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“尊重项目”的试点整群随机对照试验方案:一项基于学校的干预措施,旨在预防约会和关系暴力,并解决年轻人中的健康不平等问题。

Protocol for pilot cluster RCT of project respect: a school-based intervention to prevent dating and relationship violence and address health inequalities among young people.

作者信息

Meiksin Rebecca, Allen Elizabeth, Crichton Joanna, Morgan Gemma S, Barter Christine, Elbourne Diana, Hunt Kate, Melendez-Torres G J, Morris Steve, Reyes H Luz Mc Naughton, Sturgess Joanna, Taylor Bruce, Young Honor, Campbell Rona, Bonell Chris

机构信息

1London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK.

2University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK.

出版信息

Pilot Feasibility Stud. 2019 Jan 22;5:13. doi: 10.1186/s40814-019-0391-z. eCollection 2019.

Abstract

BACKGROUND

Dating and relationship violence (DRV)-intimate partner violence during adolescence-encompasses physical, sexual and emotional abuse. DRV is associated with a range of adverse health outcomes including injuries, sexually transmitted infections, adolescent pregnancy and mental health issues. Experiencing DRV also predicts both victimisation and perpetration of partner violence in adulthood.Prevention targeting early adolescence is important because this is when dating behaviours begin, behavioural norms become established and DRV starts to manifest. Despite high rates of DRV victimisation in England, from 22 to 48% among girls and 12 to 27% among boys ages 14-17 who report intimate relationships, no RCTs of DRV prevention programmes have taken place in the UK. Informed by two school-based interventions that have shown promising results in RCTs in the USA-Safe Dates and Shifting Boundaries-Project Respect aims to optimise and pilot a DRV prevention programme for secondary schools in England.

METHODS

Design: optimisation and pilot cluster RCT. Trial will include a process evaluation and assess the feasibility of conducting a phase III RCT with embedded economic evaluation. Cognitive interviewing will inform survey development.Participants: optimisation involves four schools and pilot RCT involves six (four intervention, two control). All are secondary schools in England. Baseline surveys conducted with students in years 8 and 9 (ages 12-14). Follow-up surveys conducted with the same cohort, 16 months post-baseline. Optimisation sessions to inform intervention and research methods will involve consultations with stakeholders, including young people.Intervention: school staff training, including guidance on reviewing school policies and addressing 'hotspots' for DRV and gender-based harassment; information for parents; informing students of a help-seeking app; and a classroom curriculum for students in years 9 and 10, including a student-led campaign.Primary outcome: the primary outcome of the pilot RCT will be whether progression to a phase III RCT is justified. Testing within the pilot will also determine which of two existing scales is optimal for assessing DRV victimisation and perpetration in a phase III RCT.

DISCUSSION

This will be the first RCT of an intervention to prevent DRV in the UK. If findings indicate feasibility and acceptability, we will undertake planning for a phase III RCT of effectiveness.

TRIAL REGISTRATION

ISRCTN, ISRCTN 65324176. Registered 8 June 2017.

摘要

背景

约会与恋爱暴力(DRV)——青春期亲密伴侣暴力——包括身体、性和情感虐待。DRV与一系列不良健康后果相关,包括受伤、性传播感染、青少年怀孕和心理健康问题。经历DRV还预示着成年后成为伴侣暴力的受害者或施暴者。针对青春期早期进行预防很重要,因为这是约会行为开始、行为规范确立以及DRV开始显现的时期。尽管在英格兰DRV受害者比例很高,在报告有恋爱关系的14至17岁女孩中为22%至48%,男孩中为12%至27%,但英国尚未开展过DRV预防项目的随机对照试验(RCT)。受美国两项在RCT中显示出有前景结果的校内干预措施——“安全约会”和“改变界限”——的启发,“尊重项目”旨在优化并试点一项针对英格兰中学的DRV预防项目。

方法

设计:优化及试点整群随机对照试验。该试验将包括过程评估,并评估开展一项包含经济评估的III期随机对照试验的可行性。认知访谈将为调查问卷的编制提供信息。参与者:优化涉及四所学校,试点随机对照试验涉及六所学校(四所干预学校,两所对照学校)。所有学校均为英格兰的中学。对8年级和9年级(12至14岁)的学生进行基线调查。在基线后16个月对同一队列进行随访调查。为确定干预措施和研究方法而进行的优化会议将包括与利益相关者(包括年轻人)的磋商。干预措施:对学校工作人员进行培训,包括审查学校政策以及应对DRV和基于性别的骚扰“热点问题”的指导;为家长提供信息;告知学生一款求助应用程序;以及为9年级和10年级的学生开设课堂课程,包括一场由学生主导的活动。主要结局:试点随机对照试验的主要结局将是是否有理由开展III期随机对照试验。在试点过程中的测试还将确定在III期随机对照试验中评估DRV受害者情况和施暴情况时,现有的两个量表中哪一个最为合适。

讨论

这将是英国首个针对预防DRV干预措施的随机对照试验。如果研究结果表明该干预措施具有可行性和可接受性,我们将着手规划一项关于有效性的III期随机对照试验。

试验注册

国际标准随机对照试验编号(ISRCTN),ISRCTN 65324176。于2017年6月8日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b72/6341537/9d6204364ca8/40814_2019_391_Fig1_HTML.jpg

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