High School Follow-Up of the Dating Matters® RCT: Effects on Teen Dating Violence and Relationship Behaviors.

Teen dating violence (TDV) is a significant public health problem that can have lifelong consequences. Using a longitudinal, cluster randomized controlled trial (RCT), this study examines whether the Dating Matters comprehensive prevention model, implemented in middle school, prevented TDV and negative relationship behaviors and promoted positive relationship behaviors in high school (9th-11th grades), when compared with a standard of care intervention. Dating Matters includes programs for sixth to eighth grade youth and their parents, training for school staff, a youth communications program, and policy and data activities implemented in the community. Self-report survey data were collected from students in 46 middle schools that were randomly assigned to condition within site. Students completed two surveys (fall and spring) in each middle school grade and a single survey in the spring of each high school grade. This study examined self-reported TDV perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills in the high school follow-up. While varying patterns emerged, latent panel models demonstrated significant program effects for all outcomes. Dating Matters students reported 19% reduced risk for TDV perpetration, 24% reduced risk for TDV victimization, 7% reduced risk for use of negative conflict strategies, and 3% more use of positive relationship skills, on average across time and cohort, than standard of care students. On average, Dating Matters, implemented in middle school, continued to be more effective at reducing TDV perpetration, TDV victimization, and use of negative conflict resolution strategies in high school than an evidence-based comparison program.Trial Registration: clinicaltrials.gov Identifier: NCT01672541.

Racial Discrimination and Interpersonal Violence in Asian American Adolescents During the COVID-19 Pandemic.

PURPOSE: Racial discrimination targeting Asians in the United States has increased sharply since the COVID-19 pandemic. Despite a well-established link with mental/physical health outcomes, little is known about how racial discrimination relates to interpersonal violence, particularly in adolescents. To address this gap in knowledge, we examined cross-sectional and longitudinal (1-year follow-up) associations between racial discrimination and interpersonal violence perpetration and victimization in Asian American adolescents in a large US city. METHODS: Data from Waves 3 (2020) and 4 (2021) of a randomized clinical trial of a school-based violence prevention program were examined. We limited our sample to participants who identified as Asian American (n = 344; 48.3% female; Meanage = 14.6 years at Wave 3). RESULTS: At Wave 3, 26.5% of the adolescents reported experiencing some form of racial discrimination, including 18.3% experiencing verbal harassment due to race and 16.0% reporting inequitable treatment due to race. Relative to their nonvictimized counterparts, adolescents who experienced racial discrimination were more likely to report being a victim of bullying and teen dating violence cross-sectionally and being a bullying victim longitudinally. Moreover, those who experienced racial discrimination reported more bullying and teen dating violence perpetration concurrently, as well as more dating violence perpetration 1 year later. DISCUSSION: In the understudied population of Asian American adolescents, we found that experiencing racial discrimination contributes to both interpersonal violence victimization and perpetration. Youth violence prevention could include strategies addressing racial discrimination.

Prevalence of Violence Victimization and Perpetration During Middle and High School in Underresourced, Urban Communities.

This study describes rates of violence victimization, perpetration, and witnessing in 6th-11th grade for a multisite sample (N = 3,466) of predominantly Black and Hispanic middle- and high-school students from urban areas with high rates of crime and economic disadvantage. Students completed surveys in middle and high school assessing teen dating violence, stalking, sexual violence and harassment, bullying, cyberbullying, and physical violence perpetration and victimization, as well as witnessing violence. The highest prevalence rates are observed most often in 8th or 9th grade. Youth reported high rates of witnessing serious assault and severe community violence throughout adolescence. These findings suggest that efforts to prevent violence among youth living in under-resourced communities need to start early and address community-level socioeconomic disparities.

Dating Violence, Sexual Violence, and Bullying Victimization Among High School Students -Youth Risk Behavior Survey, United States, 2021.

Experiences of teen dating violence (TDV), sexual violence, and bullying during adolescence are all forms of interpersonal violence victimization (IVV) and are associated with health and behavioral issues during adulthood. Data from the nationally representative 2011-2021 Youth Risk Behavior Surveys were used to estimate the 2021 prevalence of IVV reported by U.S. high school students. IVV included past-year sexual TDV, physical TDV, sexual violence by anyone, electronic bullying, being bullied on school property, and lifetime forced sex and was analyzed by demographic characteristics and sex of sexual contacts. This report also explored trends in IVV over this 10-year period among U.S. high school students. In 2021, a total of 8.5% of students reported physical TDV, 9.7% reported sexual TDV, 11.0% reported sexual violence by anyone (with 59.5% of those also reporting sexual TDV), 15.0% reported bullying on school property, and 15.9% reported electronic bullying victimization during the past 12 months; 8.5% also reported experiencing forced sex in their lifetime. Disparities were observed for each form of IVV assessed for females and for most forms of IVV among racial and ethnic minority students; students who identified as lesbian, gay, bisexual, questioning, or other (LGBQ+); and students who reported their sexual contacts as same sex only or both sexes. Trend analyses indicated that physical TDV, sexual TDV, any physical or sexual TDV, and both physical and sexual TDV victimization decreased from 2013 to 2021 (although sexual TDV increased from 2019 to 2021). Any bullying victimization decreased from 2011 to 2021. Lifetime forced sexual intercourse decreased from 2011 to 2015, then increased from 2015 to 2021. Being bullied on school property was unchanged from 2011 to 2017, then decreased from 2017 to 2021. Sexual violence by anyone increased from 2017 to 2021. This report highlights disparities in IVV and provides the first national estimates among Native Hawaiian or other Pacific Islander youths. Findings, including trend analyses indicating recent increases in certain forms of IVV, point to the continued urgency of violence prevention efforts for all U.S. youths and especially those who are disproportionately affected by IVV.

Family Economics and Mental Health Among High-School Students During COVID-19.

INTRODUCTION: The COVID-19 pandemic has had unprecedented socioeconomic and health impacts in the U.S. This study examined racial/ethnic and school poverty status differences in the relationship between parent job loss, experiences with hunger, and indicators of mental health problems among public high-school students nationwide during the COVID-19 pandemic. METHODS: The study analyzed data from the Adolescent Behaviors and Experiences Survey, conducted in January-June 2021. The Adolescent Behaviors and Experiences Survey was a 1-time, cross-sectional, online survey that used a stratified, 3-stage cluster sample to obtain a nationally representative sample of high-school students in the U.S. This study was limited to public-school students (n=7,379). RESULTS: Among public high-school students nationwide, 36.9% experienced poor mental health during the pandemic, and during the past year, 43.9% experienced persistent feelings of sadness or hopelessness, 19.8% seriously considered attempting suicide, and 9.1% attempted suicide. Parent job loss and having gone hungry were associated with indicators of mental health problems overall and across racial/ethnic groups and school poverty status levels. CONCLUSIONS: Students who experience parent job loss and hunger are likely to also experience poor mental health and may be at higher risk for suicide.

Estimating From the Payer Perspective the Implementation Cost of Dating Matters®: A Comprehensive Teen Dating Violence Prevention Model.

"Dating Matters®" is a CDC-developed comprehensive, multi-component teen dating violence (TDV) prevention model, made available to the public in 2019. A longitudinal, multi-site demonstration project found that the model significantly reduced TDV during middle school relative to an evidence-based, single-program intervention (Safe Dates; Niolon et al., 2019), when implemented across 46 middle schools in four high-risk urban areas with predominantly Black (55%) and Hispanic (28%) youth participants. Research on the costs of implementing TDV prevention strategies is limited, despite recognition within the field of prevention science that such data are critical to widespread dissemination. The current study adds to the available literature on the cost of dating violence prevention by estimating the budgetary impact from the payer perspective of implementing the comprehensive Dating Matters model, compared to Safe Dates, at four sites over four school years to inform prevention planning in communities. Total costs of implementing Dating Matters were relatively stable within sites over time but varied greatly between sites (M = $175,452 per year; range = $130,149 to $227,604). The mean per-student cost of Dating Matters was $145.40 but also ranged widely ($20.66 to $324.65) across sites and years. Variation was largely driven by staffing costs and number of students served. As expected, total and per-student costs were substantially lower at all sites for the Safe Dates program (M = $12,148; range = $2,848 to $17,840; $44.81 per student) compared to Dating Matters. This study provides an estimate from the payer perspective to demonstrate the budgetary impact of Dating Matters. These estimates can help inform implementation decisions and planning by potential funders, communities, and organizations as they seek to support and implement effective TDV prevention strategies. It also adds substantially to understanding of the additional costs associated with a move from single-program interventions to community-wide initiatives.

Effects of the Dating Matters® Comprehensive Prevention Model on Health- and Delinquency-Related Risk Behaviors in Middle School Youth: a Cluster-Randomized Controlled Trial.

Teen dating violence (TDV) is associated with a variety of delinquent behaviors, such as theft, and health- and delinquency-related risk behaviors, including alcohol use, substance abuse, and weapon carrying. These behaviors may co-occur due to shared risk factors. Thus, comprehensive TDV-focused prevention programs may also impact these other risk behaviors. This study examined the effectiveness of CDC's Dating Matters®: Strategies to Promote Healthy Teen Relationships (Dating Matters) comprehensive TDV prevention model compared to a standard-of-care condition on health- and delinquency-related risk behaviors among middle school students. Students (N = 3301; 53% female; 50% black, non-Hispanic; and 31% Hispanic) in 46 middle schools in four sites across the USA were surveyed twice yearly in 6th, 7th, and 8th grades. A structural equation modeling framework with multiple imputation to account for missing data was utilized. On average over time, students receiving Dating Matters scored 9% lower on a measure of weapon carrying, 9% lower on a measure of alcohol and substance abuse, and 8% lower on a measure of delinquency by the end of middle school than students receiving an evidence-based standard-of-care TDV prevention program. Dating Matters demonstrated protective effects for most groups of students through the end of middle school. These results suggest that this comprehensive model is successful at preventing risk behaviors associated with TDV. clinicaltrials.gov Identifier: NCT01672541.

Effects of Dating Matters® on Sexual Violence and Sexual Harassment Outcomes among Middle School Youth: a Cluster-Randomized Controlled Trial.

Sexual violence (SV), including sexual harassment (SH), is a significant public health problem affecting adolescent health and well-being. This study extends prior research by evaluating the effectiveness of a comprehensive teen dating violence prevention model, Dating Matters, on SV and SH perpetration and victimization, inclusive of any victim-perpetrator relationship, among middle school students. Dating Matters includes classroom-delivered programs for youth in 6th, 7th, and 8th grades; community-based programs for parents; a youth communications program; training for educators; and community-level activities. Middle schools in four urban areas in the USA were randomly assigned to receive Dating Matters (DM, N = 22) or a standard-of-care intervention (SC, N = 24) over four consecutive school years (2012-2016). The analytic sample included two cohorts who entered the study in 6th grade and completed 8th grade by the end of the study allowing for full exposure to Dating Matters (DM: N = 1662; SC: N = 1639; 53% female; 50% black, non-Hispanic; 6 waves of data collection for each cohort). Structural equation modeling was employed with multiple imputation to account for missing data. Dating Matters was associated with significant reductions in SV and SH perpetration and victimization scores in most-but not all-sex/cohort groups by the end of 8th grade relative to an evidence-based TDV prevention program. On average, students receiving Dating Matters scored 6% lower on SV perpetration, 3% lower on SV victimization, 4% lower on SH perpetration, and 8% lower on SH victimization by the end of middle school than students receiving an evidence-based violence prevention program. Overall, Dating Matters shows promise for reducing SV and SH, occurring both within and outside dating relationships, through middle school. Clinicaltrials.gov Identifier: NCT01672541.

The Dating Matters® Toolkit: Approaches to increase adoption, implementation, and maintenance of a comprehensive violence prevention model.

Purpose: This practical implementation report describes a comprehensive teen dating violence prevention model-Dating Matters®-and the approach taken to maximize its potential for widespread dissemination through development of the Dating Matters Toolkit. Dating Matters has evidence of effectiveness for preventing teen dating violence and other adolescent risk behaviors from a multi-site randomized controlled trial. Identifying strategies that reduce barriers to the dissemination and implementation of evidence-based comprehensive prevention models, like Dating Matters, is critical to their widespread adoption. Lessons learned from creating the Toolkit can inform the development and dissemination of similar comprehensive prevention strategies and speed their adoption and use in the field. Approach: We engaged in a multi-pronged, data-driven approach to maximize adoption, implementation, and maintenance of the Dating Matters model based on multiple data sources and lessons learned from the demonstration project, while retaining core components and content of the evaluated model. Potential barriers to the national dissemination of Dating Matters were identified in four key areas: training, technical assistance, model flexibility, and accessibility. A series of modifications were made to the implementation model to address these challenges and facilitate scale-up prior to national dissemination. We outline these challenges and describe solutions implemented through the development of the Dating Matters Toolkit. Outcomes: The Dating Matters Toolkit includes web-based facilitator training, enhanced implementation support through a new staff role and community of practice, online comprehensive implementation guidance and resources, and added flexibility to improve feasibility and adoption in communities during capacity-building. Findings from an initial evaluation of the Toolkit suggest users perceived the comprehensive model as feasible and accessible with enough implementation support. Most expressed interest in adopting the model. Users described cost and stakeholder buy-in as remaining barriers. Ongoing improvements to the Toolkit to address these challenges and future research to evaluate its effectiveness are planned.

E-cigarette use of young adults motivations and associations with combustible cigarette alcohol, marijuana, and other illicit drugs.

BACKGROUND AND OBJECTIVES: Although the prevalence of e-cigarette use among adolescents and young adults has caught up to or eclipsed that of combustible cigarette use, there is relatively little known about (a) the link between e-cigarettes and other substances and (b) the reasons underlying this increase in e-cigarette use. To address this gap in knowledge, the current study examined associations between e-cigarette use and other substances and identified motives for e-cigarette use among young adults. METHODS: Participants included an ethnically diverse sample of African American, White, and Hispanic young adults (N = 662; 61% female) who were participating in an ongoing survey-based longitudinal study of health and risky behaviors. RESULTS: Hispanic, White, and male young adults reported significantly greater past year e-cigarette use compared to their African American and female counterparts. Bivariate correlations showed that use of e-cigarettes was positively associated with use of combustible cigarettes, alcohol, marijuana, cocaine, amphetamines, inhalants, hallucinogens, ecstasy, and misuse of over-the-counter and prescription medications. Furthermore, e-cigarette users reported a higher prevalence of substance use relative to those who did not use e-cigarettes. The taste of e-cigarettes was identified as an important motive for use. CONCLUSIONS AND SIGNIFICANCE: Although the potential harm associated with e-cigarettes remains largely unknown, e-cigarettes appear to be a risk marker for the use of substances that are known to pose substantial health problems. Health care providers should screen for e-cigarette use, and youth substance use prevention programs should target the reduction of e-cigarette use with particular attention to addressing their taste appeal. (Am J Addict 2017;26:343-348).