis-with clear relevance for uncertainties in practice-was that differential impacts by sexuality or sexual minority status were not frequently evaluated.

Economic Evaluation of an Intervention to Prevent Adolescent Dating Violence (Me & You)

Me & You: Building Healthy Relationships (Me & You) is a multilevel, technology-enhanced adolescent dating violence (DV) prevention program that aimed to reduce DV among ethnic-minority, early adolescent, urban youth. A group-randomized control trial of Me & You, conducted with 10 middle schools from a large urban school district in Southeast Texas in 2014-2015, found it to be effective in reducing DV perpetration and decreasing some forms of DV victimization. Economic evaluations of DV interventions are extremely limited, despite calls for more economic analyses to be incorporated in research. We help fill this gap by evaluating the cost-effectiveness from the payer and societal perspectives of implementing the Me & You program. Using cost data collected alongside the Me & You group-randomized trial, we computed incremental cost-effectiveness ratios. Our primary outcome was "any DV perpetrated" within 12 months of the intervention. We conducted a cost-benefit analysis beyond the intervention endpoint by using literature estimates of per-victim lifetime costs of DV. We performed sensitivity analyses to assess effects of uncertain parameters. Under the base-case scenario, the cost of the Me & You curriculum compared to the standard curriculum was $103.70 per-student from the societal perspective, and the effectiveness was 34.84 perpetrations averted, implying an incremental cost per perpetration averted of $2.98, which ranged from $0.48 to $73.24 in sensitivity analysis. Thus, we find the Me & You curriculum is cost-effective and cost-saving in most scenarios. Policymakers should carefully consider school-based DV prevention programs, and cost data should be regularly collected in adolescent prevention program evaluations.

School-based interventions for preventing dating and relationship violence and gender-based violence: A systematic review and synthesis of theories of change

School-based interventions for preventing dating and relationship violence (DRV) and gender-based violence (GBV) are an important way of attempting to prevent and reduce the significant amount of DRV and GBV that occurs in schools. A theoretical understanding of how these interventions are likely to cause change is essential for developing and evaluating effectiveness, so developing an overarching theory of change for school-based interventions to prevent DRV and GBV was the first step in our systematic review. Theoretical data were synthesised from 68 outcome evaluations using methods common to qualitative synthesis. Specifically, we used a meta-ethnographic approach to develop a line-of-argument for an overarching theory of change and Markham and Aveyard's (2003, Social Science & Medicine, 56, 1209) theory of human functioning and school organisation as a framework for structuring the concepts. The overall theory of change generated was that by strengthening relationships between and among staff and students, between the classroom and the wider school, and between schools and communities, and by increasing students' sense of belonging with student-centred learning opportunities, schools would encourage student commitment to the school and its values, prosocial behaviour and avoidance of violence and aggression. The theory of human functioning informed our understanding of the mechanisms of action but from our analysis we found that it required refinement to address the importance of context and student agency.

Uses of mHealth in Injury Prevention and Control: a Critical Review

Purpose of Reviews

The purpose of this review was to summarize the current state of the literature on the use of "mHealth" (the use of mobile devices for health promotion) for injury prevention and control.

Recent Findings

mHealth is being used to measure, predict, and prevent the full spectrum of injuries. However, most literature remains preliminary or in a pilot stage. Use of best-of-class design principles (e.g., user-centered design, theory-based development) is uncommon, and wide-scale dissemination of effective monitoring or intervention tools is rare.

Summary

mHealth for injury prevention holds promise, but further work is needed across the full spectrum of development and translation.

Assessment of Psychosocial Programs to Prevent Sexual Violence During Adolescence: A Systematic Review and Meta-analysis

IMPORTANCE

Sexual violence is a public health problem that affects adolescents globally. To our knowledge, no meta-analysis of prevention programs for adolescent sexual violence has been conducted.

OBJECTIVE

To perform a systematic review and meta-analysis of randomized clinical trials evaluating the efficacy of psychosocial programs for preventing sexual violence during adolescence.

DATA SOURCES

Peer-reviewed articles published in English were searched in PsycINFO, ERIC, PsycArticles, PubMed, and Web of Science databases through December 2021.

STUDY SELECTION

Studies were included if they were randomized clinical trials assessing the efficacy of a psychosocial prevention program targeting sexual violence and delivered to adolescents aged 10 to 19 years.

DATA EXTRACTION AND SYNTHESIS

Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify studies. The quality of individual studies was assessed with the Revised Cochrane Collaboration Risk of Bias tool. A random-effects model was used to pool odds ratios (ORs). Exploratory subgroup and metaregression analyses were performed to evaluate the associations between moderators and effect sizes.

MAIN OUTCOMES AND MEASURES

Primary outcomes were perpetration of sexual violence, experience of sexual violence, and a composite measure of any perpetration or experience of sexual violence.

RESULTS

Data were analyzed from 20 trials involving 37 294 adolescents. Compared with control conditions, prevention programs were associated with a significant reduction in the perpetration (OR, 0.83; 95% CI, 0.73-0.95; P = .005) and experience (OR, 0.87; 95% CI, 0.78-0.98; P = .02) of sexual violence, as well as a 13% significant reduction of any sexual violence (OR, 0.87; 95% CI, 0.78-0.97; P = .009). Exploratory analyses of the combination of program setting and participant age indicated that programs that were delivered in school settings and targeted at adolescents aged 15 to 19 years yielded significantly larger effect sizes (Cochran Q = 4.8; P = .03) compared with programs that were either delivered outside of a school setting or targeted younger adolescents. Quality assessment of trials revealed concerns of risk of bias across several included studies.

CONCLUSIONS AND RELEVANCE

In this meta-analysis, evidence suggested that prevention programs were associated with reducing adolescent sexual violence, especially when implemented at school with older adolescents. However, there is need for additional high-quality research. Prevention of adolescent sexual violence remains understudied compared with other similarly important public health prevention targets.

Components Related to Long-Term Effects in the Intra- and Interpersonal Domains: A Meta-Analysis of Universal School-Based Interventions

The aims of the present meta-analysis were to (1) examine long-term effects of universal secondary school-based interventions on a broad range of competencies and problems and (2) analyze which intervention components were related to stronger or weaker intervention effects at follow-up. Fifty-four studies of controlled evaluations (283 effect sizes) reporting on 52 unique interventions were included. Long-term intervention effects were significant but small; effect sizes ranged from .08 to .23 in the intrapersonal domain (i.e., subjective psychological functioning) and from .10 to .19 in the interpersonal domain (i.e., social functioning). Intervention components were generally related to effects on specific outcomes. Some components (e.g., group discussions) were even related to both stronger and weaker effects depending on the assessed outcome. Moreover, components associated with long-term effects differed from those associated with short-term effects. Our findings underscore the importance of carefully selecting components to foster long-term development on specific outcomes.

PROSPERO registration number: CRD42019137981.

Internet-Based Prevention Program of Victimization for Youth in Care and Care Leavers (EMPOWER YOUTH): Protocol for a Randomized Controlled Trial

BACKGROUND

The global estimate of the number of children in institutional care is around 5 million, with around 1 million of these children living in Europe. In Germany, about 75,000 children and adolescents find themselves in the foster care system and about 93,000 additional children and adolescents are living in institutions. Traumatic experiences and neglect in childhood are highly prevalent among these youth in care and are related to severe long-term effects. Childhood maltreatment and abuse can increase the risk of future victimization experiences. Although youth in care are at risk of victimization or revictimization, no specific evidence-based prevention program has been designed to address these specific needs.

OBJECTIVE

This study aims to evaluate the efficacy of a newly developed 6-module internet-based prevention program of victimization for youth in care, named EMPOWER YOUTH.

METHODS

In a randomized controlled trial, the intervention group will be compared to a waiting-list control group with an unblinded 1:1 allocation ratio. Assessments will take place before randomization (baseline) and at follow-up 18 weeks after baseline (ie, 12 weeks after finishing the last module of the program). The primary endpoint is the number of victimization, and online and offline bullying experiences (composite score) at the 18-week follow-up. Secondary endpoints are risk-taking behavior, aggressive tendencies, empathy, prosocial behavior, depressiveness, and loneliness at follow-up. The expected outcome requires a sample size of 156 subjects to achieve a power of 80%. Assuming a 30% dropout rate at follow-up, we require 225 participants to be allocated to the trial. Participants are youth in care, that is, adolescents in foster care, adopted adolescents, or young care leavers aged 14 to 21 years.

RESULTS

Ethical approval was granted by the Ethics Committee of the Medical School Berlin in March 2021 (MSB-2021/55). Recruitment started in September 2021 and is planned until November 2022. The results are expected to be published in January 2023.

CONCLUSIONS

Given the increased likelihood for future victimization experiences among youth in care, there is a strong need for a low-threshold intervention specifically for this high-risk age group. There are no existing nationwide mental health programs exclusively for youth in care in Germany.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00024749; https://tinyurl.com/tjaahayw.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/34706.

Psychological violence in dating relationships among adolescents: A systematic review and meta-analysis of prevention programs

Teen Psychological Dating Violence (TPDV) is a serious public health concern. However, there is limited evidence on the capacity of programs to prevent this form of violence. This study aimed to conduct a systematic review and meta-analysis of RCTs to evaluate the efficacy of prevention programs for TPDV. PsycINFO/Eric/PsycArticles, PubMed and Web of Science were searched from inception through January 2021 to identify RCTs of prevention programs for adolescents that reported a measure of TPDV. The effect sizes were computed as the difference between the prevention program and control group at post or follow-up assessment by calculating Hedges's g with a random-effect model. Thirteen trials met inclusion criteria and were included in the meta-analysis. There was a small but significant effect size in favor of the prevention group as compared to the control condition for victimization (g = 0.23; 95% CI, 0.10 to 0.37; p < 0.001) and perpetration (g = 0.24; 95% CI, 0.12 to 0.37; p < 0.001) of TPDV. Overall, the combined effect size for any TPDV perpetration/victimization was 0.22 (95% CI, 0.11 to 0.34; p < 0.001). Exploratory subgroup analysis showed that programs implemented at multiple levels (such as home, school, community) reported significantly larger effect sizes compared to single-level interventions. Significant differences in effect sizes were also associated with the type of scale used to assess TPDV. Current evidence suggests that intervention programs for TPDV may be effective, particularly when implemented at multiple levels. Further research focusing on refining tools to assess TPDV is needed.

Efficacy of Interventions to Prevent Physical and Sexual Dating Violence Among Adolescents: A Systematic Review and Meta-analysis

IMPORTANCE

Sexual and physical dating violence is prevalent among adolescents and is associated with adverse health effects.

OBJECTIVE

To conduct a systematic review and meta-analysis of randomized clinical trials to assess the efficacy of prevention programs for sexual and physical dating violence in adolescents.

DATA SOURCES

Search terms were combined for dating violence, adolescents, and randomized clinical trials in PsycINFO/Eric/PsycArticles, PubMed, and Web of Science databases from inception through April 2021.

STUDY SELECTION

Included studies had a randomized design of any type examining the efficacy of an intervention to reduce dating violence among adolescents and provided at least 1 measure of sexual or physical dating violence.

DATA EXTRACTION AND SYNTHESIS

Data extraction coded characteristics of trials, participants, and interventions and assessed risk of bias using the Revised Cochrane Collaboration Risk of Bias tool. Outcomes were pooled using a random-effects model. Subgroup and meta-regression analyses were performed to explore the target population and intervention factors associated with positive outcomes.

MAIN OUTCOMES AND MEASURES

The odds ratio (OR) was calculated for 3 different outcomes: (1) sexual dating violence, (2) physical dating violence, and (3) composite measures of sexual and physical dating violence. For each outcome, separate analyses were conducted for survivorship and perpetration scores. We also combined the scores of physical/sexual violence and perpetration/survivorship of teen dating violence into a single composite overall outcome including all studies.

RESULTS

Eighteen trials (22 781 adolescents) were included. Overall, interventions were associated with reduced physical and sexual dating violence (OR, 0.78; 95% CI, 0.69-0.89; P < .001). Separate analyses further indicated that this association was significant for physical violence perpetration (OR, 0.74; 95% CI, 0.59-0.92; P = .01) and survivorship (OR, 0.78; 95% CI, 0.64-0.95; P = .01). For sexual violence, the association was not statistically significant. Exploratory subgroup analyses revealed that trials targeting at-risk youth, older adolescents (age >15 years), and trials involving parents in the intervention reported significantly larger effect sizes. Meta-regression analyses did not show any significant associations between intervention effect sizes and length or intensity of the programs. Publication bias was observed, but the adjusted ORs remained significant. Three studies reported iatrogenic associations.

CONCLUSIONS AND RELEVANCE

Findings from this study suggest that prevention programs may be effective in reducing physical teen dating violence, but there is unclear evidence of the effect on sexual violence outcomes. Further research assessing the active ingredients of interventions, especially in the area of sexual dating violence, is warranted.

A Dating Violence Prevention Program for Middle School Youth: A Cluster Randomized Trial

OBJECTIVES

We conducted a cluster randomized controlled trial to test the a priori hypothesis that students attending an intervention middle school would be less likely to report physical adolescent relationship abuse (ARA) 1 year later compared with students attending a control school. Secondary objectives were to determine if the intervention reduced substance misuse, bullying, and fighting.

METHODS

Twenty-four Texas public middle schools were matched by the size of student enrollment, number of economically disadvantaged students, and race and ethnicity of the student body and randomly assigned to the intervention (n = 12; 1237 participants) or the control (n = 12; 1531participants) group. The intervention, Fourth R, is a classroom-based curriculum delivered by existing teachers and consists of 21 lessons on injury prevention, substance use, and growth and development.

RESULTS

Participants (50% female) self-reported ethnicity as Hispanic or Latinx (35%), Black or African American (24%), Asian American (17%), White (8%), and multiethnicity or other (16%). Among those who have dated, students in the intervention schools were less likely to report perpetrating physical ARA (intervention = 14.9% versus control = 18.3%) relative to students in the control schools (adjusted odds ratio, 0.66; 95% confidence interval, 0.43-1.00; P = .05). In the overall sample, no significant differences emerged between control and intervention groups with respect to substance misuse, fighting, and bullying.

CONCLUSIONS

The middle school version of Fourth R is effective in reducing physical ARA perpetration over at least 1 year. The intervention did not have an effect on bullying perpetration, physical fighting with peers, and substance misuse. Long-term assessment, especially follow-up that covers the transition to high school, is needed to examine the program benefit on key outcomes.

Co-occurrence of Dating Violence Victimization Subtypes: Assessing the Influence of Family Factors, Dating Attitudes, Risky Behaviors, and the Moderating Effect of Gender Among School-Aged Teens

Using data from a nationally representative sample of school-aged teens (n = 795), this study examined covariates associated with three subtypes of dating violence victimization (physical violence, emotional abuse, and imposed isolation). We asked the research questions: What were the family factors, dating attitudes, and risky behaviors associated with three subtypes of dating violence victimization across two time points? Second, were these relationships moderated by gender? Overall, we found widespread co-occurrence of victimization. Contrary to our predictions, not all earlier experiences with dating violence victimization worsened or persisted overtime. Regarding family factors, we did not find substantial statistically significant effects on victimization, with the exception that greater openness with parents was associated with increased occurrence of emotional abuse at Wave 1. In terms of dating attitudes, we found that when respondents condoned violence against a girlfriend, they were more likely to experience physical violence victimization at both waves. Respondents who believed that it is okay to use violence to control a boyfriend's behavior were more likely to report emotional abuse at Wave 1. Similarly, respondents who believed that it is okay to date more than one person, as well as those who condoned sexual intercourse outside of a romantic relationship, were more susceptible to emotional abuse. Regarding risky behaviors, we found that the respondents' victimization experience did not increase with a greater sexual partner acquisition; rather, it exerted the opposite effect on their experience with physical violence victimization. These risky behaviors, however, were only statistically significant at Wave 1. Finally, the moderating effect of gender is noted in the study. Implications from the study are discussed.

Trajectories of Dating Violence Victimization and Perpetration among Rural Adolescents

Research is inconclusive about the trajectory of dating violence during adolescence and whether there are differences across gender and race/ethnicity. We examined dating victimization and perpetration trajectories among a diverse sample of rural youth (N = 580, 52.7% female, 49% Black, 39% White, 11% Hispanic or other minorities) in middle and high school who were surveyed annually across four years and explored the influences of gender and ethnicity. The results based on cohort-sequential latent growth modeling revealed that for boys, victimization peaked at 11th grade, and then declined. For girls, victimization was stable throughout adolescence. Perpetration was reported less frequently and increased steadily for males and females. For White youth, victimization peaked at grades 9 and 10, followed by a decline. For Black youth, victimization followed a linear increase. Perpetration trajectory followed a linear increase for White and Black but not Hispanic youth. The findings indicate that the developmental progression of dating violence during adolescence varies by demographics. The discussion focuses on future directions for research on teen dating violence among rural youth and implications for prevention and interventions initiatives.