Green Dot across the Bluegrass: Evaluation of a primary prevention intervention t

描述（由申请人提供）： 问题陈述：虽然在过去的五年里，肯塔基州的高中生终身被迫性交的比率有所增加，但肯塔基州正在努力减少这一趋势。通过疾病预防控制中心的援助，肯塔基州性侵犯项目协会，公司。（KASAP）准备实施“绿色点”旁观者干预方案，以初级预防性暴力。重要性：我们现在有一个独特的和时间敏感的机会，以评估全州范围内的旁观者干预，这将是由KASAP教育工作者在整个肯塔基州通过高中在2010年开始实施。绿色点使学生能够积极质疑同伴对SV的支持，并成为能够在结束SV方面发挥重要作用的变革推动者。创新：虽然已经实施了几个旁观者干预计划，但很少有经验评估，也没有使用相同的干预方案在全州范围内进行评估。目的：评价绿色点在全州高中生中的应用。我们假设高中生与绿色点将随着时间的推移报告SV率较低的学生相比，在可比的高中随机没有绿色点。SV的减少将通过减少支持SV的社会规范和增加旁观者行为来介导。具体目标：为了前瞻性地确定是否相对于没有绿色点的高中学生，有绿色点的学校（目标1）的学生报告SV的发生率较低，（目标2）旁观者行为的频率较高，（目标3）支持SV的社会规范较少。最后，因为绿色点借鉴了创新理论的社会扩散，我们提出（目标4），以确定绿色点如何影响旁观者的行为，在一阶和二阶社交网络的学生谁做和不接受绿色点培训。方法：采用以人群为基础的对照干预试验来检验绿色点的疗效。小组和基于网络的队列调查方法将被用来提供基线和前瞻性数据的学生的态度支持SV，旁观者行为和SV的经验。设定：在13个KASAP地区中的每一个地区，将招募2所人口统计学上相当的高中，每年级至少200名学生，作为干预或对照地点参加绿色点。学校将被随机分配到干预。研究人群：所有参与高中的学生将被邀请从2010年春季开始到2014年完成匿名小组调查;我们预计绿色点的6500名学生和对照学校的6500名学生每年将完成调查。我们估计，650名接受绿色点培训的学生和650名未接受培训的学生将完成网络调查（2011-2014年）。记录SV的外部数据来源将从高中获得。对预防的影响：这项全州范围的、以人群为基础的、多中心对照干预试验将为一种有希望的干预措施提供经验性检验，如果证明有效，可能会导致SV的一级预防，并减少SV的健康和学术后果。 公共卫生相关性： 确定一个有希望的初级预防干预，以减少性暴力犯罪是否有效地减少暴力在一个真实的世界设置（高中在肯塔基州）可以导致一个重要的机会，以防止性暴力的短期和长期的健康后果。性暴力的定义包括身体强迫的性活动、胁迫的性活动和性骚扰，这种暴力很常见（约25%），对健康和学业有影响，而且是可以预防的;因此，这种形式的暴力可以成为初级预防工作的一个高影响目标。

DESCRIPTION (provided by applicant): Problem Statement: While rates of lifetime forced sexual intercourse have increased in Kentucky over the past five years among high school students, Kentucky is working to reduce this trend. Through CDC assistance, Kentucky Association of Sexual Assault Programs, Inc. (KASAP) is ready to implement the "Green Dot" bystander intervention program for primary prevention of sexual violence (SV). Importance: We now have the unique and time-sensitive opportunity to evaluate a statewide bystander intervention which will be implemented by KASAP Educators across Kentucky through high schools beginning in 2010. Green Dot empowers students to actively question peer support for SV and become change agents who can play a significant role in ending SV. Innovation: While several bystander intervention programs have been implemented, few been empirically evaluated and none have been evaluated on a statewide basis using the same intervention protocol. Purpose: To evaluate the statewide application of Green Dot among high schools students. We hypothesize that students in high schools with Green Dot will over time report lower rates of SV compared with students in comparable high schools randomized not to have Green Dot. This reduction in SV will be mediated through a reduction in social norms supporting SV and an increase in bystander behaviors. Specific Aims: To prospectively determine whether relative to students in high schools without Green Dot, those in schools with Green Dot (Aim 1) report lower rates of SV, (Aim 2) a greater frequency of bystander behaviors, and (Aim 3) fewer social norms supporting SV. Finally because Green Dots draws on social diffusion of innovation theory we propose (Aim 4) to determine how Green Dot influences bystander behaviors in the first and second order social networks of students who do and do not receive Green Dot training. Methods: A population-based controlled intervention trial will be used to test the efficacy of Green Dot. Both panel and web-based cohort survey methods will be used to provide baseline and prospective data on student's attitudes supporting SV, bystander behaviors and SV experiences. Setting: In each of the 13 KASAP regions, 2 demographically comparable high schools with at least 200 students per grade will be recruited to participate in Green Dot either as the intervention or control site. Schools will be randomly assigned to the intervention. Study Population: All students in participating high schools will be invited to complete anonymous panel surveys beginning spring 2010 through 2014; we anticipate that 6500 students in Green Dot and 6500 in control schools will complete surveys each year. We estimate that 650 students receiving Green Dot training and 650 students not so trained will complete the web-surveys, (2011-2014). External sources of data to document SV will be obtained from high schools. Implications for Prevention: This state-wide, population-based, multi-site controlled intervention trial will provide an empirical test of a promising intervention, which, if proven effective, could result in the primary prevention of SV and a reduction in the health and academic consequences of SV. PUBLIC HEALTH RELEVANCE: Determining whether a promising primary prevention intervention to reduce sexual violence perpetration is effective in reducing violence in a real world setting (high schools across Kentucky) can result in an important opportunity to prevent the short and longer term health consequences of sexual violence. Sexual violence, defined to include physically forced sexual activity, coerced sexual activity, and sexual harassment, is common (~25%), has health and academic consequences and is preventable; thus this form of violence can be a high impact target for primary prevention efforts.