OBJECTIVES: We conducted a cluster randomized controlled trial to test the a priori hypothesis that students attending an interventionmiddle schoolwould be less likely to report physical adolescent relationship abuse (ARA) 1 year later comparedwith students attending a control school. Secondary objectiveswere to determine if the intervention reduced substancemisuse, bullying, and fighting. METHODS: Twenty-four Texas publicmiddle schoolswerematched by the size of student enrollment, number of economically disadvantaged students, and race and ethnicity of the student body and randomly assigned to the intervention (n5 12; 1237 participants) or the control (n5 12; 1531participants) group. The intervention, Fourth R, is a classroom-based curriculumdelivered by existing teachers and consists of 21 lessons on injury prevention, substance use, and growth and development. RESULTS: Participants (50% female) self-reported ethnicity as Hispanic or Latinx (35%), Black or African American (24%), Asian American (17%), White (8%), and multiethnicity or other (16%). Among those who have dated, students in the intervention schools were less likely to report perpetrating physical ARA (intervention 5 14.9% versus control 5 18.3%) relative to students in the control schools (adjusted odds ratio, 0.66; 95% confidence interval, 0.43-1.00; P 5 .05). In the overall sample, no significant differences emerged between control and intervention groups with respect to substance misuse, fighting, and bullying. CONCLUSIONS: Themiddle school versionof Fourth R is effective in reducing physical ARA perpetration over at least 1 year. The intervention did not have an effect on bullying perpetration, physical fighting with peers, and substancemisuse. Long-termassessment, especially follow-up that covers the transition to high school, is needed to examine the program benefit on key outcomes.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health