Efficacy of Interventions to Prevent Physical and Sexual Dating Violence Among Adolescents: A Systematic Review and Meta-analysis | Adolescent Medicine | JN Learning | AMA Ed Hub [Skip to Content]
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Efficacy of Interventions to Prevent Physical and Sexual Dating Violence Among AdolescentsA Systematic Review and Meta-analysis

Educational Objective To evaluate the efficacy of interventions in reducing physical and sexual violence in adolescents' dating relationships.
1 Credit CME
Key Points

Question  What is the efficacy of prevention programs for physical and sexual teen dating violence?

Findings  In this systematic review and meta-analysis of 18 trials including 22 781 adolescents, the implementation of interventions targeting dating violence among adolescents was associated with a significant reduction in overall physical and sexual violence. However, when examined as separate outcomes, a significant reduction was found for physical violence only.

Meaning  Prevention programs may be effective in reducing physical dating violence among adolescents; unclear evidence on sexual violence outcomes highlights the need for further research studies.

Abstract

Importance  Sexual and physical dating violence is prevalent among adolescents and is associated with adverse health effects.

Objective  To conduct a systematic review and meta-analysis of randomized clinical trials to assess the efficacy of prevention programs for sexual and physical dating violence in adolescents.

Data Sources  Search terms were combined for dating violence, adolescents, and randomized clinical trials in PsycINFO/Eric/PsycArticles, PubMed, and Web of Science databases from inception through April 2021.

Study Selection  Included studies had a randomized design of any type examining the efficacy of an intervention to reduce dating violence among adolescents and provided at least 1 measure of sexual or physical dating violence.

Data Extraction and Synthesis  Data extraction coded characteristics of trials, participants, and interventions and assessed risk of bias using the Revised Cochrane Collaboration Risk of Bias tool. Outcomes were pooled using a random-effects model. Subgroup and meta-regression analyses were performed to explore the target population and intervention factors associated with positive outcomes.

Main Outcomes and Measures  The odds ratio (OR) was calculated for 3 different outcomes: (1) sexual dating violence, (2) physical dating violence, and (3) composite measures of sexual and physical dating violence. For each outcome, separate analyses were conducted for survivorship and perpetration scores. We also combined the scores of physical/sexual violence and perpetration/survivorship of teen dating violence into a single composite overall outcome including all studies.

Results  Eighteen trials (22 781 adolescents) were included. Overall, interventions were associated with reduced physical and sexual dating violence (OR, 0.78; 95% CI, 0.69-0.89; P < .001). Separate analyses further indicated that this association was significant for physical violence perpetration (OR, 0.74; 95% CI, 0.59-0.92; P = .01) and survivorship (OR, 0.78; 95% CI, 0.64-0.95; P = .01). For sexual violence, the association was not statistically significant. Exploratory subgroup analyses revealed that trials targeting at-risk youth, older adolescents (age >15 years), and trials involving parents in the intervention reported significantly larger effect sizes. Meta-regression analyses did not show any significant associations between intervention effect sizes and length or intensity of the programs. Publication bias was observed, but the adjusted ORs remained significant. Three studies reported iatrogenic associations.

Conclusions and Relevance  Findings from this study suggest that prevention programs may be effective in reducing physical teen dating violence, but there is unclear evidence of the effect on sexual violence outcomes. Further research assessing the active ingredients of interventions, especially in the area of sexual dating violence, is warranted.

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Article Information

Corresponding Author: Antonio Piolanti, PhD, Health Psychology Unit, Institute of Psychology, Universität Klagenfurt, Universitätsstraße 65-67, 9020 Klagenfurt, Austria (antonio.piolanti@aau.at).

Accepted for Publication: September 7, 2021.

Published Online: November 29, 2021. doi:10.1001/jamapediatrics.2021.4829

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Piolanti A et al. JAMA Pediatrics.

Author Contributions: Dr Piolanti had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Both authors.

Acquisition, analysis, or interpretation of data: Both authors.

Drafting of the manuscript: Piolanti.

Critical revision of the manuscript for important intellectual content: Foran.

Statistical analysis: Piolanti.

Obtained funding: Foran.

Administrative, technical, or material support: Both authors.

Supervision: Foran.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by the Faculty of Cultural Studies and the Public Health Research Cluster of the University of Klagenfurt.

Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Tina Albert, MSc (University of Klagenfurt), for conducting the second screening and selection of studies, and Isabelle Perle, MSc (University of Klagenfurt), for performing the second independent data extraction. Compensation outside of standard salary was not received.

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