Focus of the intervention
Educational interventions to prevent relationship violence in adolescents and young adults (11 to 26 years old) aim to promote an awareness of acceptable dating behaviour and an individual’s rights within a relationship.
Educational interventions are usually delivered in a community or school-based setting.
Common methods of delivery include:
- videos
- discussions about violence
- challenging myths and raising awareness
- role-playing
This narrative is based on three reviews.
Review one (covering 38 studies) included 17 studies that examined the effect of educational interventions that targeted both potential perpetrators and victims of relationship violence.
Review two (covering 23 studies) examined the effects of educational interventions on self-reported dating violence perpetration (a combination of physical and sexual dating violence) and self-reported victimisation.
Lastly, Review three (covering eight studies) examined self-reported measures of physical, sexual or psychological victimisation and violence.
The primary studies in the reviews were based on evidence from the USA, Canada and South Africa.
Effect – how effective is it?
There is some evidence that educational interventions to prevent relationship violence have reduced crime, but overall the interventions have not had a statistically significant effect on crime.
Review one conducted two meta-analyses using crime outcome measures (self-reported). The first meta-analysis (covering eight studies) found that educational interventions had no statistically detectable effect of victim’s experience of dating violence. Two of these eight studies found that the intervention led to a statistically significant reduction in episodes of relationship violence for participants and the remaining six studies found no evidence of effect.
The second meta-analysis (covering five studies) found that educational interventions slightly decreased (albeit non-statistically) episodes of dating violence among young people. None of the findings in the studies within this meta-analysis were statistically significant and included four studies that suggested that the intervention decreased episodes of dating violence and one study which found that the intervention increased episodes of relationship violence.
Review two, which included two meta-analyses, found a non-statistically significant decrease in self-reported dating violence perpetration and a statistically significant decrease in self-reported victimisation for participants who had received the intervention compared to participants who had received the regular curriculum.
Two studies in Review three reported that educational interventions led to a statistically significant reduction in the self-reported perpetration of physical violence. An additional study found a statistically significant decrease in the self-reported perpetration of sexual violence. The remaining three primary studies found no statistically significant effect on victimisation or perpetration.
How strong is the evidence?
Both Review one and Review two were sufficiently systematic that most forms of bias that could influence the study conclusions can be ruled out.
Review one used a thorough search strategy and used unpublished literature.
Nevertheless, the authors note that potential biases could still exist around the selection of participants for the interventions, measurements of the performance of the participants, and the possibility of detecting the outcomes accurately.
Review two used a well-designed search strategy and considered publication bias and the validity of the outcome constructs.
Review three was sufficiently systematic that many forms of bias that could influence the study conclusions can be ruled out.
Review three demonstrated a high-quality design in terms of having a transparent and well-designed search strategy, considering the validity of the outcome constructs, and an assessment of the influence of the different study designs.
However, the authors of Review three did not quantify the overall summary effect for all of the primary studies, nor account for the possibility of outliers or publication bias.
Mechanism – how does it work?
The reviews suggested a number of mechanisms by which educational interventions might have an effect on violence in young people's dating relationships.
Review one notes that the educational interventions might reduce crime by providing participants with the skills to:
- communicate effectively
- deal constructively with stress, disappointment and rejection
- resolve conflicts and promote healthier relationships.
They may also provide young people with skills to protect themselves from the risk of relationship violence and may act to improve low self-esteem, which is linked to the likelihood of being a victim of relationship violence.
The only mechanism in Review one that is directly measured is the acquisition of relevant communication skills. Of the five studies included in the sub-analysis regarding communication skills, the results suggest slight improvement in skills following exposure to the intervention. However, the improvement was not statistically significant and no connection is made as to whether this improvement is directly or indirectly linked to reductions in sexual violence.
Review two noted that educational interventions may help to prevent crime by challenging participants’ attitudes and behaviour toward dating violence. Changes in attitudes and behaviour might be accomplished by challenging existing gender roles, sexual behaviours and teen dating violence norms, and better assessing reports of rape.
Review two analysed these mechanisms by examining primary studies that measured students' attitudes and knowledge of teen dating violence pre- and post-intervention.
Review two found a statistically significant increase in measures of knowledge and attitudes of dating violence among intervention participations compared to the control group (who did not receive the intervention).
Review two also found that participants receiving the intervention believed fewer rape myths (defined as false beliefs about rape shaped by sexism and other prejudices individuals hold) than the control group. This sub-analysis was conducted with four studies but the finding was not statistically significant.
Review three suggests that the educational interventions are presumed to reduce dating violence by disrupting early incidents and acts of relationship violence which, if left untreated, may persist into adulthood. However, this assumption was not empirically tested.
Moderators – in which contexts does it work best?
The reviews noted that the effect of the intervention might differ according to a number of contextual conditions.
- Intervention setting – educational interventions were found to be more effective in rural schools compared to urban schools (Review two). Additionally, the interventions were found to be more successful when implemented in both a community and school setting (Review three).
- Intervention duration – the effect of the intervention did not vary depending on the duration of the intervention (whether single or multiple sessions) (Review two).
- Intervention delivery – the effect of the intervention did not vary according to who delivered the intervention (teacher or professional, legal councillor) (Review two).
- Characteristics of participants: The effect of the intervention did not vary by age or sex (Review two). However, the intervention was found to be more effective for high-risk groups (such as previously sentenced adolescent males or individuals with a history of maltreatment) compared to the general population. The effect on high-risk groups was found to be a small but statistically significant reduction in risk.
Implementation – what can be said about implementing this initiative?
The reviews outlined a number of issues related to the implementation of the educational interventions.
- Review one identified that the most common method of delivery of the interventions was the use of videos, followed by a group discussion or question and answer session. In Review three, school-based lectures were the most common method of delivery.
- When implementing the programmes, most studies in Review one provided training (to varying degrees) for the personnel delivering the interventions. Of these, some described ways of minimising the potential for performance bias, such as providing personnel with a script or detailed guidance to follow. However, only six studies in Review one described how implementation fidelity or the performance of those delivering the intervention was assessed.
Economic considerations – how much might it cost?
None of the reviews mentioned the costs or benefits of the educational interventions. No formal economic analysis was provided.
General considerations
- The overall results show no overall effect, however a subset of the primary studies were positive. Therefore current interventions should not necessarily be stopped, but further research and more methodologically sound primary studies should be conducted.
- The studies in Review three only used self-reported outcomes, so caution should be taken when interpreting the results.
Summary
There is some evidence that educational interventions to prevent relationship violence in young people have reduced crime, but overall the intervention has not had a statistically significant effect on crime.
Educational interventions to prevent relationship violence are presumed to provide young people with the skills to:
- communicate effectively
- deal constructively with stress, disappointment and rejection
- resolve conflicts
- promote healthier relationships
The intervention may be more effective for high-risk participants and in particular settings.
The method of implementing educational interventions can differ (videos, discussion groups, lectures and role-playing).
There may be benefit to focusing on the development of relationship skills among adolescents as a manner of raising victim awareness and increasing self-esteem.
Reviews
Review one
Reference
Fellmeth, G. L. T., Heffernan, C., Nurse, J., Habibula, S. and Sethi D. (2013) 'Educational and skills-based interventions for preventing relationship and dating violence in adolescents and young adults', Cochrane Database of Systematic Reviews, Issue 6. Art. No.: CD004534. DOI: 10.1002/14651858.CD004534.pub3
Review two
Reference
De La Rue, L., Polanin, J.R., Espelage, D.L., Pigott, T.P. (2014) ‘School-Based Interventions to Reduce Dating and Sexual Violence: A Systematic Review’, Campbell Systematic Reviews 2014:7. DOI: 10.4073/csr.2014.7.
Review three
Reference
De Koker Petra, Mathews Catherine, Zuch Melanie, Bastien Sheri, Mason-Jones Amanda J. (2014) ‘A systematic review of interventions for preventing adolescent intimate partner violence’. Journal of Adolescent Health, 54, 3-13.
Summary prepared by
This narrative was prepared by UCL Jill Dando Institute and was co-funded by the College of Policing and the Economic and Social Research Council (ESRC). ESRC grant title: 'University Consortium for Evidence-Based Crime Reduction'. Grant reference: ES/L007223/1.