A school-based program that integrates information about healthy relationships into the existing ninth-grade curriculum appears to reduce adolescent dating violence and increase condom use two and a half years later, according to a report in the August issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. The effects of the low-cost intervention appear stronger in boys.
Approximately one in 10 to one in five high school-aged teens are hit, slapped or beaten by an individual they are dating each year, according to background information in the article. Dating violence among adolescents often leads to intimate partner violence in adulthood and also is associated with injuries, unsafe sex, substance use and suicide attempts.
David A. Wolfe, PhD, of the Centre for Addiction and Mental Health Centre for Prevention Science, London, Ontario, and the University of Toronto, and colleagues in 2004 to 2007 conducted a randomised trial of a 21-lesson curriculum delivered by teachers with special training in the dynamics of dating violence and healthy relationships.
The program, known as the "Fourth R: Skills for Youth Relationships", was taught to 968 students at 10 randomly selected high schools. "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," they continue. Another 754 students at 10 different schools were assigned to a control group, where similar objectives were targeted but without training or materials.
When the adolescents were surveyed two and a half years later – at the end of grade 11 – rates of physical dating violence were greater in the control students (9.8 percent) than in the students who participated in the program (7.4 percent). Although both boys and girls typically perpetrate dating violence, the intervention had a stronger effect on boys; 7.1 percent of boys in the control group and 2.7 percent in the intervention group reported physical dating violence, compared with 12.1 percent of girls in the control group and 11.9 percent of those in the intervention group. Sexually active boys in the program also reported a higher rate of condom use (114 of 168 or 67.9 percent vs. 65 of 111 or 58.6 percent).
Because the program met mandated education requirements in Ontario, no additional class time, scheduling or human resources assistance was needed. The average cost of training and materials was $16 Canadian per student.
"The present evaluation of the "Fourth R: Skills for Youth Relationships" suggests that methods developed for single-focused interventions (e.g. skills-based, interactive delivery) can be combined effectively from a core relationship perspective. As in related trials, teachers with supplementary training can implement evidence-based prevention programs with sufficient fidelity and effectiveness to garner significant improvements over status quo classroom methods," the authors conclude. "Similar to efforts made with academic subjects, the best policy may involve earlier introduction of these important topics at a lower grade level, with increasing knowledge and practice introduced in core courses throughout high school."
(Source: JAMA/Archives : Archives of Pediatrics & Adolescent Medicine: August 2009)