A School-Based Program to Prevent Adolescent Dating Violence: A Cluster Randomized Trial

Objective To determine whether an interactive curriculum that integrates dating violence prevention with lessons on healthy relationships, sexual health, and substance use reduces physical dating violence (PDV). Design Cluster randomized trial with 2.5-year follow-up; prespecified subgroup analyses by sex. Setting Grade 9 health classes. Participants A total of 1722 students aged 14-15 from 20 public schools (52.8% girls). Intervention A 21-lesson curriculum delivered during 28 hours by teachers with additional training in the dynamics of dating violence and healthy relationships. Dating violence prevention was integrated with core lessons about healthy relationships, sexual health, and substance use prevention using interactive exercises. Relationship skills to promote safer decision making with peers and dating partners were emphasized. Control schools targeted similar objectives without training or materials. Main Outcome Measures The primary outcome at 2.5 years was self-reported PDV during the previous year. Secondary outcomes were physical peer violence, substance use, and condom use. Analysis was by intention-to-treat. Results The PDV was greater in control vs intervention students (9.8% vs 7.4%; adjusted odds ratio, 2.42; 95% confidence interval, 1.00-6.02; P = .05). A significant group x sex interaction effect indicated that the intervention effect was greater in boys (PDV: 7.1% in controls vs 2.7% in intervention students) than in girls (12.1% vs 11.9%). Main effects for secondary outcomes were not statistically significant; however, sex x group analyses showed a significant difference in condom use in sexually active boys who received the intervention (114 of 168; 67.9%) vs controls (65 of 111 [58.6%]) (P .01). The cost of training and materials averaged CA$16 per student. Conclusion The teaching of youths about healthy relationships as part of their required health curriculum reduced PDV and increased condom use 2.5 years later at a low per-student cost. Trial Registration isrctn.org Identifier: ISRCTN76259226
Author: 
Wolfe,David A.
Crooks,Claire
Jaffe,Peter
Chiodo,Debbie
Hughes,Ray
Ellis,Wendy
Stitt,Larry
Donner,Allan
Notes: 
10.1001/archpediatrics.2009.69
Reprint Status: 
NOT IN FILE
Start Page: 
692
End Page: 
699
Journal/Periodical Name: 
Archives of Pediatrics Adolescent Medicine
Volume: 
163
Issue: 
8
Abstract: 
The purpose of this study was to determine if an interactive curriculum that integrated dating violence prevention with lessons on healthy relationships, sexual health, and substance use reduced PDV 2.5 years later among 1, 722 students in Ontario, Canada. The secondary purpose of the study was to reduce risk behaviors of peer violence, substance use, and condom use. In 2004, schools were randomly assigned to intervention or control groups and the program was implemented among 9th grade students. Findings indicated: by the end of 11th grade PDV increased for all students from approximately 1% to 8%, PDV was higher for students in control group (9%) than the intervention group (7%), the effect of the intervention was different between boys and girls. No significant differences between the groups were reported for physical peer violence, substance use, or condom use. Authors suggested that methods developed for single-focused interventions can be combined from a core relationship perspective and teachers with training can implement evidenced-based prevention programs.
Topic Areas: 
adolescent/high school, curriculum, effects, prevention
Reference Type: 
JOUR
Reference ID: 
2632
Publication Date: 
2009/08/01