Feasibility and Acceptability of Engaging Significant Adults in Youth Sexual and Relationship Violence Prevention Work

Relationship and sexual violence (RSV) disproportionately affect youth in immigrant and other marginalized communities yet few prevention initiatives are truly grounded in their experiences. The current study represents a pilot implementation evaluation of youth-led workshops to engage significant adults (parents, grandparents, aunts, adult siblings, community leaders) as RSV prevention partners in diverse communities in a large urban area. The current mixed methods evaluation examined the perceptions of 66 adults and six youth leaders of four, day-long adult training workshops. Results showed high feasibility and acceptability and an important role for significant adults in enhancing RSV prevention.

Early Life Adversity and Clinical Intimate Partner Violence in Adulthood: The Mediating Role of Interpersonal Conflict in Adolescence

Intimate partner violence (IPV) is associated with adverse outcomes for both victims and perpetrators, though there is significant heterogeneity in manifestations of relationship violence. A growing amount of research has focused on elucidating predictors of clinical IPV—defined as severe violence involving institutional or medical intervention due to actual or potential injury—so as to better understand potential prevention and intervention targets. Early life adversity (ELA) is associated with IPV in adulthood, yet this literature focuses on discrete, retrospectively reported adversities (e.g., physical abuse and neglect) and has yet to consider clinical IPV as an outcome. Little is known about if and how broadly adverse early environments may confer risk for this specific form of relationship violence. We investigated associations between exposure to ELA prior to age five and clinical IPV victimization and perpetration by age 20 in a longitudinal, community-based sample of men and women in Australia ( N = 588). Early life adversity was prospectively indexed by maternal reports of financial hardship, child chronic illness, maternal stressful life events, maternal depressive symptoms, parental discord, and parental separation. Youth interpersonal conflict life events at age 15—an interviewer-rated assessment of episodic stressors involving conflict across relationships in mid-adolescence—was tested as a potential mediator for both victims and perpetrators. Among women, ELA predicted IPV victimization and perpetration, and interpersonal conflict life events partially mediated the link between ELA and victimization, but not perpetration. Neither ELA nor interpersonal conflict life events predicted victimization or perpetration among men. Women exposed to ELA are at-risk for conflictual interpersonal relationships later in life, including violent intimate relationships, and deficits in conflict resolution skills may be one mechanism through which ELA leads to IPV victimization among this subgroup. Violence prevention and intervention efforts should target interpersonal skills, including conflict resolution, among women and girls exposed to adverse early environments.

The Positive Choices trial: study protocol for a Phase-III RCT trial of a whole-school social marketing intervention to promote sexual health and reduce health inequalities

Background Positive Choices is a whole-school social marketing intervention to promote sexual health among secondary school students. Intervention comprises school health promotion council involving staff and students coordinating delivery; student survey to inform local tailoring; teacher-delivered classroom curriculum; student-run campaigns; parent information; and review of sexual/reproductive health services to inform improvements. This trial builds on an optimisation/pilot RCT study which met progression criteria, plus findings from another pilot RCT of the Project Respect school-based intervention to prevent dating and relationship violence which concluded such work should be integrated within Positive Choices. Young people carry a disproportionate burden of adverse sexual health; most do not report competence at first sex. Relationships and sex education in schools can contribute to promoting sexual health but effects are small, inconsistent and not sustained. Such work needs to be supplemented by ‘whole-school’ (e.g. student campaigns, sexual health services) and ‘social marketing’ (harnessing commercial marketing to social ends) approaches for which there is good review-level evidence but not from the UK. Methods We will conduct a cluster RCT across 50 schools (minimum 6440, maximum 8500 students) allocated 1:1 to intervention/control assessing outcomes at 33 months. Our primary outcome is non-competent first sex. Secondary outcomes are non-competent last sex, age at sexual debut, non-use of contraception at first and last sex among those reporting heterosexual intercourse, number of sexual partners, dating and relationship violence, sexually transmitted infections, and pregnancy and unintended pregnancy for girls and initiation of pregnancy for boys. We will recruit 50 school and undertake baseline surveys by March 2022; implement the intervention over the 2022–2024 school years and conduct the economic and process evaluations by July 2024; undertake follow-up surveys by December 2024; complete analyses, all patient and policy involvement and draft the study report by March 2025; and engage in knowledge exchange from December 2024. Discussion This trial is one of a growing number focused on whole-school approaches to public health in schools. The key scientific output will be evidence about the effectiveness, costs and potential scalability and transferability of Positive Choices. Trial registration ISRCTN No: ISRCTN16723909. Trial registration summary: Date:. Funded by: National Institute for Health Research Public Health Research Programme (NIHR131487). Sponsor: LSHTM. Public/scientific contact: Chris Bonell. Public title: Positive Choices trial. Scientific title: Phase-III RCT of Positive Choices: a whole-school social marketing intervention to promote sexual health and reduce health inequalities. Countries of recruitment: UK. Intervention: Positive Choices. Inclusion criteria: Students in year 8 (age 12–13 years) at baseline deemed competent by schools to participate in secondary schools excluding pupil referral units, schools for those with special educational needs and disabilities, and schools with ‘inadequate’ Ofsted inspections. Study type: interventional study with superiority phase III cluster RCT design. Enrollment: 1/9/21-31/3/22. Sample size: 50 schools and 6440–8500 students. Recruitment status: pending. Primary outcome: binary measure of non-competent first sex. Secondary outcomes: non-competent last sex; age at sexual debut; non-use of contraception at first and last sex; number of sexual partners; dating and relationship violence (DRV) victimisation; sexually transmitted infections; pregnancy and unintended pregnancy for girls and initiation of pregnancy for boys using adapted versions of the RIPPLE measures. Ethics review: LSHTM research ethics committee (reference 26411). Completion data: 1/3/25. Sharing statement: Data will be made available after the main trial analyses have been completed on reasonable request from researchers with ethics approval and a clear protocol. Amendments to the protocol will be communicated to the investigators, sponsor, funder, research ethics committee, trial registration and the journal publishing the protocol. Amendments affecting participants’ experience of the intervention or important amendments affecting the overall design and conduct of the trial will be communicated to participants.

Traumatic Bonding and Intimate Partner Violence

<p>Intimate partner violence is a pervasive and highly detrimental phenomenon. One common aspect of abusive relationships is a reluctance to leave one’s partner. With this in mind, the current study explored the role of Stockholm syndrome in abusive relationships. Study 1 and 2 surveyed 508 diverse adults. Study 1 submitted the Stockholm syndrome scale to psychometric testing and confirmed a 3-factor solution for the scale. The three components are Core, justifying an abuser through cognitive distortions; Damage, ongoing psychological effects of abuse; and Love, the belief that one’s survival depends on the love of an abuser. Study 2 tested the predictive qualities of the scale and found that its components are linked to relationship violence in a predictable fashion. These links may be moderated by insecure attachment. Study 3 analysed dyadic data from 86 couples and found positive associations between levels of Core and relationship violence, both within and across partners. Implications and future directions are discussed.</p>

Traumatic Bonding and Intimate Partner Violence

<p>Intimate partner violence is a pervasive and highly detrimental phenomenon. One common aspect of abusive relationships is a reluctance to leave one’s partner. With this in mind, the current study explored the role of Stockholm syndrome in abusive relationships. Study 1 and 2 surveyed 508 diverse adults. Study 1 submitted the Stockholm syndrome scale to psychometric testing and confirmed a 3-factor solution for the scale. The three components are Core, justifying an abuser through cognitive distortions; Damage, ongoing psychological effects of abuse; and Love, the belief that one’s survival depends on the love of an abuser. Study 2 tested the predictive qualities of the scale and found that its components are linked to relationship violence in a predictable fashion. These links may be moderated by insecure attachment. Study 3 analysed dyadic data from 86 couples and found positive associations between levels of Core and relationship violence, both within and across partners. Implications and future directions are discussed.</p>

Sexual and Relationship Violence Prevention Programming on Commuter Campuses: Wisdom From Students and Campus Personnel

Responding to the dearth of literature regarding sexual and relationship violence prevention programming on nonresidential university campuses, this study investigates how students and staff conceptualize prevention on commuter campuses. We use qualitative analysis of data from interviews with personnel, and focus groups with students on three commuter campuses and describe (a) the unique considerations associated with implementing prevention in commuter contexts and (b) core elements of comprehensive prevention approaches on these campuses. Results suggest that comprehensive prevention programming is desired by commuter campus stakeholders, but requires policy revision, creative delivery strategies, and student involvement, among other factors, to be realized.

The Model of Systemic Relational Violence: Conceptualizing IPV as a Method of Continual and Enforced Domination

This paper provides a theoretical and historical background of explanatory and descriptive models of domestic, family, and interpersonal violence and introduces a new model that seeks to correct aspects of those models that have been heavily critiqued. The Model of Systemic Relational Violence reconceptualizes violent relationships with coercive control and emotional and psychological violence at the core and more traditional event-based markers of relationship violence as peripheral enforcement tactics in a more extensive system of interpersonal domination. This new model is built on the insights and perspectives of survivors of relational violence and the service providers who support them. It has been developed to be applied in a variety of diverse relationships and contexts.