Randomized controlled trials evaluating adolescent dating violence prevention programs with an outcome of reduced perpetration and/or victimization: A meta-analysis.

INTRODUCTION: Adolescent dating violence (ADV), including psychological, physical, threatening, and/or sexual abuse between adolescent romantic partners, is an epidemic in the United States, with youth report rates ranging from 15 to 77% for perpetration and 14-73% for victimization. ADV victimization is associated with multiple adverse outcomes in both adolescence and adulthood (e.g., suicidal ideation, substance use, bullying), as is ADV perpetration (e.g., sexually transmitted infections, intimate partner violence in adulthood). Given the high prevalence and profound impact of ADV on youth in the US, many prevention efforts have emerged in the past 20 years. Previous reviews of these efforts have focused primarily on school-based interventions or have broadly reviewed programs including all research design types and outcomes. This review is the first to provide a comprehensive, quantitative synthesis of all existing ADV prevention programs tested using randomized controlled trial designs with a control group, specifically measuring ADV perpetration and/or victimization as outcomes. METHODS: Employing a systematic literature search and screening protocol, nine studies were identified for meta-analysis. RESULTS: Results indicate that ADV prevention programs may decrease the risk of emotional, physical, and sexual perpetration, as well as emotional and physical victimization. CONCLUSIONS: This is the first review to uncover significant intervention effects on the actual occurrence of ADV, with previous reviews only finding effects on outcomes such as ADV knowledge and attitude. Findings suggest that ADV prevention programs are promising and may warrant implementation more broadly with youth, and this review provides methodological suggestions for future research evaluating new ADV prevention programs.

Adverse Childhood Experiences, Trauma Symptoms, Mindfulness, and Intimate Partner Violence: Therapeutic Implications for Marginalized Men.

Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field's scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men's physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men's victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.

Las experiencias adversas en la infancia (EAI) y los síntomas de trauma se han asociado con la perpetración de violencia de pareja y la victimización entre los hombres, sin embargo, el ámbito carece de profundidad en varias áreas clave que obstaculizan el avance hacia la intervención en la violencia. Específicamente, el trastorno por estrés postraumático (TEPT) domina el alcance de los síntomas de trauma del ámbito estudiado, lo cual limita la comprensión de otras manifestaciones de trauma, especialmente entre los hombres. Además, la mayoría de las investigaciones se centran exclusivamente en la perpetración de violencia física de pareja por parte de los hombres y rara vez se centra en otros tipos de violencia de pareja, en la gravedad de la violencia o en la victimización de los hombres. Además, pocos estudios analizan posibles factores protectores basados en el marco de las EAI, como la conciencia plena, entre las poblaciones clínicas. Finalmente, la mayoría de las investigaciones no se han centrado en los hombres de color, a pesar de algunos índices desmesurados de exposición a la violencia de pareja de grupos raciales/étnicos minoritarios. Por lo tanto, se analizó la relación entre la frecuencia de la violencia de pareja y la gravedad de esta (psicológica, física, lesiones) y las EAI, el TEPT, la sintomatología del trauma (aparte del TEPT), y la autoeficacia de la conciencia plena en una muestra de 67 hombres de color, predominantemente de bajos recursos, en un programa de intervención para golpeadores. Más de la mitad de la muestra (el 51, 5 %) informó exposición a cuatro o más EAI y el 31, 1 % alcanzó el umbral de decisión clínica para un diagnóstico probable de TEPT. Los puntajes más altos de EAI predijeron índices mayores de casi todos los tipos de perpetración de violencia de pareja y victimización autoinformadas. Los síntomas de TEPT y la gravedad de los síntomas de trauma complejo explicaron juntos entre el 13 % y el 40 % de los resultados de la violencia de pareja, y cada uno estuvo asociado exclusivamente con ciertos tipos de gravedad y frecuencia de la victimización y la perpetración de violencia de pareja autoinformadas. La autoeficacia de la conciencia plena estuvo asociada con una menor victimización y perpetración autoinformadas de la frecuencia y la gravedad de la violencia psicológica de pareja. Se revisan las implicancias clínicas relevantes para los hombres marginados, entre ellas, la evaluación, la capacitación y las posibles intervenciones terapéuticas.

Using grounded theory to develop a theory of change for a violence intervention program.

Hospital-based violence intervention programs (HVIP) are critical to interrupting the cycle of violence. These interventions are considered "complex" in that they have many mechanisms of change and related outcomes. Few HVIPs clearly identify the underlying mechanisms of intervention and explicitly link those with key outcomes however, limiting the field's ability to know what works best and for whom. To develop a program theory of change for these "complex interventions," a non-linear, robust methodology that is grounded in the lived experience of those delivering and receiving services is needed. To aid researchers, evaluators, students, and program developers, we describe the use of Grounded Theory as a methodology to enhance the development of complex interventions, illuminating a non-linear approach that engages key stakeholders. To illustrate application, we describe a case example of The Antifragility Initiative, a HVIP in Cleveland, Ohio. The development of the program theory of change was conducted in four phases: (1) review of existing program documents, (2) semi-structured interviews with program developers (n = 6), (3) a focus group with program stakeholders (n = 8), and (4) interviews with caregivers and youth (n = 8). Each phase informed the next and culminated in a theoretical narrative and visual model of the Antifragility Initiative. Together, the theoretical narrative and visual model identify the underlying mechanisms that can promote change by the program.

How Trauma, Depression, and Gender Roles Lead to Intimate Partner Violence Perpetration Among a Sample of Predominately Low-Income Black, Indigenous, Men of Color: A Mixed Methods Study.

Despite decades of research and significant efforts by practitioners and advocates, intimate partner violence (IPV) in the United States remains a public health issue that disproportionately affects racial/ethnic minorities. The lack of mixed methods and qualitative studies, particularly with Black, Indigenous, Men of Color (BIMOC), limits the field's ability to tease apart the complex, multifaceted aspects of IPV perpetration and minimizes diverse perspectives of how childhood trauma and key proximal factors culminate in IPV perpetration. An explanatory design, follow-up explanations model, was used with a sample of predominately low-income BIMOC in a batterer intervention program (BIP). Associations between IPV and theoretically supported factors (e.g., trauma symptoms, depression, gender roles) were examined using a cross-sectional survey (N = 67) with ordinary least squares regression. Following up, processes explaining how these factors might lead to IPV perpetration were explored using semistructured interviews (N = 11) with narrative analysis. Results indicate that depressive and posttraumatic stress disorder (PTSD) symptoms together predict men's IPV perpetration. Participants' collective narrative explains how key factors-such as adverse childhood experiences, PTSD, depression, social isolation, anger, and restricted emotionality-work together to culminate in IPV perpetration. Findings shed light on potential trajectories and antecedents that manifest in IPV perpetration, providing implications for practice techniques and program development with low-income BIMOC in BIPs.

A phenomenological study identifying facilitators and barriers to Black and Latinx youth's engagement in hospital-based violence intervention programs.

Black and Latinx youth are disproportionately affected by violence in the United States. Hospital-based violence intervention programs (HVIPs) have emerged as an effective response to this epidemic; however, participation rates remain low. This study aimed to identify facilitators and barriers to recruitment and engagement amongst black and Latinx youth from the perspective of HVIP staff. Employing a phenomenological approach, a purposive sample of key informants was recruited. Focus groups and semi-structured interviews lasting approximately 90 min were conducted with representatives (N = 12) from five HVIPs in U.S. cities across the Midwest and Northeast, making up 15% of all HVIPs in the United States. Each interview was recorded and transcribed verbatim. The research team employed rigorous content analysis of the data. Three themes and subsequent categories resulted from the analysis: (1) Interpersonal/Relational Facilitators (building rapport; connecting with youth; enhancing the teachable moment; building relational health); (2) Structural/Systemic Barriers (lack of reinforcement; difficulties connecting after discharge from the hospital; hospital workflow; institutional challenges); (3) Structural/Systemic Facilitators (embedding the HVIP; trauma-informed practices and policies). Given the limited research on black and Latinx youth and the disproportionate rate of violent injuries amongst these groups, an evidence-based systematic approach to engage youth is essential to promote health equity. The findings from this study suggest that there are several steps that HVIPs and hospitals can take to enhance their recruitment and engagement of youth and their families.

Understanding How Relational Health Effects Intimate Partner Violence Perpetration among Low-Income, Black, Indigenous, Men of Color Exposed to Adverse Childhood Experiences: An Exploratory Study.

Relational health has emerged as a consistent factor that can mitigate the effects of trauma among children; however, less is known about relational health with adults, particularly related to intimate partner violence (IPV) perpetration among racially and socioeconomically marginalized men. The Exploratory Sequential Design, Taxonomy Development Model was used. Semi-structured interviews (N = 11) and narrative analysis were conducted in Phase I. In Phase II, variables approximating the key themes that emerged in Phase I were selected from an existing dataset (N = 67), and relationships were examined using bivariate associations. The sample consisted of low-income Black, Indigenous, men of color (BIMOC) in a batterer intervention program (BIP). Adverse life experiences shaped participants' world view via mistrust in others, stifling emotions and vulnerability, and a sense of personal guilt and shame. These orientations were then carried into adult relationships where men coped using social isolation to manage challenges, negatively affecting intimate relationships. For some men, mental health exacerbated these circumstances. Significant bivariate and multivariate associations supported this narrative. This study lays the foundation for future research to examine the potential effects of social support on IPV perpetration. BIPs should consider augmenting programming to enhance men's social networks to support their use of nonviolence after program completion.