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Integrating Prevention and Intervention: A School Health Center Program to Promote Healthy Relationships

NCJ Number
Date Published
January 2015
18 pages
This National Institute of Justice (NIJ) funded research study examined and tested the effectiveness of brief adolescent relationship abuse education and counseling interventions in school health centers.
The School Health Center Healthy Adolescent Relationship Program (SHARP) is a school health center (SHC) multi-level intervention to reduce adolescent relationship abuse (ARA) among adolescents ages 14-19. Intervention SHCs involve student outreach teams who conducted ARA educational events and encouraged students learn more about how to respond to ARA. SHCs offer the opportunity to reach adolescents experiencing ARA, identify at risk adolescents, and provide education about ARA and healthy relationships. During 2012-2013, 11 SHCs were randomized to SHARP or a standard-of-care control condition. Among 1,062 eligible students at 8 SHCs that participated after randomization, 1,011 completed computer-assisted surveys before a clinic visit, and 939 completed surveys 3 months later. Surveys in the intervention SHCs were conducted prior to training and six months after training. Focus groups with the student outreach teams were conducted at school to seek feedback on the SHARP intervention, the range of activities they included to raise awareness about ARA, and the SHC as a resource. Intervention versus control adjusted mean differences on changes in primary outcomes (recognition of abuse, intention to intervene, and knowledge of resources) were not statistically significant. Intervention participants had improved recognition of sexual coercion compared with controls, and 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. Adolescents in intervention clinics who reported ever being in an unhealthy relationship were more likely to report disclosure during an SHC visit. At the six month post-training time point, 33% of providers reported increased counseling about harm reduction strategies with their clients and 65% reported more comfort working with a client to identify a safe adult with whom they can share sexual and violence-related concerns.

Date Published: January 1, 2015