Abuse, Violence
Conditions
Keywords
gender-based violence, intimate partner violence, relationship abuse, sexual harassment, sexual violence
Brief summary
Despite the high prevalence of adolescent relationship abuse (ARA) reported among adolescent females and substantial reports of perpetration by young males, effective prevention programs to prevent ARA are limited. Male athletes are an important target for prevention efforts given their higher rates of abuse perpetration compared to non-athlete peers as well as their social influence among their peers. This cluster-randomized school-based investigation examines the effectiveness of a program for the primary prevention of ARA. Coaching Boys into Men (CBIM) is a social norms theory-based program intended to alter norms that foster ARA perpetration, promote bystander intervention, and reduce ARA perpetration by engaging athletic coaches as positive role models to deliver violence prevention scripts and tools to high school age male athletes. Coaches receive a 60-minute training session to administer the intervention to their athletes via 11 lessons across a sport season. Trained high school coaches talk to their male athletes about 1) what constitutes disrespectful and harmful vs. respectful behaviors, 2) promoting more gender-equitable attitudes, and 3) modeling bystander intervention when disrespectful behaviors toward women and girls are witnessed. The current investigation evaluates the intervention in 16 urban high schools randomized either to receive the CBIM program (i.e., intervention schools, n=8) or to a control condition (n=8). Baseline computer-based surveys are collected for all intervention and control site student athletes entering grades 9 through 12 at the start of each of three sports seasons across Year 1 (Time 1). Follow up surveys are collected for these same athletes at the end of their first sports season (Time 2). Participating athletes in grades 9 - 11 at baseline are re-surveyed 12 months after Time 1 to examine the longer term effects of the CBIM intervention (Time 3; N of athletes completing all 3 waves of data collection = 1500). Primary assessment of intervention effects are based on intent-to-treat estimates, utilizing generalized linear mixed models to account for clustering arising from school randomization. Hypothesized outcomes for male athletes include a) an increase in recognition of what constitutes abusive behaviors, b) more gender-equitable attitudes, c) an increase in intentions and reports of bystander intervention regarding ARA, and through these intermediate outcomes, d) a decrease in perpetration of ARA among adolescent male athletes.
Detailed description
Additional process evaluation includes baseline and follow up surveys with coaches (from both intervention and control arms), individual interviews with coaches, as well as focus groups with students to collect coach and athlete perspectives on the relevance and local impact of the intervention program.
Interventions
BEHAVIORALCoaching Boys Into Men program
Coaching Boys into Men (CBIM) program consists of a 60 minute training for high school coaches led by a violence prevention advocate to introduce coaches to the rationale for CBIM and the CBIM Coaches Kit. The Coaches use this CBIM toolkit to provide weekly discussions with their athletes (generally 10-15 minute mini-sessions) throughout their athletic season (11 weeks). Discussion topics include how to prevent disrespectful and harmful behaviors towards women and girls and how to promote healthy choices and relationships among youth.
Sponsors
Centers for Disease Control and Prevention
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
14 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
School Eligibility: Inclusion Criteria -urban and suburban public high schools in Sacramento region with athletics program
Exclusion criteria
-private high schools, rural high schools Coach Eligibility: Inclusion Criteria * coaching an athletic team at one of the participating schools (intervention or control) * age 18 or older
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline to 3 Months Using the Recognition of Abusive Behavior Scale | 3 months | Recognition of disrespectful and harmful behaviors against girls as abusive comparing baseline and follow up mean scores, using a 5-point Likert-like scale ranging from not abusive to extremely abusive (minimum = 1 and maximum = 5). This scale was developed by Silverman et al to assess perceptions of the degree of abusiveness of specified relationship behaviors and modeled as a mean of responses to 12 items. |
| Change From Baseline to 3 Months Using the Gender Equitable Attitudes Scale | 3 months | Assessment of gender-equitable attitudes comparing baseline mean score with follow up mean score, using a 5-point Likert-like scale ranging from strongly agree to strongly disagree (minimum = 1 and maximum = 5). This scale includes questions modified from Barker's Gender-Equitable Norms Scale and modeled as a mean of responses to 11 items. |
| Change From Baseline to 3 Months Using the Intentions to Intervene Scale | 3 months | Proclivity to intervene when witnessing disrespectful and harmful behaviors among peers comparing baseline and follow up mean scores, using a 5-point Likert-like scale ranging from very unlikely to very likely (minimum = 1 and maximum = 5). This scale was investigator developed by Miller (PI) et al to assess participants report of how likely they would be to do something to stop the behavior and modeled as a mean of 8 items. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Control School Control schools (where the coaches do not receive the Coaching Boys into Men (CBIM) training until following academic year 'wait list control') | 998 |
| Intervention School Intervention schools (where coaches receive the CBIM training at start of sports season)
Coaching Boys Into Men program: Coaching Boys into Men (CBIM) program consists of a 60 minute training for high school coaches led by a violence prevention advocate to introduce coaches to the rationale for CBIM and the CBIM Coaches Kit. The Coaches use this CBIM toolkit to provide weekly discussions with their athletes (generally 10-15 minute mini-sessions) throughout their athletic season (11 weeks). Discussion topics include how to prevent disrespectful and harmful behaviors towards women and girls and how to promote healthy choices and relationships among youth. | 1,008 |
| Total | 2,006 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 47 | 161 |
Baseline characteristics
| Characteristic | Control School | Intervention School | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 998 Participants | 1008 Participants | 2006 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 169 Participants | 220 Participants | 389 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 822 Participants | 776 Participants | 1598 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 7 Participants | 12 Participants | 19 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 114 Participants | 78 Participants | 192 Participants |
| Race (NIH/OMB) Black or African American | 191 Participants | 248 Participants | 439 Participants |
| Race (NIH/OMB) More than one race | 86 Participants | 107 Participants | 193 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 33 Participants | 61 Participants | 94 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 7 Participants | 12 Participants | 19 Participants |
| Race (NIH/OMB) White | 567 Participants | 502 Participants | 1069 Participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 998 Participants | 1008 Participants | 2006 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 998 | 0 / 1,008 |
| serious Total, serious adverse events | 0 / 998 | 0 / 1,008 |
Outcome results
Primary
Change From Baseline to 3 Months Using the Gender Equitable Attitudes Scale
Assessment of gender-equitable attitudes comparing baseline mean score with follow up mean score, using a 5-point Likert-like scale ranging from strongly agree to strongly disagree (minimum = 1 and maximum = 5). This scale includes questions modified from Barker's Gender-Equitable Norms Scale and modeled as a mean of responses to 11 items.
Time frame: 3 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control School | Change From Baseline to 3 Months Using the Gender Equitable Attitudes Scale | 3.09 mean scores | Standard Deviation 0.63 |
| Intervention School | Change From Baseline to 3 Months Using the Gender Equitable Attitudes Scale | 3.00 mean scores | Standard Deviation 0.65 |
Primary
Change From Baseline to 3 Months Using the Intentions to Intervene Scale
Proclivity to intervene when witnessing disrespectful and harmful behaviors among peers comparing baseline and follow up mean scores, using a 5-point Likert-like scale ranging from very unlikely to very likely (minimum = 1 and maximum = 5). This scale was investigator developed by Miller (PI) et al to assess participants report of how likely they would be to do something to stop the behavior and modeled as a mean of 8 items.
Time frame: 3 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control School | Change From Baseline to 3 Months Using the Intentions to Intervene Scale | 3.51 mean scores | Standard Deviation 0.75 |
| Intervention School | Change From Baseline to 3 Months Using the Intentions to Intervene Scale | 3.73 mean scores | Standard Deviation 0.81 |
Primary
Change From Baseline to 3 Months Using the Recognition of Abusive Behavior Scale
Recognition of disrespectful and harmful behaviors against girls as abusive comparing baseline and follow up mean scores, using a 5-point Likert-like scale ranging from not abusive to extremely abusive (minimum = 1 and maximum = 5). This scale was developed by Silverman et al to assess perceptions of the degree of abusiveness of specified relationship behaviors and modeled as a mean of responses to 12 items.
Time frame: 3 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control School | Change From Baseline to 3 Months Using the Recognition of Abusive Behavior Scale | 3.38 mean scores | Standard Deviation 0.82 |
| Intervention School | Change From Baseline to 3 Months Using the Recognition of Abusive Behavior Scale | 3.37 mean scores | Standard Deviation 0.92 |