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

描述(由申请者提供)：我们的目的是评估绿点横跨蓝草的长期影响，这是一项积极的、基于常备的随机干预试验，在肯塔基州的26所高中进行，旨在减少一群高年级学生在过渡到年轻成年期时的约会和性暴力。我们的中心问题是：绿点在改变接受暴力的文化和减少接触绿点的学生中的暴力行为方面是否继续发挥作用，相对于那些没有接触到绿点的学生，随着这群人进入青年期？在这个由大约7,500名学生组成的预期队列中，我们将衡量个人在绿点计划和青年时期的暴露水平，从而估计约会和性暴力受害和实施的风险。很少有研究前瞻性地估计在随机接受初级预防干预并跟踪到青年时期的队列中约会和性暴力的风险。R01也是独一无二的，因为队列成员将被跟踪，无论他们是否上过大学。单独跟踪这群老年人是一个重要的增值和时间敏感的机会，因为绿点计划的全面实施始于2011年底。只有现在(2013-2015)，我们才能预计到绿点运动在不断崛起的老年人中对改变现状和潜在减少暴力的影响。目的1.前瞻性地确定绿点干预是否以及如何通过(A)改变接受暴力的社会规范，(B)增加积极的旁观者，以及(C)通过同伴网络传播干预，从而降低青少年约会和青年时期的性暴力发生率。大约7500名就读于肯塔基州高中的高三学生被随机分配到绿点干预学校(n~3750)或对照学校(n~3750)，他们将被跟踪观察42个月，直到成年。目的2.确定参与者的高中后生活经历对接触绿点干预与旁听行为、青少年约会和性暴力事件之间的关联的潜在影响。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，而不是没有额外的教育。还将探讨具体的生活压力来源，如关系状况、怀孕、军事部署、家庭和同伴暴力以及药物滥用。这项队列研究有适当的动力(90%)来解决这两个目标。将每隔6个月和42个月的随访期进行比较，并评估按时间进行干预的相互作用。将使用广义估计方程来测试绿点随时间的影响，同时考虑高中的群集性和个别学生之间重复测量之间的相关性，并对混杂因素进行调整。这一前瞻性队列建立在一项以人群为基础、前景看好的初级预防干预措施的基础上，旨在减少高中生中的约会和性暴力，并对该计划在成年后的长期效果进行了重要的测试。

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.