RT Journal Article
SR Electronic
T1 A School Health Center Intervention for Abusive Adolescent Relationships: A Cluster RCT
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP 76
OP 85
DO 10.1542/peds.2014-2471
VO 135
IS 1
A1 Miller, Elizabeth
A1 Goldstein, Sandi
A1 McCauley, Heather L.
A1 Jones, Kelley A.
A1 Dick, Rebecca N.
A1 Jetton, Johanna
A1 Silverman, Jay G.
A1 Blackburn, Samantha
A1 Monasterio, Erica
A1 James, Lisa
A1 Tancredi, Daniel J.
YR 2015
UL http://pediatrics.aappublications.org/content/135/1/76.abstract
AB BACKGROUND AND OBJECTIVES: Few evidence-based interventions address adolescent relationship abuse in clinical settings. This cluster randomized controlled trial tested the effectiveness of a brief relationship abuse education and counseling intervention in school health centers (SHCs).METHODS: In 2012–2013, 11 SHCs (10 clusters) were randomized to intervention (SHC providers received training to implement) or standard-of-care control condition. Among 1062 eligible students ages 14 to 19 years at 8 SHCs who continued participation after randomization, 1011 completed computer-assisted surveys before a clinic visit; 939 completed surveys 3 months later (93% retention).RESULTS: Intervention versus control adjusted mean differences (95% confidence interval) on changes in primary outcomes were not statistically significant: recognition of abuse = 0.10 (−0.02 to 0.22); intentions to intervene = 0.03 (−0.09 to 0.15); and knowledge of resources = 0.18 (−0.06 to 0.42). Intervention participants had improved recognition of sexual coercion compared with controls (adjusted mean difference = 0.10 [0.01 to 0.18]). In exploratory analyses adjusting for intensity of intervention uptake, intervention effects were significant for increased knowledge of relationship abuse resources and self-efficacy to use harm reduction behaviors. Among participants reporting relationship abuse at baseline, intervention participants were less likely to report such abuse at follow-up (mean risk difference = −0.17 [−0.21 to −0.12]). Adolescents in intervention clinics who reported ever being in an unhealthy relationship were more likely to report disclosing this during the SHC visit (adjusted odds ratio = 2.77 [1.29 to 5.95]).CONCLUSIONS: This is the first evidence of the potential benefit of a SHC intervention to address abusive relationships among adolescents.