Engendering Healthy Masculinities to Prevent Sexual Violence

 描述(由申请者提供)：全球卫生组织强调让男子和男孩参与预防对妇女的暴力行为，这是一项潜在的有影响力的公共卫生战略。“性别变革”方法涉及改变助长暴力侵害妇女行为的性别和性规范，同时促进旁观者干预(即，让男孩掌握技能，打断他们在同龄人中目睹的虐待行为)，以减少性暴力和青少年关系虐待(ARA)。这项研究将通过双臂整群随机对照试验，在14-17岁的非裔美国青少年男性中测试一项名为“男孩关爱”的“性别变革性”SV/ARA犯罪预防计划。这是一种利益攸关方参与的干预措施，在社区青年服务机构(基督教青年会和城市联盟)进行为期18小时的课程，分为3个周末课程，为期2个月(每隔4周)。控制站点将实施一项以证据为基础的生活技能课程。主要关注社会弱势社区的非裔美国青年的理由有两个。首先，在这项研究的背景匹兹堡，种族/民族在健康方面的差异是明显的；预防 需要在贫困、性暴力和健康状况不佳的社区作出努力。其次，预防教育工作者来自这些社区，具有高度的信任和尊重，这对建立积极的青年关系至关重要。创新是：第一，结合性别理论、青春期性发展和社区合作研究的交叉方法，以评估性别变革性规划对社会弱势社区SV/ARA实施的影响；第二，将围绕性别规范变化的教育和技能建设与性教育相结合的计划，理论上针对SV实施并增加健康的性行为；第三，利益相关者参与设计和实施的方法，以确保当地相关性、可行性和可复制性；以及第四，使用以艺术为基础的战略，鼓励年轻人探索男子气概。通过在青年服务机构(10个小组，N=960名14-17岁的青少年男性)进行的双臂整群随机试验，这项研究将评估与生活技能课程相比的“男孩关怀”的有效性。在2个月的计划结束时(时间2)，与对照组相比，年轻人将表现出更多的积极旁观者干预行为(次要结果)。中间结果是：避孕套和避孕自我效能增加；对虐待行为的认可度增加；性别平等态度增加；与同龄人进行干预的意向增加。干预6个月后(时间3)，与对照组相比，年轻人报告对女性实施SV和ARA的行为较少(主要结果)。这项研究将提供迫切需要的关于性别转变计划的有效性的信息，该计划结合健康的性行为技能、性别规范的改变和旁观者的技能来中断同龄人的不尊重和有害行为，以减少青春期男性的SV/ARA行为。

 DESCRIPTION (provided by applicant): Global health organizations highlight engaging men and boys in preventing violence against women as a potentially impactful public health strategy. A "gender transformative" approach involves altering gender and sexuality norms that foster violence against women while promoting bystander intervention (i.e., giving boys skills to interrupt abusive behaviors they witness among peers) to reduce the perpetration of sexual violence (SV) and adolescent relationship abuse (ARA). This study will test, via a two arm cluster randomized controlled trial, a "gender transformative" SV/ARA perpetration prevention program titled "Boys Care" implemented in a community-based setting among African American adolescent males ages 14-17. This is a stakeholder- engaged intervention that involves an 18 hour curriculum divided into 3 weekend day sessions delivered over a 2 month period (at 4 week intervals) in community-based youth-serving agencies (YMCA and Urban League). Control sites will implement an evidence-based life skills curriculum. The rationale for focusing on primarily African American youth in socially disadvantaged neighborhoods is two-fold. First, racial/ethnic disparities in health are stark in Pittsburgh, the setting for this study; prevention efforts in communities with high prevalence of poverty, sexual violence, and poor health outcomes are needed. Second, the prevention educators are from these communities and have high degrees of trust and respect fundamental to building positive youth relationships. Innovations are: first, an intersectional approach combining gender theory, adolescent sexual development, and community-partnered research to evaluate the impact of gender transformative programming on SV/ARA perpetration in socially disadvantaged communities; second, a program that integrates education and skills building around gender norms change with sexuality education theorized to target SV perpetration and increase healthy sexual behaviors; third, a stakeholder-engaged approach in design and implementation to ensure local relevance, feasibility, and replicability; and fourth, use of arts-based strategies to encourage youth to explore masculinities. Via a 2-arm cluster-randomized trial in youth-serving agencies (10 clusters, N=960 adolescent males ages 14-17), this study will assess the effectiveness of "Boys Care" compared to a life skills curriculum. At the end of the 2 month program (Time 2), compared to controls, youth will demonstrate increased positive bystander intervention behaviors (secondary outcome). Intermediate outcomes are: increased condom and contraceptive self-efficacy; increased recognition of abusive behaviors; increased gender-equitable attitudes; and increased intentions to intervene with peers. Six months after the intervention (Time 3), youth will report less perpetration of SV and ARA toward females (Primary Outcome) compared to controls. This study will provide urgently needed information about the effectiveness of a gender transformative program that combines healthy sexuality skills, gender norms change, and bystander skills to interrupt peers' disrespectful and harmful behaviors to reduce SV/ARA perpetration among adolescent males.