Evaluating the long-term effects of Green Dot on teen dating violence prevention

描述（由申请人提供）：我们的目的是评估绿点在整个蓝草的长期影响，这是一项基于积极旁观者的随机干预试验，在肯塔基州的26所高中进行，旨在减少一群进入青年期的老年人的约会和性暴力。我们的核心问题是：当这群人进入青年期时，接触绿点的学生相对于未接触绿点的学生而言，在改变暴力接受文化和减少暴力犯罪方面，绿点是否继续发挥作用？在这个大约7500名学生的前瞻性队列中，我们将测量绿点计划的个人水平，并进入青年期，使我们能够估计约会和性暴力受害和犯罪的风险。很少有研究对随机分配到初级预防干预并随访到青年期的队列中约会和性暴力的风险进行前瞻性估计。这个R01也是独一无二的，因为队列成员将被跟踪，无论他们是否上大学。单独跟踪这群老年人代表着一个重要的增值和时间敏感的机会，因为绿点计划从2011年底开始全面实施。直到现在（2013- 2015年），我们才期望看到绿点计划对即将步入老年的学生产生的影响，改变他们的旁观行为，并可能减少暴力行为。目的1。前瞻性地确定绿点干预是否以及如何通过(a)改变暴力接受的社会规范，(b)增加积极的旁观，以及(c)通过同伴网络扩散干预来降低青少年约会和性暴力的发生率。大约7500名在肯塔基高中就读的高中毕业生被随机分配到绿点干预学校（n~3750）或对照学校（n~3750），他们将被跟踪42个月直到成年。目标2。确定被试高中后生活经历对绿点干预暴露与旁观行为、青少年约会和性暴力发生率之间关系的潜在调节作用。高中毕业后的经历将被归类为参加任何形式的学院或大学与没有额外的教育。具体的生活压力源，如关系状况，怀孕，军事部署，家庭和同伴暴力，以及药物滥用也将被探讨。这项队列研究的动力（¿90%）适当地解决了这两个目标。每隔6个月和42个月的随访进行比较，并按时间评估干预的相互作用。广义估计方程将用于测试绿点随时间的影响，同时考虑到高中的聚类和个别学生重复测量之间的相关性，并对混杂因素进行调整。这一前瞻性队列研究建立在以大量人群为基础的、有前景的初级预防干预的基础上，旨在减少高中生中的约会和性暴力，并为该项目在青年期的长期有效性提供了重要的测试。

DESCRIPTION (provided by applicant): Our purpose is to evaluate the longer-term impact of Green Dot across the Bluegrass, an active bystanding-based randomized intervention trial in 26 high schools across Kentucky designed to reduce dating and sexual violence in a cohort of seniors as they transition into young adulthood. Our central question is: Does Green Dot continues to have an effect in changing the culture of violence acceptance and reducing violence perpetration among students exposed to Green Dot relative to those not exposed as this cohort enters young adulthood? In this prospective cohort of approximately 7,500 students, we will measure the individual level exposure to the Green Dot program and into young adulthood allowing us to estimate the risk of dating and sexual violence victimization and perpetration. Very few studies have prospectively estimated the risk of dating and sexual violence among a cohort randomized to a primary prevention intervention and followed into young adulthood. This R01 is also unique because cohort members will be followed independent of whether they do or do not attend college. Individually following this cohort of seniors represents a significant value-added and time-sensitive opportunity because the full implementation of Green Dot began in late 2011. Only now (2013-15) would we anticipate seeing an effect of Green Dot among rising seniors on changing bystanding and potentially reducing violence. Aim 1. Prospectively determine whether and how the Green Dot intervention reduces rates of teen dating and sexual violence into young adulthood by (a) changing social norms of violence acceptance, (b) increasing active bystanding, and (c) diffusing the intervention through peer networks. Approximately 7500 high school seniors who attended Kentucky high schools randomized to the Green Dot intervention (n~3750) or control schools (n~3750) will be followed 42 months into young adulthood. Aim 2. To determine the potentially modifying effects of participants' post-high school life experience on the association between exposure to the Green Dot intervention and bystanding actions, teen dating and sexual violence incidence. Post-high school experience will be categorized as attending any form of college or university versus no additional education. Specific life stressors such as relationship status, pregnancy, military deployment, family and peer violence, and substance abuse will also be explored. This cohort study is appropriately powered (¿90%) to address both aims. Comparisons will be made at 6-month intervals and across the 42-month follow-up and the interaction of intervention by time will be evaluated. Generalized Estimating Equations will be used to test the impact of Green Dot over time while taking clustering of high schools and correlation among repeated measurements among individual students into account and adjusting for confounders. This prospective cohort builds upon a large population-based and promising primary prevention intervention, designed to reduce dating and sexual violence among high school students and provides an important test of the longer-term efficacy of this program into young adulthood.