Sex Offenses
Conditions
Brief summary
The purpose of this study is to evaluate the statewide application of Green Dot among high schools students. We hypothesize that students in high schools with Green Dot will over time report lower rates of sexual violence (SV) compared with students in comparable high schools randomized not to have Green Dot. This reduction in sexual violence will be mediated through a reduction in social norms supporting sexual violence (measured with violence acceptance scales) and an increase in bystander behaviors.
Detailed description
Green Dot is a bystander intervention program that empowers students to actively question peer support for sexual violence (SV) and become change agents who play a significant role in preventing sexual violence. The purpose of this study is to evaluate the statewide application of Green Dot among high schools students. We hypothesize that students in high schools with Green Dot will over time report lower rates of SV compared with students in comparable high schools randomized not to have Green Dot. A high school based controlled intervention trial is being used to test the efficacy of Green Dot. Both panel and cohort survey methods will be used to provide baseline and prospective data on student's attitudes supporting SV, bystander behaviors and violence victimization and perpetration. In 13 Kentucky regions, 2 demographically comparable high schools were recruited to participate in Green Dot intervention either as the intervention or control site. Schools were randomly assigned to the intervention. Study Population includes all students in participating high schools invited to complete anonymous panel surveys beginning spring 2010 through 2014. This state-wide, population-based, multi-site controlled intervention trial provides an empirical test of a promising intervention, which, if proven effective, could result in the primary prevention of SV and a reduction in the health and academic consequences of SV.
Interventions
BEHAVIORALGreen Dot Bystander Intevention
Intervention allocated at the school level
BEHAVIORALControl
Awareness Education
Sponsors
University of Kentucky
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
14 Years to 19 Years
Healthy volunteers
Yes
Inclusion criteria
Only high school students attending the intervention or comparison high schools will be eligible. Two groups will be recruited: those receiving bystanding training and those not receiving such training who may or may not be in the social network of those receiving bystanding training.
Exclusion criteria
All other high school students in Kentucky
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Average Number of Sexual Assault Events Used (Perpetrated) Per School. | up to 5 years follow up from baseline intervention | Students self report of sexual assault perpetration averaged at the school level and adjusted for baseline and number of students. Adjustments were made by including baseline measure and number of students as a covariate in the model. Data will be collected at baseline and annually for 4 years. |
| Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Data will be collected at baseline and annually for 4 years. | Students self report of sexual assault victimization averaged at the school level and adjusted for baseline and number of students. Adjustments made by including baseline measure and number of students as covariates in models. Data will be collected at baseline and annually for 4 years. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in Violence Acceptance | Data will be collected at baseline and annually for 4 years. | Illinois Rape Myth Acceptance Scale measure students' beliefs about rape which may indicate social norms supporting sexual violence. The scale consists of 22 questions scored 1 -5. Were 1 is strongly agree and 5 is strongly disagree. The higher the cumulative score, the more likely the participant is to accept rape myths. 5-item Acceptance of General Dating Violence Scale was used to measure norms supporting dating violence. Scores will range from 1-6, were the higher the score the more likely the participant was to reject dating violence as normal. |
| Increase in Bystanding Behaviors | Data will be collected at baseline and annually for 4 years. | 7 item survey measuring self-reports of students actively engaging their peers in behaviors that may prevent violence. Response options: 0 times, 1-2 times, 3-5 times, 6-9 times, 10 or more times, didn't see or hear someone doing this Above items repeated to measure student observing others doing these behaviors. Data will be presented as the total number of interventions were the bigger the number the more likely the bystander was to intervene on behalf of the victim. |
Countries
United States
Participant flow
Recruitment details
A total of 89,707 students completed surveys. However, due to anonymous response, it is not possible to know the number of unique students who completed surveys within the study period. Two schools within each of the 13 regions were selected by the Rape Crisis Centers for simple randomization to each condition in this cluster RCT (n=26).
Pre-assignment details
46 demographically similar public high schools were identified as willing participate in the trial. Two schools were excluded by researchers because these were too small (\<100 per grade). Among the remaining 36 schools, two schools within each of the 13 regions were selected and randomized (n=26).
Participants by arm
| Arm | Count |
|---|---|
| Green Dot Bystander Training 26 high schools: 13 receiving Green Dot intervention and 13 no intervention
Green Dot Bystander Intevention: Intervention allocated at the school level | 30,853 |
| Green Dot Bystander Training 26 high schools: 13 receiving Green Dot intervention and 13 no intervention
Green Dot Bystander Intevention: Intervention allocated at the school level | 13 |
| Control Training | 27,516 |
| Control Training | 13 |
| Total | 58,395 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Baseline | Surveys not fully completed | 2,497 | 1,800 |
| Implementation Year 1 | Surveys not fully completed | 3,202 | 2,549 |
| Implementation Year 2 | Surveys not fully completed | 3,281 | 2,841 |
| Implementation Year 3 | Surveys not fully completed | 3,494 | 2,980 |
| Implementation Year 4 | Surveys not fully completed | 3,604 | 3,007 |
Baseline characteristics
| Characteristic | Green Dot Bystander Training | Control Training | Total |
|---|---|---|---|
| Age, Customized Year in School: First Year | 31.1 Percentage of Participants per School STANDARD_DEVIATION 5.54 | 30.37 Percentage of Participants per School STANDARD_DEVIATION 3.3 | 30.69 Percentage of Participants per School STANDARD_DEVIATION 4.48 |
| Age, Customized Year in School: Junior | 25.2 Percentage of Participants per School STANDARD_DEVIATION 5.95 | 26.37 Percentage of Participants per School STANDARD_DEVIATION 4.52 | 25.78 Percentage of Participants per School STANDARD_DEVIATION 5.21 |
| Age, Customized Year in School: Senior | 15.54 Percentage of Participants per School STANDARD_DEVIATION 9.94 | 16.45 Percentage of Participants per School STANDARD_DEVIATION 7.96 | 16 Percentage of Participants per School STANDARD_DEVIATION 8.83 |
| Age, Customized Year in School: Sophomore | 27.99 Percentage of Participants per School STANDARD_DEVIATION 3.95 | 26.72 Percentage of Participants per School STANDARD_DEVIATION 3.69 | 27.35 Percentage of Participants per School STANDARD_DEVIATION 3.8 |
| Race/Ethnicity, Customized American Indian or Alaska Native | 1.08 Percentage of Participants per School STANDARD_DEVIATION 0.56 | 1.13 Percentage of Participants per School STANDARD_DEVIATION 0.27 | 1.11 Percentage of Participants per School STANDARD_DEVIATION 0.43 |
| Race/Ethnicity, Customized Asian | 1.44 Percentage of Participants per School STANDARD_DEVIATION 1.59 | 1.2 Percentage of Participants per School STANDARD_DEVIATION 1.08 | 1.32 Percentage of Participants per School STANDARD_DEVIATION 1.33 |
| Race/Ethnicity, Customized Black or African American | 8.03 Percentage of Participants per School STANDARD_DEVIATION 10.77 | 6.47 Percentage of Participants per School STANDARD_DEVIATION 8.65 | 7.25 Percentage of Participants per School STANDARD_DEVIATION 9.6 |
| Race/Ethnicity, Customized Hispanic or Latino/Latina | 3.16 Percentage of Participants per School STANDARD_DEVIATION 2.99 | 1.31 Percentage of Participants per School STANDARD_DEVIATION 0.92 | 2.23 Percentage of Participants per School STANDARD_DEVIATION 2.37 |
| Race/Ethnicity, Customized Other | 3.78 Percentage of Participants per School STANDARD_DEVIATION 3.28 | 2.67 Percentage of Participants per School STANDARD_DEVIATION 2.21 | 3.23 Percentage of Participants per School STANDARD_DEVIATION 2.8 |
| Race/Ethnicity, Customized White | 82.51 Percentage of Participants per School STANDARD_DEVIATION 17.06 | 87.22 Percentage of Participants per School STANDARD_DEVIATION 11.93 | 84.86 Percentage of Participants per School STANDARD_DEVIATION 14.62 |
| Sex/Gender, Customized Female | 54.56 Percentage of Participants per School STANDARD_DEVIATION 3.2 | 54.11 Percentage of Participants per School STANDARD_DEVIATION 2.98 | 54.33 Percentage of Participants per School STANDARD_DEVIATION 3.04 |
| Sex/Gender, Customized Male | 45.44 Percentage of Participants per School STANDARD_DEVIATION 3.2 | 45.89 Percentage of Participants per School STANDARD_DEVIATION 2.98 | 45.67 Percentage of Participants per School STANDARD_DEVIATION 3.04 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Average Number of Sexual Assault Events Used (Perpetrated) Per School.
Students self report of sexual assault perpetration averaged at the school level and adjusted for baseline and number of students. Adjustments were made by including baseline measure and number of students as a covariate in the model. Data will be collected at baseline and annually for 4 years.
Time frame: up to 5 years follow up from baseline intervention
Population: Anonymous survey data collected over 5 years and sorted by intervention. To complete ITT analysis, schools that dropped out were included in analysis using imputed data.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| Green Dot Bystander Training | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 1 | 518 Number of events per school |
| Green Dot Bystander Training | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 2 | 485 Number of events per school |
| Green Dot Bystander Training | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 3 | 292 Number of events per school |
| Green Dot Bystander Training | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 4 | 308 Number of events per school |
| Control | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 4 | 370 Number of events per school |
| Control | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 1 | 420 Number of events per school |
| Control | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 3 | 459 Number of events per school |
| Control | Average Number of Sexual Assault Events Used (Perpetrated) Per School. | Year 2 | 472 Number of events per school |
p-value: 0.0003Mixed Models Analysis
Primary
Average Number of Sexual Assaults Experienced (Victimization) Events Per School.
Students self report of sexual assault victimization averaged at the school level and adjusted for baseline and number of students. Adjustments made by including baseline measure and number of students as covariates in models. Data will be collected at baseline and annually for 4 years.
Time frame: Data will be collected at baseline and annually for 4 years.
Population: anonymous survey data collected over 5 years and sorted by intervention. To keep ITT analysis, all schools were included and data were imputed for schools that dropped out.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| Green Dot Bystander Training | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 1 | 300 Number of events per school |
| Green Dot Bystander Training | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 2 | 292 Number of events per school |
| Green Dot Bystander Training | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 3 | 161 Number of events per school |
| Green Dot Bystander Training | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 4 | 157 Number of events per school |
| Control | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 4 | 245 Number of events per school |
| Control | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 1 | 211 Number of events per school |
| Control | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 3 | 281 Number of events per school |
| Control | Average Number of Sexual Assaults Experienced (Victimization) Events Per School. | Year 2 | 269 Number of events per school |
p-value: 0.0003Mixed Models Analysis
Other Pre-specified
Change in Violence Acceptance
Illinois Rape Myth Acceptance Scale measure students' beliefs about rape which may indicate social norms supporting sexual violence. The scale consists of 22 questions scored 1 -5. Were 1 is strongly agree and 5 is strongly disagree. The higher the cumulative score, the more likely the participant is to accept rape myths. 5-item Acceptance of General Dating Violence Scale was used to measure norms supporting dating violence. Scores will range from 1-6, were the higher the score the more likely the participant was to reject dating violence as normal.
Time frame: Data will be collected at baseline and annually for 4 years.
Other Pre-specified
Increase in Bystanding Behaviors
7 item survey measuring self-reports of students actively engaging their peers in behaviors that may prevent violence. Response options: 0 times, 1-2 times, 3-5 times, 6-9 times, 10 or more times, didn't see or hear someone doing this Above items repeated to measure student observing others doing these behaviors. Data will be presented as the total number of interventions were the bigger the number the more likely the bystander was to intervene on behalf of the victim.
Time frame: Data will be collected at baseline and annually for 4 years.