Intervention programs significantly decrease dating violence in adolescents

1. In a meta-analysis of 18 randomized trials, interventions aimed at reducing dating violence in adolescents significantly prevented physical violence but had no significant effect on sexual violence.

2. Interventions targeting high-risk and older adolescents and interventions involving parents had larger effect sizes on average.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Teen dating violence (TDV), defined as either physical aggression toward or sexual assault of a partner, is a large and growing issue in the adolescent population. Survivors of TDV have been shown to experience significant short- and long-term physical and psychiatric health effects. In recent years, many trials have implemented and reported on programs aimed at reducing TDV. This meta-analysis aimed to determine whether these programs were effective overall and identify program and population factors predicting an effect. Across 18 trials including more than 22,000 adolescents, interventions included group discussions, individual interviews, parent-child activities, and classroom activities. Overall, teens in intervention groups were significantly less likely to experience or perpetrate dating violence. When physical and sexual violence were separated, this effect remained significant for physical but not for sexual violence. Interventions targeting adolescents with a history of violence and those 15 years or older reported larger effect sizes on average. Formal analysis indicated low-to-moderate heterogeneity of effect sizes between the randomized trials. However, the heterogeneity of the interventions themselves is also significant: some interventions took place within a single day, while others were years-long programs. Interestingly, this study’s analysis did not find any difference in effect size based on duration of intervention or number of sessions. While this study provides encouraging evidence that TDV can be effectively prevented, further elucidation is needed on how exactly to best reach adolescents and achieve future behavioral change.

Click to read the study in JAMA Pediatrics

Click to read an accompanying editorial in JAMA Pediatrics

Relevant Reading: Understanding teen dating violence: Practical screening and intervention strategies for pediatrics and adolescent healthcare providers

In-Depth [meta-analysis]: Studies identified based on database searches were included if they randomized participants aged 18 or younger to either an intervention group or a control group then followed up with the same cohort. Effect sizes were standardized by calculating odds ratios for both survivorship and perpetration of sexual, physical, and a composite of sexual and physical violence. Effect sizes were then pooled using random-effects models. The pooled odds ratio was 0.78 (95% confidence interval 0.69-0.89), indicating a significant reduction in TDV. The I² statistic was 29.9%, indicating low/moderate heterogeneity. Length of follow-up was associated with a small but significant decrease in effect size (coefficient -0.03, 95% confidence interval -0.06 to 0). Meta-regression analyses were used to examine differences between subgroups. Though publication bias was observed, adjusted odds ratios using the trim-and-fill procedure were still significant.

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