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

Area of Science:

• Public Health
• Adolescent Health
• Clinical Interventions

Background:

• Adolescent relationship abuse is a significant public health issue.
• Evidence-based clinical interventions for adolescent relationship abuse are limited.
• School health centers (SHCs) offer a potential setting for intervention delivery.

Purpose of the Study:

• To test the effectiveness of a brief relationship abuse education and counseling intervention delivered in SHCs.
• To evaluate the intervention's impact on adolescent recognition of abuse, intentions to intervene, and knowledge of resources.

Main Methods:

• A cluster randomized controlled trial was conducted across 11 SHCs (10 clusters).
• Providers in intervention SHCs received training to implement the program.
• 1011 adolescents (ages 14-19) completed baseline surveys, with 939 retained at 3-month follow-up.

Main Results:

• The intervention did not significantly improve overall recognition of abuse, intentions to intervene, or knowledge of resources.
• However, intervention participants showed improved recognition of sexual coercion.
• Exploratory analyses indicated significant benefits for knowledge of resources and self-efficacy in harm reduction behaviors.
• Participants reporting abuse at baseline were less likely to report it at follow-up in the intervention group.
• Adolescents in intervention clinics were more likely to disclose unhealthy relationships during their SHC visit.

Conclusions:

• This study provides initial evidence for the potential benefits of SHC-based interventions for addressing adolescent relationship abuse.
• The findings suggest that SHCs can be a viable setting for delivering interventions to support adolescents experiencing unhealthy relationships.