Title: School-based interventions TO Prevent dating and relationship violence and gender-based violence (STOP-DRV-GBV): systematic review to understand characteristics, mechanisms, implementation and effectiveness
Funder: Department of Health and Social Care

Abstract: Background and aims_x000D_ Violence that occurs between people who are dating or in a relationship (dating and relationship violence) and violence towards others based on gender or sexuality (gender-based violence) are major public health problems. Young people are affected a great deal by these issues, and have negative effects on their health as a result. Dating and relationship violence includes physical, sexual, and emotional violence (for example, hitting a partner, forcing a partner to have sex, or verbal abuse and controlling behaviour). Gender-based violence includes harassment and bullying based on gender or sexuality. Young people affected by these types of violence and young people who are violent in this way are more likely to have mental health problems, use illegal drugs, and engage in risky sex in the long-term. Young people who have been affected also report poorer mental and physical health, and are more likely to be affected by violence again. _x000D_ Many young people affected by these types of violence are of school age, and a lot of these types of violence occurs in schools. Therefore, interventions conducted within schools may be well placed to reach young people affected by these types of violence. Also, interventions that aim to reduce one type of violence may actually reduce both. One reason for this is that dating and relationship violence and gender-based violence often co-exist in relationships. In this research, we will look at evidence for school-based interventions for dating and relationship violence and gender-based violence. We will look at how effective these interventions are and what lessons have been learnt from putting them in place, to support schools that want to prevent these kinds of violence._x000D_ _x000D_ What we will do_x000D_ We will conduct a systematic review; meaning that we will look for published evidence about interventions for dating and relationship violence or gender-based violence, either separately or together. We will also look for evidence of how those interventions were carried out, including interviews and focus groups with staff and pupils who were part of the intervention. _x000D_ _x000D_ The research aims to answer the following questions:_x000D_ 1. What did the interventions do, and why?_x000D_ 2. What helped schools to roll out the interventions and what caused problems?_x000D_ 3. Were the interventions effective? Did they reduce both dating and relationship violence and gender-based violence? And did all students benefit?_x000D_ 4. What parts of the interventions were most effective? How was this different in different schools?_x000D_ 5. Based on the learning from questions 1-4, we will identify what factors in interventions are the most important for reducing both dating and relationship violence and gender-based violence?_x000D_ We will work closely with stakeholders, including a group of young people affected by dating and relationship violence and gender based violence (coordinated by the Association for Young People’s Health) and with two young people’s advisory groups. We will also work directly with schools, and with an advisory group that includes school health experts._x000D_ _x000D_ Dissemination_x000D_ We will share our findings with academic and policy audiences, with schools and with organisations involved in child development and public health. The Association for Young People’s Health will run a dissemination event for the project and we will produce a webinar for the School Health Research Network to share our learning.

Lay abstract: Dating and relationship violence (DRV) and Gender-based Violence (GBV) are important public health problems in the UK, with evidence demonstrating short- and long-term health consequences for both perpetrators and victims. In 2020, Relationship and Sex Education (RSE) will become a statutory subject in England, providing an opportunity for the delivery of interventions to reduce the incidence of DRV and GBV and the subsequent harms they cause. However, the evidence base to support interventions in this context is fragmented, despite evidence that DRV and GBV share common mechanisms and structural features (such as antisocial norms and beliefs, societal gender norms, and inconsistent violence prevention policies in schools). Clarity is needed on the most effective school-based interventions to prevent DRV and GBV, and on the way in which these may be implemented._x000D_ The aim of this systematic review is to synthesise the evidence for school-based interventions to prevent DRV and GBV, to evaluate the clinical and cost effectiveness of those interventions for preventing DRV and/or GBV, and to identify implementation factors and mechanisms of change. The evidence from this review will be used to generate recommendations for the implementation of the most effective school-based interventions for DRV and GBV._x000D_ The research questions are:_x000D_ 1. What are the components and theories of change of evaluated interventions?_x000D_ 2. Are interventions effective and cost-effective in preventing DRV and GBV and reducing social inequalities in these outcomes?_x000D_ 3. What do process evaluations and mediator and moderator analyses suggest about intervention mechanisms and how these are contingent on context?_x000D_ 4. What factors are important for joint effectiveness on DRV and GBV outcomes?_x000D_ 5. What factors affect the implementation of evaluated interventions?_x000D_ Adhering to PRISMA criteria, a systematic review will be conducted to identify: randomised controlled trials (RCTs), economic evaluations, and implementation studies evaluating school-based interventions to prevent DRV and/or GBV. Studies associated with RCTs that evaluate equity impacts and mechanisms of change of evaluated interventions will also be included. Included interventions will target children of school-age (5-18 years), whether as general populations, or those identified as previous victims or perpetrators of DRV and/or GBV. Interventions may be at the individual, classroom, or policy level. Interventions must be, at least in part, conducted in school contexts. Comparators may include business as usual, waitlist control or another active intervention. Meta-analysis of intervention effects and meta-regression of intervention mechanisms will be conducted, where feasible. Qualitative synthesis will be used to address the remaining research questions. Quality appraisal of all included studies will be conducted using validated checklists. The research will be informed at all stages by relevant stakeholders, including young people affected by DRV and GBV, and policy and practice representatives._x000D_ Findings will be informed by engagement with young people led by the Association for Young People's Health and an advisory group of policy and practice stakeholders, and will be disseminated via publications, policy and practice briefings and dissemination events.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE