Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Query Trace: DeGue S[original query] |
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Interpersonal violence victimization among high school students - Youth Risk Behavior Survey, United States, 2019
Basile KC , Clayton HB , DeGue S , Gilford JW , Vagi KJ , Suarez NA , Zwald ML , Lowry R . MMWR Suppl 2020 69 (1) 28-37 Adolescent interpersonal violence victimization is an adverse childhood experience and a serious public health problem for youths, their families, and communities. Violence victimization includes dating violence, sexual violence, and bullying. Youth Risk Behavior Survey data for 2019 were used to examine physical and sexual dating violence; sexual violence by anyone; and bullying victimization, whether on school property or electronic, of U.S. high school students by sex, race/ethnicity, and sexual identity. In addition, this report explores frequency of dating violence and frequency of sexual violence among students who reported these forms of victimization and presents composites of dating violence and bullying. Findings reveal that 8.2% of students reported physical dating violence; 8.2% reported sexual dating violence; 10.8% reported sexual violence by anyone, of which 50% of cases were by a perpetrator other than a dating partner; 19.5% reported bullying on school property; and 15.7% reported electronic bullying victimization during the previous 12 months. Approximately one in eight students reported any dating violence, and one in four reported any bullying victimization. Female students; lesbian, gay, and bisexual students; and students not sure of their sexual identity reported the highest prevalence estimates across all five violence victimization types, any and both forms of dating violence, and any bullying victimization. Non-Hispanic white students reported the highest prevalence of bullying victimization. Among students experiencing physical or sexual dating violence or sexual violence by anyone, the most common frequency reported was one time during the previous year; higher frequency was more prevalent among male students compared with female students. These findings provide a contextual understanding of the prevalence of interpersonal violence of U.S. high school students, highlighting those with highest prevalence. Findings can be used by public health professionals to guide prevention efforts with youths in schools and communities. |
Dating violence, sexual violence, and bullying victimization among high school students -Youth Risk Behavior Survey, United States, 2021
Clayton HB , Kilmer G , DeGue S , Estefan LF , Le VD , Suarez NA , Lyons BH , Thornton JE . MMWR Suppl 2023 72 (1) 66-74 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. |
Mental health, suicidality, and connectedness among high school students during the COVID-19 pandemic - Adolescent Behaviors and Experiences Survey, United States, January-June 2021
Jones SE , Ethier KA , Hertz M , DeGue S , Le VD , Thornton J , Lim C , Dittus PJ , Geda S . MMWR Suppl 2022 71 (3) 16-21 Disruptions and consequences related to the COVID-19 pandemic, including school closures, social isolation, family economic hardship, family loss or illness, and reduced access to health care, raise concerns about their effects on the mental health and well-being of youths. This report uses data from the 2021 Adolescent Behaviors and Experiences Survey, an online survey of a probability-based, nationally representative sample of U.S. public- and private-school students in grades 9-12 (N = 7,705), to assess U.S. high school students' mental health and suicidality during the COVID-19 pandemic. The study also examines whether mental health and suicidality are associated with feeling close to persons at school and being virtually connected to others during the pandemic. Overall, 37.1% of students experienced poor mental health during the pandemic, and 31.1% experienced poor mental health during the preceding 30 days. In addition, during the 12 months before the survey, 44.2% experienced persistent feelings of sadness or hopelessness, 19.9% had seriously considered attempting suicide, and 9.0% had attempted suicide. Compared with those who did not feel close to persons at school, students who felt close to persons at school had a significantly lower prevalence of poor mental health during the pandemic (28.4% versus 45.2%) and during the past 30 days (23.5% versus 37.8%), persistent feelings of sadness or hopelessness (35.4% versus 52.9%), having seriously considered attempting suicide (14.0% versus 25.6%), and having attempted suicide (5.8% versus 11.9%). The same pattern was observed among students who were virtually connected to others during the pandemic (i.e., with family, friends, or other groups by using a computer, telephone, or other device) versus those who were not. Comprehensive strategies that improve feelings of connectedness with others in the family, in the community, and at school might foster improved mental health among youths during and after the COVID-19 pandemic. |
High school follow-up of the Dating Matters® RCT: Effects on teen dating violence and relationship behaviors
Niolon PH , Estefan LF , DeGue S , Le VD , Tracy AJ , Ray C , Bontempo D , Little TD , Vivolo-Kantor AM , Latzman N , Taylor B , Tharp A . Prev Sci 2024 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. |
Prevalence of violence victimization and perpetration during middle and high school in under-resourced, urban communities
DeGue S , Ray CM , Bontempo D , Niolon PH , Tracy AJ , Estefan LF , Le VD , Little TD . Violence Vict 2023 38 (6) 839-857 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. |
A qualitative analysis of beliefs about masculinity and gender socialization among U.S. mothers and fathers of school-age boys
DeGue Sarah , Singleton Robyn , Kearns Megan . Psychology of Men & Masculinities 2023 No Pagination Specified Internalization of culturally dominant masculine gender role norms can have harmful impacts on the physical and emotional health of men and boys. Although parents play an important role in influencing gender-related beliefs in their children, limited research has examined how contemporary parents conceptualize masculinity and their role in gender socialization. The present study conducted 13 focus groups with Black, Latino, and White parents (N = 83) of school-age boys from rural and urban areas in a large Southeastern state in the United States. Parent beliefs about masculinity existed across a spectrum from "rigid" (representing narrow, culturally dominant masculine norms) to "flexible" (defining a broader set of behaviors and attitudes as masculine). In general, more flexible beliefs were expressed by mothers than fathers and by White than Black and Latino parents. Most parents reacted positively to messages about potential harms associated with restrictive masculinity norms; however, many saw these issues primarily as parenting challenges (e.g., teaching boys to resist negative peer influences) rather than related to gender socialization. Some unique themes also emerged within racial/ethnic groups, with Black parents noting the impact of racial discrimination on societal expectations for Black men and fathers and Latino parents describing generational shifts toward more equitable gender role attitudes and parenting practices. These findings highlight the need for more complex and nuanced messages about masculinity norms and their relationship to health and well-being and can help inform the development of interventions to promote healthy masculine gender socialization, increase health equity, and prevent injury and violence. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement Culturally dominant masculine gender role norms (e.g., emotional stoicism, social and physical dominance, independence, toughness) are associated with negative social and health consequences for boys and men, along with public health and safety concerns related to risk behaviors and violence perpetration. Parents and caregivers of young boys are an ideal target for preventative interventions addressing these norms in early and middle childhood, when gender socialization begins. Findings from this study suggest variation by gender and race/ethnicity in contemporary parents' attitudes toward masculinity and norms-challenging messages about parenting boys and can inform the development of social norms-based and parenting interventions to improve health equity and address multiple public health concerns, including injury and violence. (PsycInfo Database Record (c) 2023 APA, all rights reserved) |
COVID-19 pandemic impact on United States intimate partner violence organizations: Administrator perspectives
Randell KA , Balascio P , Ragavan MI , Duplessis V , Miller E , Hurley TP , Garcia R , Villaveces A , DeGue S , Chang JC . J Fam Violence 2023 Purpose: The COVID-19 pandemic has increased challenges to intimate partner violence (IPV) service provision. This study aimed to explore administrative perspectives on the impacts of the COVID-19 pandemic on United States regional and national IPV service organizations. Methods: We interviewed 35 administrators working within state, regional, or national organizations addressing IPV. Interview domains included (1) organizational response to COVID-19, including communication and supporting employees and partner agencies, (2) impact on marginalized communities, and (3) resource needs. We used a hybrid deductive-inductive approach and thematic analysis for coding and analysis. Results: We identified four key themes: (1) COVID-19 worsened pre-existing challenges and created new challenges at multiple levels within IPV service organizations; (2) IPV service organizations initiated multi-level initiatives to support IPV survivors, their staff, their organization, and their member/partner agencies; (3) Organizations identified changes that should continue beyond the pandemic; and (4) Systemic racism compounded the impact of COVID-19 on IPV survivors and IPV service agencies. Conclusions: Findings suggest that (1) multi-level responses are needed for robust support of IPV survivors during and beyond the pandemic and (2) a syndemic model that addresses underlying structural inequities may strengthen efforts to support IPV survivors during a pandemic or other large-scale disaster. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. |
The Dating Matters(®) Toolkit: Approaches to increase adoption, implementation, and maintenance of a comprehensive violence prevention model
DeGue S , Le VD , Roby SJ . Implement Res Pract 2020 1 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. |
Prevalence and Correlates of Non-Dating Sexual Violence, Sexual Dating Violence, and Physical Dating Violence Victimization among U.S. High School Students during the COVID-19 Pandemic: Adolescent Behaviors and Experiences Survey, United States, 2021.
Krause KH , DeGue S , Kilmer G , Niolon PH . J Interpers Violence 2022 38 8862605221140038 The COVID-19 pandemic created an environment of disruption and adversity for many adolescents. We sought to establish the prevalence of non-dating sexual violence, sexual dating violence, and physical dating violence victimization among adolescents during the COVID-19 pandemic and to investigate whether experiences of disruption and adversity placed adolescents at greater risk for these forms of interpersonal violence. We conducted a secondary analysis of data from the Adolescent Behavior and Experiences Survey, collected January to June 2021 from a nationally representative sample of U.S. high school students (N = 7,705). Exposures included abuse by a parent; economic, housing, and food and nutrition insecurity; interpersonal connectedness; and personal well-being. Among female students, 8.0% experienced non-dating sexual violence; 12.5% experienced sexual dating violence; and 7.7% experienced physical dating violence. Among male students, 2.2% experienced non-dating sexual violence; 2.4% experienced sexual dating violence; and 4.9% experienced physical dating violence. Among female students, both emotional and physical abuse by a parent was related to non-dating sexual violence, emotional abuse was related to sexual dating violence, and physical abuse was related to physical dating violence. Among males, emotional abuse by a parent was related to physical dating violence and physical abuse by a parent was related to sexual dating violence. Hunger was associated with sexual and physical dating violence among female students and homeless was associated with physical dating violence among male students. Although there were differences by sex, abuse by a parent, hunger, and homelessness created precarity that may have increased the likelihood that adolescents would be exposed to risky peer or dating relationships. Adolescents need support that stops and prevents experiences of non-dating sexual and dating violence connected to interventions that address adversities experienced during the COVID-19 pandemic. |
Family Economics and Mental Health Among High-School Students During COVID-19.
Jones SE , Hertz MF , DeGue SA , Merlo CL , Piepenbrink RP , Le VD , Dittus PJ , Houston AL , Thornton JE , Ethier KA . Am J Prev Med 2022 64 (3) 414-422 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. |
The Impact of the COVID-19 Pandemic on the Needs and Lived Experiences of Intimate Partner Violence Survivors in the United States: Advocate Perspectives.
Ragavan MI , Risser L , Duplessis V , DeGue S , Villaveces A , Hurley TP , Chang J , Miller E , Randell KA . Violence Against Women 2022 28 3114-3134 We explored the challenges and lived experiences of intimate partner violence (IPV) survivors during the COVID-19 pandemic by interviewing 53 U.S.-based IPV advocates between June and November 2020. Advocates described how the COVID-19 pandemic limited survivors' abilities to meet their basic needs. The pandemic was also described as being used by abusive partners to perpetrate control and has created unique safety and harm reduction challenges. IPV survivors experienced compounding challenges due to structural inequities. IPV must be considered by local, state, and federal governments when developing disaster planning policies and practices, including in the context of pandemics. |
The impact of the COVID-19 pandemic on child protective services caseworkers and administrators.
Renov V , Risser L , Berger R , Hurley T , Villaveces A , DeGue S , Katz A , Henderson C , Premo K , Talis J , Chang JC , Ragavan M . Child Abuse Negl 2021 130 105431 BACKGROUND: The COVID-19 pandemic has impacted children and young people experiencing child abuse and neglect. Child Protective Services (CPS) has played an important role in supporting children and families during the COVID-19 pandemic. Few studies to-date have evaluated the impact of the pandemic on CPS caseworkers and administrators in the United States. OBJECTIVES: We conducted interviews to explore CPS caseworkers' and administrators' experiences working and serving families during the pandemic. METHODS: Participants were U.S.-based CPS caseworkers and administrators. We conducted semi-structured virtual interviews with participants and used an inductive thematic analysis approach. RESULTS: We conducted 37 interviews. Participants discussed how the COVID-19 pandemic has changed the way they conduct investigations and provide services to families in the CPS system. Several services were adapted to occur virtually, providing challenges and unique opportunities. Participants also described the personal barriers they faced during the pandemic, including working remotely, experiencing burnout, and challenges obtaining personal protective equipment. Finally, participants shared creative solutions they engaged in to support children and families during the COVID-19 pandemic, including expanding collaborations with other community-based organizations. DISCUSSION: This study suggests the important role that CPS has played during the pandemic and challenges individual CPS workers felt, in terms of both experiencing burnout and difficulty obtaining personalized protective equipment. Inclusion of the CPS system in emergency preparedness planning for future pandemics or natural disasters will ensure continuation of these vital services. |
Intimate Partner and Sexual Violence Prevention Among Youth: A Community Guide Systematic Review
Finnie RKC , Okasako-Schmucker DL , Buchanan L , Carty D , Wethington H , Mercer SL , Basile KC , DeGue S , Niolon PH , Bishop J , Titus T , Noursi S , Dickerson SA , Whitaker D , Swider S , Remington P . Am J Prev Med 2021 62 (1) e45-e55 INTRODUCTION: Intimate partner violence and sexual violence are widespread and often occur early in life. This systematic review examines the effectiveness of interventions for primary prevention of intimate partner violence and sexual violence among youth. METHODS: Studies were identified from 2 previous systematic reviews and an updated search (January 2012-June 2016). Included studies were implemented among youth, conducted in high-income countries, and aimed to prevent or reduce the perpetration of intimate partner violence or sexual violence. In 2016-2017, Guide to Community Preventive Services (Community Guide) methods were used to assess effectiveness as determined by perpetration, victimization, or bystander action. When heterogeneity of outcomes prevented usual Community Guide methods, the team systematically applied criteria for favorability (statistically significant at p<0.05 or approaching significance at p<0.10) and consistency (75% of results in the same direction). RESULTS: A total of 28 studies (32 arms) met inclusion and quality of execution criteria. Interventions used combinations of teaching healthy relationship skills, promoting social norms to protect against violence, or creating protective environments. Overall, 18 of 24 study arms reported favorable results on the basis of the direction of effect for decreasing perpetration; however, favorability for bystander action diminished with longer follow-up. Interventions did not demonstrate consistent results for decreasing victimization. A bridge search conducted during Fall 2020 confirmed these results. DISCUSSION: Interventions for the primary prevention of intimate partner violence and sexual violence are effective in reducing perpetration. Increasing bystander action may require additional follow-up as effectiveness diminishes over time. Findings may inform researchers, school personnel, public health, and other decision makers about effective strategies to prevent intimate partner violence and sexual violence among youth. |
The Impact of the COVID-19 Pandemic on Intimate Partner Violence Advocates and Agencies.
Garcia R , Henderson C , Randell K , Villaveces A , Katz A , Abioye F , DeGue S , Premo K , Miller-Wallfish S , Chang JC , Miller E , Ragavan MI . J Fam Violence 2021 37 (6) 1-14 Relatively few studies have considered the impact of the COVID-19 pandemic on intimate partner violence (IPV) advocates or the agencies where they work. In this study, based on United States IPV advocates' experiences working with survivors during the COVID-19 pandemic, we conducted interviews to explore: 1) personal challenges and resilience working as IPV advocates during the COVID-19 pandemic; 2) how agencies adapted to the pandemic to support IPV survivors and advocates; and 3) specific needs and challenges of culturally-specific agencies. We conducted semi-structured interviews with 53 IPV advocates from June to November 2020. Participants were included if they worked directly with survivors, identified as an IPV advocate, worked at a US-based agency, and spoke and understood English. We created a sampling matrix to ensure adequate representation from IPV advocates serving survivors from communities which have been marginalized. Interviews were conducted through a virtual platform by a trained member of the research team. We used an inductive thematic analysis approach, with weekly coding meetings to resolve discrepancies in coding. Five themes emerged from the data: 1) IPV advocates described how working as an IPV advocate during the COVID-19 pandemic impacted them personally; 2) agencies developed new methods of addressing IPV advocates' needs; 3) agencies developed new solutions to address pandemic-related client needs; 4) transitioning advocacy work to virtual formats created challenges but also opportunities and; 5) pandemic limitations and impacts compounded pre-pandemic challenges for culturally specific agencies. IPV advocates are frontline workers who have played essential roles in adjusting services to meet survivor needs during the COVID-19 pandemic while simultaneously coping with pandemic impacts on themselves and their agencies. Developing inter-agency collaborations and promoting advocates' safety and wellbeing during future public health crises will help support IPV survivors. |
Estimating from the payer perspective the implementation cost of Dating Matters: A Comprehensive teen dating violence prevention model
Luo F , DeGue S , Le VD . J Interpers Violence 2020 37 NP9144-NP9167 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. |
School-level poverty and persistent feelings of sadness or hopelessness, suicidality, and experiences with violence victimization among public high school students
Jones SE , Michael Underwood J , Pampati S , Le VD , Degue S , Demissie Z , Adkins SH , Barrios LC . J Health Care Poor Underserved 2020 31 (3) 1248-1263 Objectives. To examine the association between school-level poverty status and students’ persistent feelings of sadness or hopelessness, suicidality, and experiences with violence victimization among U.S. high school students. Methods. Public schools captured in the 2015 and 2017 national Youth Risk Behavior Surveys were categorized as high-, mid-, or low-poverty based on the percentage of students eligible for free or reduced-price meals (N=29,448). Results. Students in high-poverty schools were significantly more likely than students in low-poverty schools to experience persistent feelings of sadness or hopelessness, experience suicidal thoughts and attempts, not go to school because of safety concerns, be threatened or injured with a weapon on school property, be bullied on school property, be physically forced to have sexual intercourse, and be victims of sexual and physical dating violence. Conclusions. School and community approaches to address suicide and violence victimization may be especially important for students living in poverty. |
Effects of Dating Matters on sexual violence and sexual harassment outcomes among middle school youth: A cluster-randomized controlled trial
DeGue S , Niolon PH , Estefan LF , Tracy AJ , Le VD , Vivolo-Kantor AM , Little TD , Latzman NE , Tharp A , Lang KM , Taylor B . Prev Sci 2020 22 (2) 175-185 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. |
A process for identifying indicators with public data: An example from sexual violence prevention
McKool M , Freire K , Basile KC , Jones KM , Klevens J , DeGue S , Smith SG . Am J Eval 2020 41 (4) Despite advances in the sexual violence (SV) prevention field, practitioners still face challenges with identifying indicators to measure the impact of their prevention strategies. Public data, such as existing administrative and surveillance system data, may be a good option for organizations to examine trends in indicators for the purpose of program evaluation. In this article, we describe a framework and a process for identifying indicators with public data. Specifically, we present the SV Indicator Framework and a five-step indicator review process, which we used to identify indicators for a national SV prevention program. We present the findings of the indicator review and explain how the process could be used by evaluators and program planners within other developing topic areas. Tracking indicators with public data, in conjunction with other evaluation methods, may be a viable option for state-level program evaluations. We discuss limitations and implications for practice and research. |
Prevention of sexual violence among college students: Current challenges and future directions
Bonar EE , DeGue S , Abbey A , Coker AL , Lindquist CH , McCauley HL , Miller E , Senn CY , Thompson MP , Ngo QM , Cunningham RM , Walton MA . J Am Coll Health 2020 70 (2) 1-14 Objective: Preventing sexual violence among college students is a public health priority. This paper was catalyzed by a summit convened in 2018 to review the state of the science on campus sexual violence prevention. We summarize key risk and vulnerability factors and campus-based interventions, and provide directions for future research pertaining to campus sexual violence. Results and Conclusions: Although studies have identified risk factors for campus sexual violence, longitudinal research is needed to examine time-varying risk factors across social ecological levels (individual, relationship, campus context/broader community and culture) and data are particularly needed to identify protective factors. In terms of prevention, promising individual and relational level interventions exist, including active bystander, resistance, and gender transformative approaches; however, further evidence-based interventions are needed, particularly at the community-level, with attention to vulnerability factors and inclusion for marginalized students. |
Effects of the Dating Matters(R) comprehensive prevention model on health- and delinquency-related risk behaviors in middle school youth: A cluster-randomized controlled trial
Estefan LF , Vivolo-Kantor AM , Niolon PH , Le VD , Tracy AJ , Little TD , DeGue S , Latzman NE , Tharp A , Lang KM , McIntosh WL . Prev Sci 2020 22 (2) 163-174 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(R): 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. |
Middle school effects of the Dating Matters(R) Comprehensive Teen Dating Violence Prevention Model on physical violence, bullying, and cyberbullying: A cluster-randomized controlled trial
Vivolo-Kantor AM , Niolon PH , Estefan LF , Le VD , Tracy AJ , Latzman NE , Little TD , Lang KM , DeGue S , Tharp AT . Prev Sci 2019 22 (2) 151-161 Few comprehensive primary prevention approaches for youth have been evaluated for effects on multiple types of violence. Dating Matters(R): Strategies to Promote Healthy Teen Relationships (Dating Matters) is a comprehensive teen dating violence (TDV) prevention model designed by the Centers for Disease Control and Prevention and evaluated using a longitudinal stratified cluster-randomized controlled trial to determine effectiveness for preventing TDV and promoting healthy relationship behaviors among middle school students. In this study, we examine the prevention effects on secondary outcomes, including victimization and perpetration of physical violence, bullying, and cyberbullying. This study examined the effectiveness of Dating Matters compared to a standard-of-care TDV prevention program in 46 middle schools in four high-risk urban communities across the USA. The analytic sample (N = 3301; 53% female; 50% Black, non-Hispanic; and 31% Hispanic) consisted of 6th-8th grade students who had an opportunity for exposure to Dating Matters in all three grades or the standard-of-care in 8th grade only. Results demonstrated that both male and female students attending schools implementing Dating Matters reported 11% less bullying perpetration and 11% less physical violence perpetration than students in comparison schools. Female Dating Matters students reported 9% less cyberbullying victimization and 10% less cyberbullying perpetration relative to the standard-of-care. When compared to an existing evidence-based intervention for TDV, Dating Matters demonstrated protective effects on physical violence, bullying, and cyberbullying for most groups of students. The Dating Matters comprehensive prevention model holds promise for reducing multiple forms of violence among middle school-aged youth. ClinicalTrials.gov Identifier: NCT01672541. |
Do violence acceptance and bystander actions explain the effects of green dot on reducing violence perpetration in high schools
Bush HM , Coker AL , DeGue S , Clear ER , Brancato CJ , Fisher BS . J Interpers Violence 2019 36 10753-10774 This study extends prior analyses from a 5-year multisite cluster-randomized controlled trial to examine how the previously reported effects of the Green Dot bystander-based prevention program worked to reduce violence perpetration. Bystander-based interventions are hypothesized to prevent violence by reducing violence acceptance and increasing trained participants' willingness and ability to actively engage others in violence prevention using safe and effective bystander actions to diffuse or avoid potentially violent situations. We tested this hypothesis by examining whether Green Dot worked to reduce violence through two mediators measured over time: reducing violence acceptance and increasing bystander actions. When accounting for changes in these mediators over time, the effect of this intervention on violence perpetration was hypothesized to be attenuated or explained. At baseline (spring 2010) and annually (2011-2014), all students in recruited high schools (13 intervention, 13 control) completed an anonymous survey (response rate = 83.9%). Student responses were aggregated as school-level counts for the analysis. Path analyses estimated direct and indirect effects at specific points in the implementation of the intervention. Longitudinal models were used to determine if changes in violence acceptance and bystander actions could explain or attenuate the effect of the intervention. Time-framed path model analyses indicated that the intervention worked as expected to increase bystander behaviors and reduce violence acceptance; both potential mediators were significantly associated with sexual violence perpetration. In addition, after adjusting intent-to-treat models for the hypothesized mediators, the intervention was no longer associated with violence perpetration. In conclusion, these findings indicate that this bystander intervention worked as hypothesized to reduce sexual violence perpetration by creating theory-based changes in students' violence acceptance and bystander actions. |
Using a Community Preventive Services Task Force Recommendation to prevent and reduce intimate partner violence and sexual violence
Okasako-Schmucker DL , Cole KH , Finnie RKC , Basile KC , DeGue S , Niolon PH , Swider SM , Remington PL . J Womens Health (Larchmt) 2019 28 (10) 1335-1337 Intimate partner violence (IPV) and sexual violence (SV) are preventable public health problems affecting millions in the United States. The Community Preventive Services Task Force (CPSTF), an independent panel of experts that develops evidence-based recommendations based on rigorous systematic reviews, recommends interventions that aim to prevent or reduce IPV and SV among youth aged 12-24 years. Decision makers can use these findings to select interventions appropriate for their populations, identify additional areas for research, and justify funding requests. |
An RCT of Dating Matters: Effects on Teen Dating Violence and Relationship Behaviors
Niolon PH , Vivolo-Kantor AM , Tracy AJ , Latzman NE , Little TD , DeGue S , Lang KM , Estefan LF , Ghazarian SR , McIntosh WLK , Taylor B , Johnson LL , Kuoh H , Burton T , Fortson B , Mumford EA , Nelson SC , Joseph H , Valle LA , Tharp AT . Am J Prev Med 2019 57 (1) 13-23 INTRODUCTION: Teen dating violence is a serious public health problem with few effective prevention strategies. This study examines whether the Dating Matters comprehensive prevention model, compared with a standard of care intervention, prevented negative relationship behaviors and promoted positive relationship behaviors. STUDY DESIGN: This longitudinal, cluster-RCT compared the effectiveness of Dating Matters with standard of care across middle school. Standard of care was an evidence-based teen dating violence prevention curriculum (Safe Dates) implemented in eighth grade. SETTING/PARTICIPANTS: Forty-six middle schools in high-risk urban neighborhoods in four U.S. cities were randomized. Schools lost to follow-up were replaced with new schools, which were independently randomized (71% school retention). Students were surveyed in fall and spring of sixth, seventh, and eighth grades (2012-2016). The analysis sample includes students from schools implementing Dating Matters or standard of care for >2 years who started sixth grade in the fall of 2012 or 2013 and had dated (N=2,349 students, mean age 12 years, 49% female, and 55% black, non-Hispanic, 28% Hispanic, 17% other). INTERVENTION: Dating Matters is a comprehensive, multicomponent prevention model including classroom-delivered programs for sixth to eighth graders, training for parents of sixth to eighth graders, educator training, a youth communications program, and local health department activities to assess capacity and track teen dating violence-related policy and data. MAIN OUTCOME MEASURES: Self-reported teen dating violence perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills were examined as outcomes. Imputation and analyses were conducted in 2017. RESULTS: Latent panel models demonstrated significant program effects for three of four outcomes; Dating Matters students reported 8.43% lower teen dating violence perpetration, 9.78% lower teen dating violence victimization, and 5.52% lower use of negative conflict resolution strategies, on average across time points and cohorts, than standard of care students. There were no significant effects on positive relationship behaviors. CONCLUSIONS: Dating Matters demonstrates comparative effectiveness, through middle school, for reducing unhealthy relationship behaviors, such as teen dating violence and use of negative conflict resolution strategies, relative to the standard of care intervention. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01672541. |
Introduction to the special issue: The role of public policies in preventing IPV, TDV, and SV
D'Inverno AS , Kearns MC , Reidy DE . J Interpers Violence 2018 33 (21) 3259-3266 Intimate partner violence (IPV), teen dating violence (TDV), and sexual violence (SV) constitute a major public health problem within the United States. More than 37 million men and 43 million women have experienced contact SV, physical violence, and/or stalking by an intimate partner in their life-time; 25.5 million women and 2.8 million men have been the victims of completed or attempted rape at some point in their lives (Smith et al., 2018). Furthermore, in 2017, 8.0% of high school students reported experiencing physical dating violence and 6.9% reported sexual dating violence in the last year (Kann et al., 2018). Both IPV and SV are associated with multiple negative health impacts and related costs to society, with recent studies suggesting an estimated lifetime economic burden of US $3.6 trillion for IPV and US $3.1 trillion for rape (Peterson, DeGue, Florence, & Lokey, 2017; Peterson et al., 2018). There are numerous efforts and strategies implemented to prevent and reduce these acts of violence; however, the few that have been evaluated and shown to be effective focus on individual- or relationship-level factors and have limited population impact due to difficulty in scaling up these strategies (Spivak et al., 2014; Whitaker, Hall, & Coker, 2009; Whitaker, Murphy, Eckhardt, Hodges, & Cowart, 2013). To this end, the Centers for Disease Control and Prevention (CDC) has prioritized the development and evaluation of innovative prevention strategies for IPV, TDV, and SV to have a population-level impact (CDC, National Center for Injury Prevention and Control, 2015). |
Short-term lost productivity per victim: Intimate partner violence, sexual violence, or stalking
Peterson C , Liu Y , Kresnow MJ , Florence C , Merrick MT , DeGue S , Lokey CN . Am J Prev Med 2018 55 (1) 106-110 INTRODUCTION: The purpose of this study is to estimate victims' lifetime short-term lost productivity because of intimate partner violence, sexual violence, or stalking. METHODS: U.S. nationally representative data from the 2012 National Intimate Partner and Sexual Violence Survey were used to estimate a regression-adjusted average per victim (female and male) and total population number of cumulative short-term lost work and school days (or lost productivity) because of victimizations over victims' lifetimes. Victims' lost productivity was valued using a U.S. daily production estimate. Analysis was conducted in 2017. RESULTS: Non-institutionalized adults with some lifetime exposure to intimate partner violence, sexual violence, or stalking (n=6,718 respondents; survey-weighted n=130,795,789) reported nearly 741 million lost productive days because of victimizations by an average of 2.5 perpetrators per victim. The adjusted per victim average was 4.9 (95% CI=3.9, 5.9) days, controlling for victim, perpetrator, and violence type factors. The estimated societal cost of this short-term lost productivity was $730 per victim, or $110 billion across the lifetimes of all victims (2016 USD). Factors associated with victims having a higher number of lost days included a higher number of perpetrators and being female, as well as sexual violence, physical violence, or stalking victimization by an intimate partner perpetrator, stalking victimization by an acquaintance perpetrator, and sexual violence or stalking victimization by a family member perpetrator. CONCLUSIONS: Short-term lost productivity represents a minimum economic valuation of the immediate negative effects of intimate partner violence, sexual violence, and stalking. Victims' lost productivity affects family members, colleagues, and employers. |
RCT testing bystander effectiveness to reduce violence
Coker AL , Bush HM , Cook-Craig PG , DeGue SA , Clear ER , Brancato CJ , Fisher BS , Recktenwald EA . Am J Prev Med 2017 52 (5) 566-578 INTRODUCTION: Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years. DESIGN: A cluster RCT was conducted. SETTING/PARTICIPANTS: Kentucky high schools were randomized to intervention or control (wait list) conditions. INTERVENTION: Green Dot-trained educators conducted schoolwide presentations and recruited student popular opinion leaders to receive bystander training in intervention schools beginning in Year 1. MAIN OUTCOME MEASURES: The primary outcome was sexual violence perpetration, and related forms of interpersonal violence victimization and perpetration were also measured using anonymous student surveys collected at baseline and annually from 2010 to 2014. Because the school was the unit of analysis, violence measures were aggregated by school and year and school-level counts were provided. RESULTS: A total of 89,707 students completed surveys. The primary, as randomized, analyses conducted in 2014-2016 included linear mixed models and generalized estimating equations to examine the condition-time interaction on violence outcomes. Slopes of school-level totals of sexual violence perpetration (condition-time, p<0.001) and victimization (condition-time, p<0.001) were different over time. During Years 3-4, when Green Dot was fully implemented, the mean number of sexual violent events prevented by the intervention was 120 in Intervention Year 3 and 88 in Year 4. For Year 3, prevalence rate ratios for sexual violence perpetration in the intervention relative to control schools were 0.83 (95% CI=0.70, 0.99) in Year 3 and 0.79 (95% CI=0.67, 0.94) in Year 4. Similar patterns were observed for sexual violence victimization, sexual harassment, stalking, and dating violence perpetration and victimization. CONCLUSIONS: Implementation of Green Dot in Kentucky high schools significantly decreased not only sexual violence perpetration but also other forms of interpersonal violence perpetration and victimization. |
Lifetime economic burden of rape among U.S. adults
Peterson C , DeGue S , Florence C , Lokey CN . Am J Prev Med 2017 52 (6) 691-701 INTRODUCTION: This study estimated the per-victim U.S. lifetime cost of rape. METHODS: Data from previous studies was combined with current administrative data and 2011 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Rape was defined as any lifetime completed or attempted forced penetration or alcohol- or drug-facilitated penetration, measured among adults not currently institutionalized. Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Average age at first rape was assumed to be 18 years. Future costs were discounted by 3%. The main outcome measures were the average per-victim (female and male) and total population discounted lifetime cost of rape. Secondary outcome measures were marginal outcome probabilities among victims (e.g., suicide attempt) and perpetrators (e.g., incarceration) and associated costs. Analysis was conducted in 2016. RESULTS: The estimated lifetime cost of rape was $122,461 per victim, or a population economic burden of nearly $3.1 trillion (2014 U.S. dollars) over victims' lifetimes, based on data indicating >25 million U.S. adults have been raped. This estimate included $1.2 trillion (39% of total) in medical costs; $1.6 trillion (52%) in lost work productivity among victims and perpetrators; $234 billion (8%) in criminal justice activities; and $36 billion (1%) in other costs, including victim property loss or damage. Government sources pay an estimated $1 trillion (32%) of the lifetime economic burden. CONCLUSIONS: Preventing sexual violence could avoid substantial costs for victims, perpetrators, healthcare payers, employers, and government payers. These findings can inform evaluations of interventions to reduce sexual violence. |
Deaths due to use of lethal force by law enforcement: Findings from the National Violent Death Reporting System, 17 U.S. states, 2009-2012
DeGue S , Fowler KA , Calkins C . Am J Prev Med 2016 51 S173-s187 INTRODUCTION: Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by law enforcement (LE), yet research on such fatalities is limited. Using data from a public health surveillance system, this study examined the characteristics and circumstances of these violent deaths to inform prevention. METHODS: All fatalities (N=812) resulting from use of lethal force by on-duty LE from 2009 to 2012 in 17 U.S. states were examined using National Violent Death Reporting System data. Case narratives were coded for additional incident circumstances. RESULTS: Victims were majority white (52%) but disproportionately black (32%) with a fatality rate 2.8 times higher among blacks than whites. Most victims were reported to be armed (83%); however, black victims were more likely to be unarmed (14.8%) than white (9.4%) or Hispanic (5.8%) victims. Fatality rates among military veterans/active duty service members were 1.4 times greater than among their civilian counterparts. Four case subtypes were examined based on themes that emerged in incident narratives: about 22% of cases were mental health related; 18% were suspected "suicide by cop" incidents, with white victims more likely than black or Hispanic victims to die in these circumstances; 14% involved intimate partner violence; and about 6% were unintentional deaths due to LE action. Another 53% of cases were unclassified and did not fall into a coded subtype. Regression analyses identified victim and incident characteristics associated with each case subtype and unclassified cases. CONCLUSIONS: Knowledge about circumstances of deaths due to the use of lethal force can inform the development of prevention strategies, improve risk assessment, and modify LE response to increase the safety of communities and officers and prevent fatalities associated with LE intervention. |
Shared risk factors for the perpetration of physical dating violence, bullying, and sexual harassment among adolescents exposed to domestic violence
Foshee VA , McNaughton Reyes HL , Chen MS , Ennett ST , Basile KC , DeGue S , Vivolo-Kantor AM , Moracco KE , Bowling JM . J Youth Adolesc 2016 45 (4) 672-86 The high risk of perpetrating physical dating violence, bullying, and sexual harassment by adolescents exposed to domestic violence points to the need for programs to prevent these types of aggression among this group. This study of adolescents exposed to domestic violence examined whether these forms of aggression share risk factors that could be targeted for change in single programs designed to prevent all three types of aggression. Analyses were conducted on 399 mother victims of domestic violence and their adolescents, recruited through community advertising. The adolescents ranged in age from 12 to 16 years; 64 % were female. Generalized estimating equations was used to control for the covariation among the aggression types when testing for shared risk factors. Approximately 70 % of the adolescents reported perpetrating at least one of the three forms of aggression. In models examining one risk factor at a time, but controlling for demographics, adolescent acceptance of sexual violence, mother-adolescent discord, family conflict, low maternal monitoring, low mother-adolescent closeness, low family cohesion, depressed affect, feelings of anger, and anger reactivity were shared across all three aggression types. In multivariable models, which included all of the risk factors examined and the demographic variables, low maternal monitoring, depressed affect and anger reactivity remained significant shared risk factors. Our findings suggest that programs targeting these risk factors for change have the potential to prevent all three forms of aggression. In multivariable models, poor conflict management skills was a risk for bullying and sexual harassment, but not dating violence; acceptance of dating violence was a risk for dating violence and bullying, but not sexual harassment; and none of the examined risk factors were unique to aggression type. The study's implications for the development of interventions and future research are discussed. |
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