School Health Center Healthy Adolescent Relationship Program

Study Overview
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Brief Summary
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This community-partnered participatory study will work within high school health centers (SHCs) to test, via a 2-armed cluster randomized controlled trial, a multi-level intervention to reduce adolescent relationship abuse (ARA) among adolescents ages 14-19. The goal of this study is to examine the effectiveness of the School Health Center Healthy Adolescent Relationships Program (SHARP) intervention in SHCs on individual SHC clients, the SHC clinic environment, and the schools in which the SHCs are located. Evaluation of the intervention will involve random assignment of eight comparable SHCs in the Greater Bay Area of California that provide comprehensive health services, to either intervention or control sites. Adolescent females and males ages 14-19 seeking care at any of these SHCs (N=1200) will be assessed via audio computer-assisted survey instrument (ACASI) at baseline and 16-20 weeks follow-up to examine intervention effects on knowledge and self-efficacy regarding ARA, harm reduction and ARA-related resources as well as intentions to intervene with peers. For youth reporting recent ARA victimization, the investigators will assess for increases in ARA disclosure, resource utilization, as well as reduction in ARA victimization.

Official Title
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School Health Center Healthy Adolescent Relationship Program

Conditions
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Adolescent Relationship Abuse

Intervention / Treatment
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* Behavioral: SHARP Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 14-19 receiving services at one of the eight SHARP Intervention school health centers able to read English or Spanish Exclusion Criteria: clients not of the specified age range clients who are intoxicated or otherwise not able to provide their own consent

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SHARP Intervention<br>School health centers randomized to the SHARP Intervention will be trained to address adolescent relationship abuse with school health center clients. | Behavioral: SHARP Intervention<br>* Providers and staff located in high school school health centers (i.e., nurse practitioners, nurses,physicians, health educators, medical assistants) will be trained to address adolescent relationship abuse with school health center clients using knowledge, skills, and resources gained through the SHARP Intervention training. The training includes strategies to help youth recognize adolescent relationship abuse among themselves and their peers, to learn strategies to increase safety (harm reduction), and to utilize adolescent relationship abuse-related resources.<br>|
| No Intervention: Control<br>School health centers randomized to Control will provide standard of care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recognition of adolescent relationship abuse | Recognition of abusive behaviors -- Between-arm adjusted mean differences on a 9-item summary scale | 4 months | 
| Intentions to positively intervene in adolescent relationship abuse among peers | Intentions to intervene -- Between-arm adjusted mean differences on a 9-item summary scale | 4 months | 
| Knowledge of violence victimization resources | Knowledge of resources -- Between arm differences of summary score of single items which assess the extent to which participants are aware of places they could go for specific support services. | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disclosure of adolescent relationship abuse to school health center providers | Between-arm adjusted differences in proportion disclosing adolescent relationship abuse (ARA) to school health providers at baseline. Comparisons restricted to subgroup of clients reporting ARA on ACASI survey at baseline. | baseline (after clinic visit) | 
| Uptake of adolescent relationship abuse harm reduction and utilization of resources | Between-arm adjusted differences in proportion reporting any use of ARA resources in the 3-month period prior to the follow-up survey. Comparisons restricted to clients reporting ARA on ACASI survey at baseline. | 4 months | 
| Adolescent relationship abuse victimization | Between-arm adjusted differences in proportion screened positive for at least one adolescent relationship abuse (ARA) behavior, based on screening tests for reproductive coercion, intimate partner and sexual violence victimization and psychological abuse. Comparisons restricted to clients reporting ARA at baseline. | 4 months | 
| Knowledge of harm reduction strategies | Participants are presented with a series of harm reduction behaviors to reduce risk for ARA, and asked to what extent they are aware of these strategies and self-efficacy in enacting these behaviors based on a 7-point Likert-type scale | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Health Care Provider, Adolescent, Intervention, Female, Male, Interpersonal Relations, School Health Services, Community-Based Participatory Research, Randomized Controlled Trial, Training Program, Harm Reduction, Prevention, Reproductive Coercion, Tech-Based Abuse, Social Environment, Sexual Partners