A Randomized Efficacy Trial of Moms and Teens for Safe Dates

描述（由申请人提供）： 遭受家庭暴力的儿童面临许多负面后果的风险增加，包括内化和外化问题和行为，1-6，当他们成为青少年时，他们对约会伴侣使用暴力的风险增加。7-13，183尽管这种风险增加，而且每年约有1500万儿童遭受家庭暴力，14但没有对针对这一群体的约会虐待预防方案进行评估。目的：这项拟议的研究是为了测试一个选择性的以家庭为基础的计划，针对青少年谁已经暴露于家庭暴力的约会虐待犯罪的初级预防的有效性。有待评估的“母亲和青少年安全约会”方案针对的是离开虐待伴侣的母亲及其12至15岁的青少年。在国家司法研究所的支持下，该方案已得到充分发展，但其效力尚未得到评估。本研究的目的是：1）测试妈妈和青少年安全约会在预防青少年心理，身体和性约会虐待犯罪方面的功效; 2）确定是否通过改变我们概念模型中基于理论和实践的中介变量来影响约会虐待犯罪结果;（3）检验项目效果的调节因素，包括青少年的性别和少数民族地位、青少年遭受家庭暴力的程度以及母亲的心理健康状况。研究设计：将采用前测后测对照组实验设计来评价该方案的有效性。将对560名符合条件的母亲及其青少年进行基线电话访谈。在基线访谈后，这些家庭中的一半（n = 280）将被随机分配到治疗条件下，另一半则分配到对照条件下。在治疗条件下的家庭将收到妈妈和青少年的安全日期。干预分娩后1年，将对治疗组和对照组母亲和青少年进行随访电话访谈。除了支持该计划的发展，国家司法研究所的资金支持了拟议研究所需的所有研究方案和数据收集工具的开发;因此，我们准备在拟议的随机试验中评估Moms and Teens for Safe Dates的有效性，并能够将所有资金支持用于计划评估，而不是计划开发和评估。设定：研究人员将与来自北卡罗来纳州反对家庭暴力联盟（NCCADV）的工作人员合作，招募符合条件的母亲，并提供“妈妈和青少年安全约会”计划。NCCADV是疾控中心通过DELTA方案资助的14个州一级联盟之一，DELTA方案是疾控中心用于促进亲密伴侣暴力初级预防的机制。通过与NCCADV合作，将建立系统和协议，如果发现有效，它们和其他DELTA联盟将来可以使用这些系统和协议来传播“妈妈和青少年安全约会”。此外，将在整个研究过程中收集与项目实施相关的费用，以便在发现项目有效时向希望传播该项目的机构提供。参会人员：将主要通过NCCADV的活动在整个北卡罗来纳州招募560名遭受家庭暴力但不再与施虐者生活在一起的母亲及其12至15岁的青少年。干预措施：《妈妈和青少年安全约会》包括6本邮寄给研究母亲的小册子，每次邮寄后两周，健康教育工作者都会打电话给她们。这些小册子包括母亲与青少年一起做的信息和互动练习，健康教育者的电话促进参与，评估方案活动的完成情况，并回答问题。这种结构类似于我们预防青少年约会虐待的普遍家庭计划的结构，称为安全约会家庭，以及我们以家庭为基础的物质使用预防计划，称为家庭事务，这两个计划都在随机试验中证明了有效性，并导致高家庭参与。133，134，186该计划的内容基于一个理论和实践为基础的概念模型，从司法的国家研究所资助的形成性研究的结果，和安全日期的家庭的内容。结局指标：将评估该计划对身体约会虐待犯罪的启动以及心理，身体和性约会虐待犯罪的有效性（目标1）。理论和实践为基础的调解人，这些程序的影响将进行评估（目标2），将主持人的程序对心理和身体的约会虐待犯罪（目标3）。 公共卫生相关性： 青少年约会虐待会干扰青少年的发展任务，扭曲对规范行为的看法，成为评估未来关系的不适当指南，并产生负面的心理和身体后果。迄今为止，遭受家庭暴力的青少年遭受虐待的风险更大。本研究旨在测试以家庭为基础的计划在预防遭受家庭暴力的青少年约会虐待方面的有效性。如果该方案有效，其传播将有助于打破导致我们社会许多健康和社会问题的家庭暴力循环。

DESCRIPTION (provided by applicant): Children who have been exposed to domestic violence are at increased risk for many negative outcomes, including internalizing and externalizing problems and behaviors, 1-6 and they are at increased risk of using violence against their dating partners when they become adolescents. 7-13, 183 Despite this increased risk and the fact that approximately 15 million children are exposed to domestic violence yearly, 14 there have been no evaluations of dating abuse prevention programs conducted with this population. Objectives: The proposed study is to test the efficacy of a selective family-based program for the primary prevention of dating abuse perpetration targeted at adolescents who have been exposed to domestic violence. The program to be evaluated, Moms and Teens for Safe Dates, targets mothers who have left an abusive partner and their 12 to 15 year old adolescents. This program has been fully developed with support from the National Institute of Justice, but its efficacy has not yet been evaluated. The aims of the study are to: 1) Test the efficacy of Moms and Teens for Safe Dates in preventing psychological, physical, and sexual dating abuse perpetration by adolescents; 2) Determine if program effects on dating abuse perpetration outcomes occur through changes in the theoretically- and empirically-based mediating variables presented in our conceptual model; and 3) Test for moderators of program effects including sex and minority status of the adolescent, degree of adolescent exposure to domestic violence, and the mother's psychological health. Study Design: A pre-test post-test control group experimental design will be used to evaluate the efficacy of the program. Baseline telephone interviews will be conducted with 560 eligible mothers and their adolescents. After the baseline interview, half (n = 280) of these families will be randomly allocated to the treatment condition and the other to the control condition. Families in the treatment condition will receive Mom's and Teens for Safe Dates. Follow-up telephone interviews will be conducted with the treatment and control group mothers and adolescents 1-year after intervention delivery. In addition to supporting the development of the program, the National Institute of Justice funding supported the development of all research protocols and data collection instruments needed for the proposed study; thus we are poised to evaluate the efficacy of Moms and Teens for Safe Dates in the proposed randomized trial with the ability to devote all of the funding support to program evaluation rather than to both program development and evaluation. Setting: UNC research staff will collaborate with staff from the North Carolina Coalition against Domestic Violence (NCCADV) to recruit eligible mothers and to deliver the Moms and Teens for Safe Dates program. NCCADV is one of 14 state-level coalitions funded by CDC through the DELTA program which is a mechanism used by CDC to promote the primary prevention of intimate partner violence. By collaborating with the NCCADV, systems and protocols will be set up that could be used by them and other DELTA coalitions in the future to disseminate Moms and Teens for Safe Date if it is found to be efficacious. Also, costs associated with program implementation will be collected throughout the study so that it will be available to agencies wanting to disseminate the program if it is found to be efficacious. Participants: 560 mothers who have been exposed to domestic violence, but are no longer living with the abuser, and their 12 to 15 year old adolescents will be recruited throughout North Carolina primarily through the activities of the NCCADV. Intervention: Moms and Teens for Safe Dates consists of 6 booklets mailed to study mothers, followed by health educator telephone calls two weeks after each mailing. The booklets include information and interactive exercises for mothers to do with their adolescents and the health educator telephone calls promote participation, assess program activity completion, and answer questions. This structure is similar to the structure of our universal family-based program for preventing adolescent dating abuse called Families for Safe Dates and our family-based substance use prevention program called Family Matters, both of which demonstrated efficacy in randomized trials and resulted in high family participation. 133,134,186 The content of the program is based on a theoretically- and empirically-based conceptual model, the results from formative research funded by the National Institutes of Justice, and the content of Families for Safe Dates. Outcome measures: The efficacy of the program on the initiation of physical dating abuse perpetration and the amount of psychological, physical, and sexual dating abuse perpetration will be assessed (Aim 1). Theoretically- and empirically-based mediators of these program effects will be assessed (Aim 2), as will moderators of program effects on psychological and physical dating abuse perpetration (Aim 3). PUBLIC HEALTH RELEVANCE: Adolescent dating abuse can interfere with the developmental tasks of adolescents, distort perceptions of normative behaviors, become inappropriate guides for evaluating future relationships, and have negative psychological and physical consequences. Adolescents who have been exposed to domestic violence are at increased risk of being abusive to dates. This study tests the efficacy of a family-based program in preventing dating abuse perpetration by adolescents exposed to domestic violence. If the program is effective its dissemination could contribute toward breaking the cycle of family violence that leads to so many of our society's health and social problems.