Study data published in JAMA Pediatrics outline the efficacy of interventions designed to prevent physical and sexual dating violence among adolescents. In a meta-analysis of literature on dating violence in adolescents, interventions were associated with significantly reduced risk for physical violence perpetration and survivorship. However, existing interventions appeared to have less of an effect on sexual violence rates.
Investigators searched the PsycINFO/Eric/PsycArticles, PubMed, and Web of Science databases from inception through April 2021 for randomized controlled trials examining means of reducing dating violence among adolescents. Two reviewers extracted data and performed quality assessment using the Revised Cochrane Collaboration Risk of Bias tool. Meta-regression analyses were used to identify reductions in the risk of 3 outcomes: sexual dating violence; physical dating violence; and composite measures of sexual and physical dating violence. Results were presented as pooled odds ratios (ORs).
The meta-analysis used data from 18 studies with a pooled cohort size of 22,781 adolescents. Mean participant age ranged from 12.2 to 17.6 years. Thirteen studies described interventions implemented at school; 5 studies described implementation in other settings.
The number of intervention sessions ranged from 1 to 24; intervention length ranged from 1 day to 2 years. Interventions typically included group discussion, individual interviews, classroom activities, parent-child activities, or a combination of classroom and parent-child activities. Overall, the interventions were associated with reduced risk of dating violence survivorship and perpetration.
The risk of dating violence of any kind was substantially reduced in the pooled intervention cohort compared with the pooled control cohort (OR, 0.78; 95% CI, 0.69-0.89; P <.001). This effect remained significant for physical violence perpetration (OR, 0.74; 95% CI, 0.59-0.92) and physical violence survivorship (OR, 0.78; 95% CI, 0.64-0.95) (both P =.01). However, while the rates of sexual violence perpetration and survivorship were generally lower in the intervention groups, the difference was not statistically significant.
Publication bias was observed for each outcome, but ORs remained significant even after adjustment for data missing. In subgroup analyses, intervention session length and type did not appear to influence outcomes.
Results from this systematic review and meta-analysis support the efficacy of interventions designed to reduce dating violence among adolescents. In particular, interventions were found to substantially reduce the risk of physical violence perpetration and survivorship. However, the outcomes were not statistically significant for sexual violence, highlighting the need for further research in the area.
Regarding study limitations, the investigators noted the small study cohorts for certain violence outcomes and the risk of bias in certain trials.
“[T]here is need for better designed trials assessing the active ingredients of interventions and the differential efficacy of intervention components,” the investigators wrote.
“Trials should also test the efficacy of interventions in vulnerable populations such as lesbian, gay, bisexual, transgender, and queer youth, low-income families, and adolescents with disabilities.”
Piolanti A, Foran HM. Efficacy of interventions to prevent physical and sexual dating violence among adolescents: a systematic review and meta-analysis. JAMA Pediatr. Published online November 29, 2021. doi:10.1001/jamapediatrics.2021.4829