Our purpose is to evaluate the longer-term impact of Green Dot across the Bluegrass, an active bystanding-based randomized intervention trial in 26 high schools across Kentucky designed to reduce dating and sexual violence in a cohort of seniors as they transition into young adulthood. Our central question is: Does Green Dot continues to have an effect in changing the culture of violence acceptance and reducing violence perpetration among students exposed to Green Dot relative to those not exposed as this cohort enters young adulthood? In this prospective cohort of approximately 7,500 students, we will measure the individual level exposure to the Green Dot program and into young adulthood allowing us to estimate the risk of dating and sexual violence victimization and perpetration. Very few studies have prospectively estimated the risk of dating and sexual violence among a cohort randomized to a primary prevention intervention and followed into young adulthood. This R01 is also unique because cohort members will be followed independent of whether they do or do not attend college. Individually following this cohort of seniors represents a significant value-added and time-sensitive opportunity because the full implementation of Green Dot began in late 2011. Only now (2013-15) would we anticipate seeing an effect of Green Dot among rising seniors on changing bystanding and potentially reducing violence.
Aim 1. Prospectively determine whether and how the Green Dot intervention reduces rates of teen dating and sexual violence into young adulthood by (a) changing social norms of violence acceptance, (b) increasing active bystanding, and (c) diffusing the intervention through peer networks. Approximately 7500 high school seniors who attended Kentucky high schools randomized to the Green Dot intervention (n~3750) or control schools (n~3750) will be followed 42 months into young adulthood.
Aim 2. To determine the potentially modifying effects of participants'post-high school life experience on the association between exposure to the Green Dot intervention and bystanding actions, teen dating and sexual violence incidence. Post-high school experience will be categorized as attending any form of college or university versus no additional education. Specific life stressors such as relationship status, pregnancy, military deployment, family and peer violence, and substance abuse will also be explored. This cohort study is appropriately powered (?90%) to address both aims. Comparisons will be made at 6-month intervals and across the 42-month follow-up and the interaction of intervention by time will be evaluated. Generalized Estimating Equations will be used to test the impact of Green Dot over time while taking clustering of high schools and correlation among repeated measurements among individual students into account and adjusting for confounders. This prospective cohort builds upon a large population-based and promising primary prevention intervention, designed to reduce dating and sexual violence among high school students and provides an important test of the longer-term efficacy of this program into young adulthood.

Public Health Relevance

Because teen dating and sexual violence rates remain high, tests of promising primary prevention interventions with sufficient lengths of follow-up to detect changes in violence are needed. We propose a cohort study of high school seniors (n=7,500) followed for up to 42 months, who participated in a high school based randomized intervention trial of an active bystanding prevention program.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Community-Level Health Promotion Study Section (CLHP)
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Newcomer, Susan
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University of Kentucky
Obstetrics & Gynecology
Schools of Medicine
United States
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Coker, Ann L; Bush, Heather M; Follingstad, Diane R et al. (2017) Frequency of Guns in the Households of High School Seniors. J Sch Health 87:153-158
Follingstad, Diane R; Coker, Ann L; Chahal, Jaspreet K et al. (2016) Do Guns in the Home Predict Gender and Relationship Attitudes? An Exploratory Study. J Aggress Maltreat Trauma 25:1097-1116