Evaluating the Long-Term Effects of Green Dot on Teen Dating Violence Prevention

The purpose of this R01 is to evaluate the longer-term impact of Green Dot Across the Bluegrass, an active bystanding-based randomized intervention trial in 26 high school across Kentucky designed to reduce sexual and partner violence (5U01CE001675) in a cohort of seniors as they transition into young adulthood. Our central question is: Does Green Dot continue 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 of students enters young adulthood and into different environments beyond high school? In this prospective cohort of approximately 7,500 students, we will measure the individual level exposure to the Green Dot program in and outside of high schools and into young adulthood allowing us to estimate the risk of partner violence and sexual violence victimization and perpetration. Very few studies have prospectively estimated the risk of partner and sexual violence among a cohort randomized to a primary prevention intervention while in high school and then 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 (2013-14) among rising seniors would we anticipate seeing an effect of Green Dot on changing bystanding and potentially reducing violence. Aim 1. Prospectively determine whether Green Dot reduces rates of partner and sexual violence by directly changing social norms of violence acceptance resulting in greater frequency of active bystanding when potentially violent situations arise by following 7500 high school seniors who attended Kentucky high schools randomized to the Green Dot intervention (n~3,750) relative to the control arm (n~3750) and followed up to 42 months. Aim 2. To determine the modifying effects of studentsf post-high school life experience on the association between the Green Dot exposure and bystanding actions, violence acceptance, partner violence incidence, sexual violence incidence, and substance use. Post-high school experience will be simply categorized as attending any form of college or university versus no additional education. This cohort study is appropriately powered (.80%) to address both aims. Comparisons will be made at 6 month intervals and across the 42 month follow-up; the interaction of intervention by time will be evaluated. Generalized Estimating Equations (GEE) will be used to test the impact of Green Dot over time while taking clustering of high schools and correlation among repeated measurements from individual students into account and adjusting for potential confounders. This prospective cohort builds upon a large population-based and promising primary prevention intervention, Green Dot, designed to reduce partner and sexual violence among high school students and provides an important test of the longer-term efficacy of this program into young adulthood.