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Meta-Analysis
. 2013 Jun 19;2013(6):CD004534.
doi: 10.1002/14651858.CD004534.pub3.

Educational and skills-based interventions for preventing relationship and dating violence in adolescents and young adults

Gracia L T Fellmeth  1 , Catherine Heffernan, Joanna Nurse, Shakiba Habibula, Dinesh Sethi
Affiliations
Meta-Analysis

Educational and skills-based interventions for preventing relationship and dating violence in adolescents and young adults

Gracia L T Fellmeth et al. Cochrane Database Syst Rev. .

Abstract

Background: Educational and skills-based interventions are often used to prevent relationship and dating violence among young people.

Objectives: To assess the efficacy of educational and skills-based interventions designed to prevent relationship and dating violence in adolescents and young adults.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, six other databases and a trials register on 7 May 2012. We handsearched the references lists of key articles and two journals (Journal of Interpersonal Violence and Child Abuse and Neglect). We also contacted researchers in the field.

Selection criteria: Randomised, cluster-randomised and quasi-randomised studies comparing an educational or skills-based intervention to prevent relationship or dating violence among adolescents and young adults with a control.

Data collection and analysis: Two review authors independently assessed study eligibility and risk of bias. For each study included in the meta-analysis, data were extracted independently by GF and one other review author (either CH, JN, SH or DS). We conducted meta-analyses for the following outcomes: episodes of relationship violence, behaviours, attitudes, knowledge and skills.

Main results: We included 38 studies (15,903 participants) in this review, 18 of which were cluster-randomised trials (11,995 participants) and two were quasi-randomised trials (399 participants). We included 33 studies in the meta-analyses. We included eight studies (3405 participants) in the meta-analysis assessing episodes of relationship violence. There was substantial heterogeneity (I(2) = 57%) for this outcome. The risk ratio was 0.77 (95% confidence interval (CI) 0.53 to 1.13). We included 22 studies (5256 participants) in the meta-analysis assessing attitudes towards relationship violence. The standardised mean difference (SMD) was 0.06 (95% CI -0.01 to 0.15). We included four studies (887 participants) in the meta-analysis assessing behaviour related to relationship violence; the SMD was -0.07 (95% CI -0.31 to 0.16). We included 10 studies (6206 participants) in the meta-analysis assessing knowledge related to relationship violence; the results showed an increase in knowledge in favour of the intervention (SMD 0.44, 95% CI 0.28 to 0.60) but there was substantial heterogeneity (I(2) = 52%). We included seven studies (1369 participants) in the meta-analysis assessing skills related to relationship violence. The SMD was 0.03 (95% CI -0.11 to 0.17). None of the included studies assessed physical health, psychosocial health or adverse outcomes. Subgroup analyses showed no statistically significant differences by intervention setting or type of participants. The quality of evidence for all outcomes included in our meta-analysis was moderate due to an unclear risk of selection and detection bias and a high risk of performance bias in most studies.

Authors' conclusions: Studies included in this review showed no evidence of effectiveness of interventions on episodes of relationship violence or on attitudes, behaviours and skills related to relationship violence. We found a small increase in knowledge but there was evidence of substantial heterogeneity among studies. Further studies with longer-term follow-up are required, and study authors should use standardised and validated measurement instruments to maximise comparability of results.

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Conflict of interest statement

Gracia LT Fellmeth ‐ none known. Joanna Nurse ‐ none known. Catherine Heffernan ‐ none known. Shakiba Habibula ‐ none known. Dinesh Sethi ‐ none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
4
4
Funnel plot of comparison of studies included in meta‐analysis for outcome 1.3: attitudes towards relationship violence
5
5
Funnel plot of comparison of studies included in meta‐analysis for outcome 1.5: knowledge of relationship violence
1.1
1.1. Analysis
Comparison 1 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults, Outcome 1 Episodes of relationship violence (events).
1.2
1.2. Analysis
Comparison 1 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults, Outcome 2 Episodes of relationship violence (scores) (higher score = greater frequency of violence).
1.3
1.3. Analysis
Comparison 1 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults, Outcome 3 Attitudes towards relationship violence (higher score = less accepting of dating violence).
1.4
1.4. Analysis
Comparison 1 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults, Outcome 4 Behaviour towards relationship violence (higher score = more positive behaviour).
1.5
1.5. Analysis
Comparison 1 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults, Outcome 5 Knowledge of relationship violence (higher score = better knowledge).
1.6
1.6. Analysis
Comparison 1 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults, Outcome 6 Skills related to relationship violence (higher score = better skills).
2.1
2.1. Analysis
Comparison 2 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults: subgroup analyses, Outcome 1 Knowledge of relationship violence (higher score = better knowledge).
2.2
2.2. Analysis
Comparison 2 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults: subgroup analyses, Outcome 2 Episodes of relationship violence (events).
2.3
2.3. Analysis
Comparison 2 Educational and skills‐based interventions for preventing relationship and dating violence in adolescents and young adults: subgroup analyses, Outcome 3 Attitudes towards relationship violence (higher score = less accepting of dating violence).
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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References to studies excluded from this review

Baumann 2004 {published data only}
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Callahan 2003 {published data only}
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Echols 1998 {published data only}
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Edwards 2000 {published data only}
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Foshee 2000 {published data only}
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Gidycz 1995 {published data only}
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Gidycz 2007 {published data only}
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Hanson 1993 {published data only}
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Holcomb 1993a {published data only}
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Jensen 1993a {published data only}
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Jouriles 2009 {published data only}
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Kilian 1996 {published data only}
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Krajewski 1996 {published data only}
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Lavoie 1995 {published data only}
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Lonsway 2000 {published data only}
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Melendez 2003 {published data only}
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Michener 1997 {published data only}
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Pittman 2000 {published data only}
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Proto‐Campise 1998 {published data only}
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Rothman 2006 {published data only}
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Sanchez‐Cesareo 2002 {published data only}
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Taylor 2010 {published data only}
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Weisz 2001 {published data only}
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Wolf 2004 {published data only}
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References to studies awaiting assessment

Abrams 1992 {published data only}
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Avina 2005 {published data only}
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Bernardo 1994 {published data only}
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Bond 1995 {published data only}
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Brown 2002 {published data only}
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Chrappa 1991 {published data only}
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Deiter 1994 {published data only}
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Halvorson 2007 {published data only}
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Heimerdinger 2006 {published data only}
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Hill 1995 {published data only}
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Holcomb 1993 {published data only}
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Lawson 2006 {published data only}
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Layman‐Guadalupe 1996 {published data only}
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Murphy 1997 {published data only}
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Northam 1997 {published data only}
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Sanchez 2011 {published data only}
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Walther 1986 {published data only}
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