Abstract
BackgroundDating and relationship violence (DRV)—intimate partner violence during adolescence—encompasses physical, sexual and emotional abuse. DRV is associated with a range of adverse health outcomes including injuries, sexually transmitted infections, adolescent pregnancy and mental health issues. Experiencing DRV also predicts both victimisation and perpetration of partner violence in adulthood.Prevention targeting early adolescence is important because this is when dating behaviours begin, behavioural norms become established and DRV starts to manifest. Despite high rates of DRV victimisation in England, from 22 to 48% among girls and 12 to 27% among boys ages 14–17 who report intimate relationships, no RCTs of DRV prevention programmes have taken place in the UK. Informed by two school-based interventions that have shown promising results in RCTs in the USA—Safe Dates and Shifting Boundaries—Project Respect aims to optimise and pilot a DRV prevention programme for secondary schools in England.MethodsDesign: optimisation and pilot cluster RCT. Trial will include a process evaluation and assess the feasibility of conducting a phase III RCT with embedded economic evaluation. Cognitive interviewing will inform survey development.Participants: optimisation involves four schools and pilot RCT involves six (four intervention, two control). All are secondary schools in England. Baseline surveys conducted with students in years 8 and 9 (ages 12–14). Follow-up surveys conducted with the same cohort, 16 months post-baseline. Optimisation sessions to inform intervention and research methods will involve consultations with stakeholders, including young people.Intervention: school staff training, including guidance on reviewing school policies and addressing ‘hotspots’ for DRV and gender-based harassment; information for parents; informing students of a help-seeking app; and a classroom curriculum for students in years 9 and 10, including a student-led campaign.Primary outcome: the primary outcome of the pilot RCT will be whether progression to a phase III RCT is justified. Testing within the pilot will also determine which of two existing scales is optimal for assessing DRV victimisation and perpetration in a phase III RCT.DiscussionThis will be the first RCT of an intervention to prevent DRV in the UK. If findings indicate feasibility and acceptability, we will undertake planning for a phase III RCT of effectiveness.Trial registrationISRCTN, ISRCTN 65324176. Registered 8 June 2017.
Highlights
Dating and relationship violence (DRV)—intimate partner violence during adolescence—encompasses physical, sexual and emotional abuse
Is progression to a phase III randomised controlled trial (RCT) justified in terms of pre-specified criteria? These criteria are: randomisation occurs and four or more schools out of six accept randomisation and continue within the study; the intervention is implemented with fidelity in at least three of the four intervention schools; the process evaluation indicates the intervention is acceptable to 70% or more of year 9 and 10 students and staff involved in implementation; computer assisted self-interview (CASI) surveys of students are acceptable and achieve response rates of at least 80% in four or more schools; and methods for economic evaluation in a phase III RCT are feasible
Further work is required to elaborate the intervention methods and produce materials, optimising these for use in the UK. This process will be led by the investigators and NSPCC working in close collaboration, and with the participation of students and teachers drawn from four secondary schools, as well as the Advice Leading to Public Social and Economic (Health) Advancement (ALPHA) group [50]—a young people’s research advisory group—and policy stakeholders
Summary
Dating and relationship violence (DRV)—intimate partner violence during adolescence—encompasses physical, sexual and emotional abuse. DRV is associated with a range of adverse health outcomes including injuries, sexually transmitted infections, adolescent pregnancy and mental health issues. Dating violence and public health Dating and relationship violence (DRV)—used to describe intimate partner violence during adolescence [1,2,3]—encompasses threats, emotional abuse, controlling behaviours, physical violence and coerced, non-consensual or abusive sexual activities perpetrated by a partner [4]. Experience of DRV is associated with subsequent adverse outcomes such as substance misuse and anti-social behaviour [18,19,20], sexually transmitted infections (STIs) and teenage pregnancy [21], eating disorders [17], suicidal behaviours and other mental health problems [17, 22], physical injuries [23] and low educational attainment [22]. In 2008 in the UK, it was estimated that domestic violence cost the National Health Service £1.73 billion per year with total costs to the UK economy of £15.73 billion per year [25]
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