
Dating Violence (DV)
› 1 in 5 teens report lifetime psychological,
physical and/or sexual DV
› 9% of U.S. high school students report
physical DV in the past 12 months
 CDC, 2012
› Adolescent DV is one of the strongest
predictors of intimate partner violence in
adulthood
 CDC, 2006

DV Prevention in Schools
› A growing number of U.S.
states have mandated DV
education in public schools
› Several school-based,
primary prevention programs
have shown promising results
in reducing attitudes
supportive of DV and DV
behaviors
•
Whitaker et al., 2006




Partnership with a non-profit CBO dedicated to
promoting respectful relationships by teaching
alternatives to relationship violence
5 50-min sessions delivered by B.A.-level educators
>54,000 students in New England
Each session includes lecture, discussion, group
and individual activities, handouts, and worksheets.

KBEP curriculum is a fullydeveloped program that has
never been empirically tested
› Feasible for high schools and
acceptable to staff and students
› Freestanding program, easy to
integrate into existing health class
curricula
› Appropriate for both male and
female students
 Addresses gender roles and stereotypes
 Portrays people of both genders as
perpetrators and victims
Session
Topic
Example Activities
1
Understanding Violence
Violence 101 Presentation
5 Types of Violence Activity
2
3
Wants and Needs in a
Relationship
Expectations in Dating
Relationships
Agree/Disagree Game
Dating Characteristics Activity
Fair and Unfair Expectations Discussion
Expectation Cards Activity
Jealousy Discussion
4
Communication Skills
What is Healthy Communication?
Aggressive/Passive/Assertive Communication
Role-Play
Assertive Comebacks Game
5
Cycles of Violence and
Warning Signs
Cycle of Violence Discussion
Warning Signs of an Abusive Relationship

Primary Outcomes
› DV knowledge
› DV attitudes
› DV behaviors
 Perpetration
 Victimization

Hypotheses
 More DV knowledge, less approval of DV at the
end of the program (T2) and 3-month follow up (T3)
 Lower rates of DV perpetration and victimization at
3-month follow-up (T3)

Cluster randomized wait-list control trial
› 24 10th grade health classes
Compared KBEP curriculum to time &
attention comparison condition
 Large public high school in MA where
KBEP was already implemented annually
 Assessments: baseline (T1), postintervention (T2), 3-month follow-up (T3)

575 eligible students in 24 classes
 Present analyses limited to students who
had dated in the past 3 months at
baseline (N=225)

› 86 Active,139 Control
› 54% female, 20% Hispanic, M age = 15.85
› 73% White, 12% African American or Black,
6% Asian, 3% Native American, 1% Native
Hawaiian/Pacific Islander, 12% other
579 students enrolled in 10th grade
health classes
441 permission slips returned (76%)
433 consented (98%)
6 refused
2 incomplete consent forms
12 classrooms randomized to
intervention condition
12 classrooms randomized to
wait-list control condition
N = 172 (40%)
N = 261 (60%)
Baseline assessment
completed
N = 146 (85%)
Baseline assessment
completed
N= 224 (86%)
Post-intervention
assessment completed
N = 151 (88%)
Post-intervention
assessment completed
N = 214 (82%)
3 month follow-up
assessment completed
N = 144 (84%)
3 month follow-up
assessment completed
N = 213 (82%)
Included in data
analysis
N = 164 (95%)
Included in data
analysis
N = 249 (95%)

Treatment Fidelity
› 38% sessions rated for adherence
› 97% of session modules completed
› Students attended 4.2/5 sessions on average

Primary Outcomes: Attitudes (T1, T2, T3)
› KBEP Questionnaire
 Dating attitudes and DV knowledge
› Normative Beliefs about Aggression Scale
 NOBAGS; Huesmann & Guerra, 1997
 Approval of aggression
› Attitudes Towards Dating Violence Scale
 ATDVS; Price, Byers, & The Dating Violence
Research Team, 1999
 Attitudes about male and female DV perpetration

Primary Outcomes: Behaviors (T1 and T3)
› Conflict in Adolescent Dating Relationships
Inventory
 CADRI; Wolfe et al., 2001
 DV perpetration and victimization frequency
 Never vs. ever in the past 3 months
 Emotional/verbal DV, relational aggression,
threatening behaviors, physical DV


Primary Hypothesis: there will be differences
between the KBEP and control groups in terms
of DV-related cognitive factors and behaviors
Generalized estimating equations (GEE) in SPSS
› Students nested within classrooms
› Continuous and dichotomous outcomes

Separate models for
› Scores on each of the 6 cognitive outcome variables
at the end of the study (T2)
› Cognitive variables and 8 behavioral outcomes at
the three-month follow-up (T3).
› All models controlled for baseline assessments (T1)

91.8% DV victimization in the past 3 months
› Includes threatening behavior, relational aggression,
emotional/verbal or physical DV
› 92.0% perpetration

Physical DV victimization, past 3 months:
› 36 in the control condition (26%)
› 25 in the KBEP condition (28%)

Physical DV perpetration, past 3 months:
› 34 students in the control condition (26%)
› 30 students in the KBEP condition (34%)

No significant differences across intervention
conditions on demographic characteristics or
DV history
Generalized Estimating Equations for Effect of Treatment Condition on
Cognitive Outcomes at T2 and T3
Outcome
Approval of
aggression,
general
Approval of
aggression,
retaliatory
Attitudes
towards
female DV
perp
Attitudes
towards
male DV
perp
Dating
attitudes
DV
Knowledge
B
SE
T2
95% CI
Wald ChiSquare
3.27^
B
SE
-0.20
0.06
T3
95%
CI
-0.32
–0.07
-0.24
–0.04
-0.34
–0.05
Wald ChiSquare
9.47**
-0.12
0.06 -0.24 –
0.01
-0.25
0.05 -0.35 –
-0.14
21.37***
-0.24
0.05
-0.12
0.05 -0.22 –
-0.02
5.91*
-0.20
.07
-0.17
0.07 -0.30 –
-0.03
5.61*
-0.19
0.05
-0.27
–0.10
16.66***
0.28
0.08
13.50***
0.22
0.06
14.82***
29.37***
-0.04
0.01
0.11 –
0.33
-0.06
–0.01
-0.06
0.13 –
0.43
0.01 -0.09 –
-0.04
7.08**
6.85**
10.81**
Generalized Estimating Equations for Effect of Treatment Condition on
Behavioral Outcomes at T2 and T3
Outcome
Emotional/verbal abuse
perpetration
Relational aggression
perpetration
Threatening behaviors
perpetration
Physical DV perpetration
B
SE
T3
95% CI
-1.31
0.41
-2.10 – -0.51
10.32**
-0.07
0.38
-0.81 – 0.66
0.04
-1.06
0.52
-2.08 – -0.04
4.16*
-0.55
0.40
-1.34 – 0.24
1.88
Wald ChiSquare
Generalized Estimating Equations for Effect of Treatment Condition on
Behavioral Outcomes at T2 and T3
Outcome
T3
95% CI
B
SE
Emotional/verbal abuse
victimization
-1.35
0.24
-1.81 –
-0.88
32.47***
Relational aggression
victimization
0.01
0.41
-0.80 –
0.82
0.00
Threatening behaviors
victimization
-0.50
0.36
-1.21 –
0.20
1.95
Physical DV victimization
-0.45
0.31
-1.05 –
0.16
2.07
Wald ChiSquare

Students who received the KBEP curriculum reported
changes in DV-related cognitions and behavior

At T2, students in the active condition reported less
approval of aggression, less approval of male and
female DV perpetration, and more healthy attitudes
about dating and knowledge about DV
› Effects were sustained at 3-month follow-up

We found fewer associations between condition and
DV behaviors

Students who received the KBEP program did report
less emotional/verbal DV perpetration, threatening
behavior perpetration and emotional/verbal DV
victimization at T3
Promising initial empirical support for a
widely-disseminated, community-based DV
prevention program
 Brief, universal community interventions can
be efficacious!
 This study is among the few trials of
adolescent DV prevention programs to
detect significant behavioral outcomes

 De Koker et al., 2014

Assessed behaviors across the DV spectrum
(Foshee et al., 1996), found different effects
Data are from 1 school and are self-reports
 Sample limited to active daters
 Brief program; no booster

› Limited opportunities to practice skills

Universal curriculum; not targeted to
students with DV histories
 De Koker et al., 2014

May need longer follow-up to detect more
behavioral effects
 Crooks et al., 2008
These results have the potential to inform
changes to the KBEP curriculum to improve
efficacy
 Modifications can be quickly piloted and
disseminated in high schools where
program is established

› E.g., more sessions  more skills practice 
enhanced effects on behavior

Brief trainings could enable health teachers
to deliver the curriculum in own classrooms
-Larry Brown, M.D.
-Christie Rizzo, Ph.D.
-HIV Prevention Team,
Brown/Rhode Island
Hospital/Bradley Hasbro
Children’s Research Center
-The Katie Brown Educational
Program
-Claire Spaulding McVicker,
Executive Director
Research Support:
-Rhode Island Hospital
-NIMH T32 (Larry Brown, P.I.)