A school health center intervention for abusive adolescent relationships: A cluster RCT

Elizabeth Miller, Sandi Goldstein, Heather L. McCauley, Kelley A. Jones, Rebecca N. Dick, Johanna Jetton, Jay G. Silverman, Samantha Blackburn, Erica Monasterio, Lisa James, Daniel J Tancredi

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

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 (20.02 to 0.22); intentions to intervene = 0.03 (20.09 to 0.15); and knowledge of resources = 0.18 (20.06 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 = 20.17 [20.21 to 20.12]). 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.

Original languageEnglish (US)
Pages (from-to)76-85
Number of pages10
JournalPediatrics
Volume135
Issue number1
DOIs
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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    Miller, E., Goldstein, S., McCauley, H. L., Jones, K. A., Dick, R. N., Jetton, J., Silverman, J. G., Blackburn, S., Monasterio, E., James, L., & Tancredi, D. J. (2015). A school health center intervention for abusive adolescent relationships: A cluster RCT. Pediatrics, 135(1), 76-85. https://doi.org/10.1542/peds.2014-2471