Cluster randomized trial of school-based program to prevent teen dating violence

 描述（由申请人提供）：每年，大约25%的美国青少年遭受约会伴侣的身体，心理或性虐待。许多青少年约会暴力（TDV）的受害者经历了一系列毁灭性的后果，包括急性和慢性精神和身体健康问题，自杀，犯罪，危险的性行为，药物滥用和学业失败。此外，TDV的肇事者在成年后继续遭受亲密伴侣暴力的风险更大。TDV的流行，以及与之相关的不良心理，行为和关系健康结果，强调了有效的TDV预防计划的必要性。为了获得最大的利益，这些预防计划必须在发展的时机，并促进所有青少年之间的健康关系，这就是为什么以学校为基础的计划有相当大的希望。一个循证方案，即第四个R，将促进健康关系技能和预防TDV纳入现有的学校课程。因此，我们建议在30所种族多样化的中学（即，集群：15所干预学校; 15所对照学校）在全国最大的学区之一。学生 （N = 3，375）将作为分析单位，并将进行前瞻性研究（每年一次，为期3年），通过比较干预学校和对照学校的学生，确定该计划的影响。本研究的主要目的是确定第四R是否减少学生的经验与TDV，索引的身体，性和心理TDV的犯罪和受害较少。本研究的次要目的是确定第四R（1）是否改善了学生的情感幸福感，并增加了他们对健康关系技能的获得和使用，如改善的问题解决，沟通和冲突解决技能所示，（2）改善了与TDV的实施和受害相关的可修改的认知和行为相关性，这一点可以通过减少为约会暴力辩护的态度、减少物质使用、减少危险的性行为、减少打架和欺凌、增加学校联系和减少心理症状来体现。将审查按性别和种族预先规定的差异以及各种方案组成部分的获得和利用情况。虽然TDV是一个普遍存在的问题，但它在很大程度上是可以预防的。在拟议的研究中，我们将使用严格的方法学设计来测试一个新的和增强版的Fourth R，这是极少数有希望的TDV预防计划之一。除了克服以前TDV预防研究的局限性（例如，小样本量，有限的随访时间和种族同质性），拟议的研究将是第一个在美国样本中严格评估Fourth R的研究，也是第一个测试新的7年级版本Fourth R有效性的研究。一个成本效益和相对 一项可移植的TDV预防计划可以嵌入美国中学，有可能极大地改善全国青少年的健康和福祉。

 DESCRIPTION (provided by applicant): Each year, approximately 25 percent of US teenagers sustain physical, psychological, or sexual abuse by dating partners. Many victims of teen dating violence (TDV) experience a host of devastating consequences, including acute and chronic mental and physical health problems, suicidality, delinquency, risky sexual behavior, substance abuse, and academic failure. Moreover, perpetrators of TDV are at increased risk for continuing intimate partner violence in adulthood. The prevalence of TDV, as well as the adverse mental, behavioral, and relationship health outcomes associated with it, underscores the need for effective TDV prevention programs. For maximum benefit, these prevention programs must be developmentally well-timed and promote healthy relationships among all teens, which is why school-based programs hold considerable promise. One evidence-based program, the Fourth R, integrates the promotion of healthy relationship skills and prevention of TDV into existing school curricula. Thus, we propose to conduct a school-based cluster randomized trial of the 7th-grade version of Fourth R with 30 ethnically diverse middle schools (i.e., clusters: 15 intervention schools; 15 control schools) in one of the nation's largest school districts. Students (N = 3,375) in these schools will be the unit of analysis and will be studied prospectively (annually for 3 years) to determine the impact of the program by comparing students in intervention schools with those in control schools. The primary aim of this study is to determine whether Fourth R reduces students' experiences with TDV, as indexed by less perpetration and victimization of physical, sexual, and psychological TDV. The secondary aims of this study are to determine whether Fourth R (1) improves students' emotional well-being and increases their acquisition and use of healthy relationship skills, as indexed by improved problem-solving, communication, and conflict resolution skills and (2) ameliorates the modifiable cognitive and behavioral correlates associated with the perpetration and victimization of TDV, as indexed by fewer attitudes justifying dating violence, decreased substance use, decreased risky sexual behavior, decreased fighting and bullying, increased school connectedness, and decreased psychological symptoms. Prespecified differences by gender and ethnicity will be examined as well as the acquisition and utilization of various program components. Although TDV is a pervasive problem, it is largely preventable. In the proposed study, we will use a rigorous methodological design to test a new and enhanced version of Fourth R, one of the very few promising TDV prevention programs. In addition to overcoming limitations of previous TDV prevention research (e.g., small sample sizes, limited follow-up times, and ethnic homogeneity), the proposed study will be the first to rigorously evaluate Fourth R in a US sample and the first to test the effectiveness of the new 7th-grade version of Fourth R. A cost-effective and relatively portable TDV prevention program that can be embedded in US middle schools has the potential to dramatically improve the health and well-being of adolescents across the nation.