RCT Testing Bystander Effectiveness to Reduce Violence

Introduction: Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years. Design: A cluster RCT was conducted. Setting/participants: Kentucky high schools were randomized to intervention or control (wait list) conditions. Intervention: Green Dot−trained educators conducted schoolwide presentations and recruited student popular opinion leaders to receive bystander training in intervention schools beginning in Year 1. Main outcome measures: The primary outcome was sexual violence perpetration, and related forms of interpersonal violence victimization and perpetration were also measured using anonymous student surveys collected at baseline and annually from 2010 to 2014. Because the school was the unit of analysis, violence measures were aggregated by school and year and school-level counts were provided. Results: A total of 89,707 students completed surveys. The primary, as randomized, analyses conducted in 2014–2016 included linear mixed models and generalized estimating equations to examine the condition−time interaction on violence outcomes. Slopes of school-level totals of sexual violence perpetration (condition−time, p \u3c 0.001) and victimization (condition−time, p \u3c 0.001) were different over time. During Years 3–4, when Green Dot was fully implemented, the mean number of sexual violent events prevented by the intervention was 120 in Intervention Year 3 and 88 in Year 4. For Year 3, prevalence rate ratios for sexual violence perpetration in the intervention relative to control schools were 0.83 (95% CI=0.70, 0.99) in Year 3 and 0.79 (95% CI=0.67, 0.94) in Year 4. Similar patterns were observed for sexual violence victimization, sexual harassment, stalking, and dating violence perpetration and victimization. Conclusions: Implementation of Green Dot in Kentucky high schools significantly decreased not only sexual violence perpetration but also other forms of interpersonal violence perpetration and victimization

Protocol for Pilot Cluster RCT of Project Respect: A school-based intervention to prevent dating and relationship violence and address health inequalities among young people

Background Dating and relationship violence (DRV) – intimate partner violence during adolescence – encompasses physical, sexual and emotional abuse. DRV is associated with a range of adverse health outcomes including injuries, sexually transmitted infections, adolescent pregnancy and mental health issues. Experiencing DRV also predicts both victimisation and perpetration of partner violence in adulthood. Prevention targeting early adolescence is important because this is when dating behaviours begin, behavioural norms become established and DRV starts to manifest. Despite high rates of DRV victimisation in England, from 22-48% among girls and 12-27% among boys ages 14-17 who report intimate relationships, no RCTs of DRV prevention programmes have taken place in the UK. Informed by two school-based interventions that have shown promising results in RCTs in the United States – Safe Dates and Shifting Boundaries – Project Respect aims to optimise and pilot a DRV prevention programme for secondary schools in England. Methods Design: Optimisation and pilot cluster RCT. Trial will include a process evaluation and assess the feasibility of conducting a phase III RCT with embedded economic evaluation. Cognitive interviewing will inform survey development. Participants: Optimisation involves four schools and pilot RCT involves six (four intervention, two control). All are secondary schools in England. Baseline surveys conducted with students in Years 8 and 9 (ages 12-14). Follow-up surveys conducted with the same cohort, 16 months post-baseline. Optimisation sessions to inform intervention and research methods will involve consultations with stakeholders, including young people. Intervention: School staff training, including guidance on reviewing school policies and addressing ‘hotspots’ for DRV and gender-based harassment; information for parents; informing students of a help-seeking app; and a classroom curriculum for students in years 9 and 10, including a student-led campaign. Primary Outcome: The primary outcome of the pilot RCT will be whether progression to a phase III RCT is justified. Testing within the pilot will also determine which of two existing scales is optimal for assessing DRV victimisation and perpetration in a phase III RCT. Discussion This will be the first RCT of an intervention to prevent DRV in the UK. If findings indicate feasibility and acceptability, we will undertake planning for a phase III RCT of effectiveness. Trial registration ISRCTN, ISRCTN 65324176. Registered 8 June 2017, https://doi.org/10.1186/ISRCTN6532417

Examining the Preliminary Efficacy of a Dating Violence Prevention Program for Hispanic Adolescents

The purpose of this study is to evaluate the preliminary efficacy of a dating violence (DV) prevention program for Cuban American adolescents (JOVEN/YOUTH: Juntos Opuestos a la Violence Entre Novios/Together Against Dating Violence). A randomized-controlled experimental design with a delayed condition was used to evaluate the effects on DV victimization and perpetration (N = 82). Self-administrated assessments were completed at baseline, 1 week, 3 months, and 12 months after the intervention to assess for psychological victimization and perpetration and physical and sexual victimization and perpetration. Effect sizes were estimated, and generalized estimating equations were generated to test intervention effects over time and potential gender interactions. The intervention had medium to strong effects on DV victimization and perpetration for male participants but not for females. However, intervention effects were not statistically significant over time. More research is needed to enhance intervention effects of JOVEN on DV outcomes and to evaluate these effects among a larger and more diverse sample