Purpose: This practical implementation report describes a comprehensive teen dating violence prev... more Purpose: This practical implementation report describes a comprehensive teen dating violence prevention model—Dating Matters®—and the approach taken to maximize its potential for widespread dissemination through development of the Dating Matters Toolkit. Dating Matters has evidence of effectiveness for preventing teen dating violence and other adolescent risk behaviors from a multi-site randomized controlled trial. Identifying strategies that reduce barriers to the dissemination and implementation of evidence-based comprehensive prevention models, like Dating Matters, is critical to their widespread adoption. Lessons learned from creating the Toolkit can inform the development and dissemination of similar comprehensive prevention strategies and speed their adoption and use in the field. Approach: We engaged in a multi-pronged, data-driven approach to maximize adoption, implementation, and maintenance of the Dating Matters model based on multiple data sources and lessons learned from...
Teen dating violence (TDV) is associated with a variety of delinquent behaviors, such as theft, a... more Teen dating violence (TDV) is associated with a variety of delinquent behaviors, such as theft, and health- and delinquency-related risk behaviors, including alcohol use, substance abuse, and weapon carrying. These behaviors may co-occur due to shared risk factors. Thus, comprehensive TDV-focused prevention programs may also impact these other risk behaviors. This study examined the effectiveness of CDC’s Dating Matters®: Strategies to Promote Healthy Teen Relationships (Dating Matters) comprehensive TDV prevention model compared to a standard-of-care condition on health- and delinquency-related risk behaviors among middle school students. Students (N = 3301; 53% female; 50% black, non-Hispanic; and 31% Hispanic) in 46 middle schools in four sites across the USA were surveyed twice yearly in 6th, 7th, and 8th grades. A structural equation modeling framework with multiple imputation to account for missing data was utilized. On average over time, students receiving Dating Matters scor...
The article “Middle School Effects of the Dating Matters® Comprehensive Teen Dating Violence Prev... more The article “Middle School Effects of the Dating Matters® Comprehensive Teen Dating Violence Prevention Model on Physical Violence, Bullying, and Cyberbullying: a Cluster-Randomized Controlled Trial”, written by Alana M. Vivolo-Kantor, Phyllis Holditch Niolon, Lianne Fuino Estefan, Vi Donna Le, Allison J. Tracy, Natasha E. Latzman, Todd D. Little, Kyle M. Lang, Sarah DeGue, and Andra Teten Tharp, was originally published electronically on the publisher’s internet portal on 12 December 2019 without open access.
“Dating Matters®” is a CDC-developed comprehensive, multi-component teen dating violence (TDV) pr... more “Dating Matters®” is a CDC-developed comprehensive, multi-component teen dating violence (TDV) prevention model, made available to the public in 2019. A longitudinal, multi-site demonstration project found that the model significantly reduced TDV during middle school relative to an evidence-based, single-program intervention (Safe Dates; Niolon et al., 2019 ), when implemented across 46 middle schools in four high-risk urban areas with predominantly Black (55%) and Hispanic (28%) youth participants. Research on the costs of implementing TDV prevention strategies is limited, despite recognition within the field of prevention science that such data are critical to widespread dissemination. The current study adds to the available literature on the cost of dating violence prevention by estimating the budgetary impact from the payer perspective of implementing the comprehensive Dating Matters model, compared to Safe Dates, at four sites over four school years to inform prevention planning in communities. Total costs of implementing Dating Matters were relatively stable within sites over time but varied greatly between sites ( M = $175,452 per year; range = $130,149 to $227,604). The mean per-student cost of Dating Matters was $145.40 but also ranged widely ($20.66 to $324.65) across sites and years. Variation was largely driven by staffing costs and number of students served. As expected, total and per-student costs were substantially lower at all sites for the Safe Dates program ( M = $12,148; range = $2,848 to $17,840; $44.81 per student) compared to Dating Matters. This study provides an estimate from the payer perspective to demonstrate the budgetary impact of Dating Matters. These estimates can help inform implementation decisions and planning by potential funders, communities, and organizations as they seek to support and implement effective TDV prevention strategies. It also adds substantially to understanding of the additional costs associated with a move from single-program interventions to community-wide initiatives.
Despite advances in the sexual violence (SV) prevention field, practitioners still face challenge... more Despite advances in the sexual violence (SV) prevention field, practitioners still face challenges with identifying indicators to measure the impact of their prevention strategies. Public data, such as existing administrative and surveillance system data, may be a good option for organizations to examine trends in indicators for the purpose of program evaluation. In this article, we describe a framework and a process for identifying indicators with public data. Specifically, we present the SV Indicator Framework and a five-step indicator review process, which we used to identify indicators for a national SV prevention program. We present the findings of the indicator review and explain how the process could be used by evaluators and program planners within other developing topic areas. Tracking indicators with public data, in conjunction with other evaluation methods, may be a viable option for state-level program evaluations. We discuss limitations and implications for practice and...
This study extends prior analyses from a 5-year multisite cluster-randomized controlled trial to ... more This study extends prior analyses from a 5-year multisite cluster-randomized controlled trial to examine how the previously reported effects of the Green Dot bystander-based prevention program worked to reduce violence perpetration. Bystander-based interventions are hypothesized to prevent violence by reducing violence acceptance and increasing trained participants’ willingness and ability to actively engage others in violence prevention using safe and effective bystander actions to diffuse or avoid potentially violent situations. We tested this hypothesis by examining whether Green Dot worked to reduce violence through two mediators measured over time: reducing violence acceptance and increasing bystander actions. When accounting for changes in these mediators over time, the effect of this intervention on violence perpetration was hypothesized to be attenuated or explained. At baseline (spring 2010) and annually (2011-2014), all students in recruited high schools (13 intervention, ...
American journal of preventive medicine, Jan 15, 2018
The purpose of this study is to estimate victims' lifetime short-term lost productivity becau... more The purpose of this study is to estimate victims' lifetime short-term lost productivity because of intimate partner violence, sexual violence, or stalking. U.S. nationally representative data from the 2012 National Intimate Partner and Sexual Violence Survey were used to estimate a regression-adjusted average per victim (female and male) and total population number of cumulative short-term lost work and school days (or lost productivity) because of victimizations over victims' lifetimes. Victims' lost productivity was valued using a U.S. daily production estimate. Analysis was conducted in 2017. Non-institutionalized adults with some lifetime exposure to intimate partner violence, sexual violence, or stalking (n=6,718 respondents; survey-weighted n=130,795,789) reported nearly 741 million lost productive days because of victimizations by an average of 2.5 perpetrators per victim. The adjusted per victim average was 4.9 (95% CI=3.9, 5.9) days, controlling for victim, perp...
This study estimated the per-victim U.S. lifetime cost of rape. Data from previous studies was co... more This study estimated the per-victim U.S. lifetime cost of rape. Data from previous studies was combined with current administrative data and 2011 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Rape was defined as any lifetime completed or attempted forced penetration or alcohol- or drug-facilitated penetration, measured among adults not currently institutionalized. Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Average age at first rape was assumed to be 18 years. Future costs were discounted by 3%. The main outcome measures were the average per-victim (female and male) and total population discounted lifetime cost of rape. Secondary outcome measures were marginal outcome probabilities among victims (e.g., suicide attempt) and perpetrators (e.g., incarceration) and associated costs. Analysis was conducted in 2016. The estimated lifetime cost of rape was $122,461 per vi...
Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet lim... more Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years. A cluster RCT was conducted. Kentucky high schools were randomized to intervention or control (wait list) conditions. Green Dot-trained educators conducted schoolwide presentations and recruited student popular opinion leaders to receive bystander training in intervention schools beginning in Year 1. The primary outcome was sexual violence perpetration, and related forms of interpersonal violence victimization and perpetration were also measured using anonymous student surveys collected at baseline and annually from 2010 to 2014. Because the school was the unit of analysis, violence measures were aggregated by school and year and school...
Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by ... more Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by law enforcement (LE), yet research on such fatalities is limited. Using data from a public health surveillance system, this study examined the characteristics and circumstances of these violent deaths to inform prevention. All fatalities (N=812) resulting from use of lethal force by on-duty LE from 2009 to 2012 in 17 U.S. states were examined using National Violent Death Reporting System data. Case narratives were coded for additional incident circumstances. Victims were majority white (52%) but disproportionately black (32%) with a fatality rate 2.8 times higher among blacks than whites. Most victims were reported to be armed (83%); however, black victims were more likely to be unarmed (14.8%) than white (9.4%) or Hispanic (5.8%) victims. Fatality rates among military veterans/active duty service members were 1.4 times greater than among their civilian counterparts. Four case subtypes were examined based on themes that emerged in incident narratives: about 22% of cases were mental health related; 18% were suspected "suicide by cop" incidents, with white victims more likely than black or Hispanic victims to die in these circumstances; 14% involved intimate partner violence; and about 6% were unintentional deaths due to LE action. Another 53% of cases were unclassified and did not fall into a coded subtype. Regression analyses identified victim and incident characteristics associated with each case subtype and unclassified cases. Knowledge about circumstances of deaths due to the use of lethal force can inform the development of prevention strategies, improve risk assessment, and modify LE response to increase the safety of communities and officers and prevent fatalities associated with LE intervention.
International Journal of Forensic Mental Health, 2008
Sarah DeGue, Department of Psychology, University of Nebraska-Lincoln; Mario Scalora, Department ... more Sarah DeGue, Department of Psychology, University of Nebraska-Lincoln; Mario Scalora, Department of Psychology, University of Nebraska-Lincoln; Daniel Ullman, Lincoln Regional Center, Nebraska Department of Health and Human Services; Deanna Gallavan, Department of ...
Existing research on child welfare interventions as mediators of the criminal consequences of chi... more Existing research on child welfare interventions as mediators of the criminal consequences of child maltreatment has focused on juvenile delinquency rather than adult criminality. This study uses a prospective sample of 772 maltreated youth to examine out-of-home placement as a mediator of adult criminality. Arrest data were collected from official records when the full sample was a mean age of 31.8, having ample opportunity for involvement with the criminal justice system. Overall, out-of-home placement showed a neutral or slightly positive effect on adult criminality compared to no placement, consistent with earlier findings. However, prior delinquency and placement instability were significant risk factors for adult criminality. Gender, not race, was identified as a significant moderator of the relationship between placement and adult criminality, with different patterns of response to placement for males and females. Thus, whether placement experiences influence adult criminal consequences of child maltreatment might depend on prior delinquency, placement stability, and gender.
Purpose: This practical implementation report describes a comprehensive teen dating violence prev... more Purpose: This practical implementation report describes a comprehensive teen dating violence prevention model—Dating Matters®—and the approach taken to maximize its potential for widespread dissemination through development of the Dating Matters Toolkit. Dating Matters has evidence of effectiveness for preventing teen dating violence and other adolescent risk behaviors from a multi-site randomized controlled trial. Identifying strategies that reduce barriers to the dissemination and implementation of evidence-based comprehensive prevention models, like Dating Matters, is critical to their widespread adoption. Lessons learned from creating the Toolkit can inform the development and dissemination of similar comprehensive prevention strategies and speed their adoption and use in the field. Approach: We engaged in a multi-pronged, data-driven approach to maximize adoption, implementation, and maintenance of the Dating Matters model based on multiple data sources and lessons learned from...
Teen dating violence (TDV) is associated with a variety of delinquent behaviors, such as theft, a... more Teen dating violence (TDV) is associated with a variety of delinquent behaviors, such as theft, and health- and delinquency-related risk behaviors, including alcohol use, substance abuse, and weapon carrying. These behaviors may co-occur due to shared risk factors. Thus, comprehensive TDV-focused prevention programs may also impact these other risk behaviors. This study examined the effectiveness of CDC’s Dating Matters®: Strategies to Promote Healthy Teen Relationships (Dating Matters) comprehensive TDV prevention model compared to a standard-of-care condition on health- and delinquency-related risk behaviors among middle school students. Students (N = 3301; 53% female; 50% black, non-Hispanic; and 31% Hispanic) in 46 middle schools in four sites across the USA were surveyed twice yearly in 6th, 7th, and 8th grades. A structural equation modeling framework with multiple imputation to account for missing data was utilized. On average over time, students receiving Dating Matters scor...
The article “Middle School Effects of the Dating Matters® Comprehensive Teen Dating Violence Prev... more The article “Middle School Effects of the Dating Matters® Comprehensive Teen Dating Violence Prevention Model on Physical Violence, Bullying, and Cyberbullying: a Cluster-Randomized Controlled Trial”, written by Alana M. Vivolo-Kantor, Phyllis Holditch Niolon, Lianne Fuino Estefan, Vi Donna Le, Allison J. Tracy, Natasha E. Latzman, Todd D. Little, Kyle M. Lang, Sarah DeGue, and Andra Teten Tharp, was originally published electronically on the publisher’s internet portal on 12 December 2019 without open access.
“Dating Matters®” is a CDC-developed comprehensive, multi-component teen dating violence (TDV) pr... more “Dating Matters®” is a CDC-developed comprehensive, multi-component teen dating violence (TDV) prevention model, made available to the public in 2019. A longitudinal, multi-site demonstration project found that the model significantly reduced TDV during middle school relative to an evidence-based, single-program intervention (Safe Dates; Niolon et al., 2019 ), when implemented across 46 middle schools in four high-risk urban areas with predominantly Black (55%) and Hispanic (28%) youth participants. Research on the costs of implementing TDV prevention strategies is limited, despite recognition within the field of prevention science that such data are critical to widespread dissemination. The current study adds to the available literature on the cost of dating violence prevention by estimating the budgetary impact from the payer perspective of implementing the comprehensive Dating Matters model, compared to Safe Dates, at four sites over four school years to inform prevention planning in communities. Total costs of implementing Dating Matters were relatively stable within sites over time but varied greatly between sites ( M = $175,452 per year; range = $130,149 to $227,604). The mean per-student cost of Dating Matters was $145.40 but also ranged widely ($20.66 to $324.65) across sites and years. Variation was largely driven by staffing costs and number of students served. As expected, total and per-student costs were substantially lower at all sites for the Safe Dates program ( M = $12,148; range = $2,848 to $17,840; $44.81 per student) compared to Dating Matters. This study provides an estimate from the payer perspective to demonstrate the budgetary impact of Dating Matters. These estimates can help inform implementation decisions and planning by potential funders, communities, and organizations as they seek to support and implement effective TDV prevention strategies. It also adds substantially to understanding of the additional costs associated with a move from single-program interventions to community-wide initiatives.
Despite advances in the sexual violence (SV) prevention field, practitioners still face challenge... more Despite advances in the sexual violence (SV) prevention field, practitioners still face challenges with identifying indicators to measure the impact of their prevention strategies. Public data, such as existing administrative and surveillance system data, may be a good option for organizations to examine trends in indicators for the purpose of program evaluation. In this article, we describe a framework and a process for identifying indicators with public data. Specifically, we present the SV Indicator Framework and a five-step indicator review process, which we used to identify indicators for a national SV prevention program. We present the findings of the indicator review and explain how the process could be used by evaluators and program planners within other developing topic areas. Tracking indicators with public data, in conjunction with other evaluation methods, may be a viable option for state-level program evaluations. We discuss limitations and implications for practice and...
This study extends prior analyses from a 5-year multisite cluster-randomized controlled trial to ... more This study extends prior analyses from a 5-year multisite cluster-randomized controlled trial to examine how the previously reported effects of the Green Dot bystander-based prevention program worked to reduce violence perpetration. Bystander-based interventions are hypothesized to prevent violence by reducing violence acceptance and increasing trained participants’ willingness and ability to actively engage others in violence prevention using safe and effective bystander actions to diffuse or avoid potentially violent situations. We tested this hypothesis by examining whether Green Dot worked to reduce violence through two mediators measured over time: reducing violence acceptance and increasing bystander actions. When accounting for changes in these mediators over time, the effect of this intervention on violence perpetration was hypothesized to be attenuated or explained. At baseline (spring 2010) and annually (2011-2014), all students in recruited high schools (13 intervention, ...
American journal of preventive medicine, Jan 15, 2018
The purpose of this study is to estimate victims' lifetime short-term lost productivity becau... more The purpose of this study is to estimate victims' lifetime short-term lost productivity because of intimate partner violence, sexual violence, or stalking. U.S. nationally representative data from the 2012 National Intimate Partner and Sexual Violence Survey were used to estimate a regression-adjusted average per victim (female and male) and total population number of cumulative short-term lost work and school days (or lost productivity) because of victimizations over victims' lifetimes. Victims' lost productivity was valued using a U.S. daily production estimate. Analysis was conducted in 2017. Non-institutionalized adults with some lifetime exposure to intimate partner violence, sexual violence, or stalking (n=6,718 respondents; survey-weighted n=130,795,789) reported nearly 741 million lost productive days because of victimizations by an average of 2.5 perpetrators per victim. The adjusted per victim average was 4.9 (95% CI=3.9, 5.9) days, controlling for victim, perp...
This study estimated the per-victim U.S. lifetime cost of rape. Data from previous studies was co... more This study estimated the per-victim U.S. lifetime cost of rape. Data from previous studies was combined with current administrative data and 2011 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Rape was defined as any lifetime completed or attempted forced penetration or alcohol- or drug-facilitated penetration, measured among adults not currently institutionalized. Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Average age at first rape was assumed to be 18 years. Future costs were discounted by 3%. The main outcome measures were the average per-victim (female and male) and total population discounted lifetime cost of rape. Secondary outcome measures were marginal outcome probabilities among victims (e.g., suicide attempt) and perpetrators (e.g., incarceration) and associated costs. Analysis was conducted in 2016. The estimated lifetime cost of rape was $122,461 per vi...
Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet lim... more Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years. A cluster RCT was conducted. Kentucky high schools were randomized to intervention or control (wait list) conditions. Green Dot-trained educators conducted schoolwide presentations and recruited student popular opinion leaders to receive bystander training in intervention schools beginning in Year 1. The primary outcome was sexual violence perpetration, and related forms of interpersonal violence victimization and perpetration were also measured using anonymous student surveys collected at baseline and annually from 2010 to 2014. Because the school was the unit of analysis, violence measures were aggregated by school and year and school...
Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by ... more Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by law enforcement (LE), yet research on such fatalities is limited. Using data from a public health surveillance system, this study examined the characteristics and circumstances of these violent deaths to inform prevention. All fatalities (N=812) resulting from use of lethal force by on-duty LE from 2009 to 2012 in 17 U.S. states were examined using National Violent Death Reporting System data. Case narratives were coded for additional incident circumstances. Victims were majority white (52%) but disproportionately black (32%) with a fatality rate 2.8 times higher among blacks than whites. Most victims were reported to be armed (83%); however, black victims were more likely to be unarmed (14.8%) than white (9.4%) or Hispanic (5.8%) victims. Fatality rates among military veterans/active duty service members were 1.4 times greater than among their civilian counterparts. Four case subtypes were examined based on themes that emerged in incident narratives: about 22% of cases were mental health related; 18% were suspected "suicide by cop" incidents, with white victims more likely than black or Hispanic victims to die in these circumstances; 14% involved intimate partner violence; and about 6% were unintentional deaths due to LE action. Another 53% of cases were unclassified and did not fall into a coded subtype. Regression analyses identified victim and incident characteristics associated with each case subtype and unclassified cases. Knowledge about circumstances of deaths due to the use of lethal force can inform the development of prevention strategies, improve risk assessment, and modify LE response to increase the safety of communities and officers and prevent fatalities associated with LE intervention.
International Journal of Forensic Mental Health, 2008
Sarah DeGue, Department of Psychology, University of Nebraska-Lincoln; Mario Scalora, Department ... more Sarah DeGue, Department of Psychology, University of Nebraska-Lincoln; Mario Scalora, Department of Psychology, University of Nebraska-Lincoln; Daniel Ullman, Lincoln Regional Center, Nebraska Department of Health and Human Services; Deanna Gallavan, Department of ...
Existing research on child welfare interventions as mediators of the criminal consequences of chi... more Existing research on child welfare interventions as mediators of the criminal consequences of child maltreatment has focused on juvenile delinquency rather than adult criminality. This study uses a prospective sample of 772 maltreated youth to examine out-of-home placement as a mediator of adult criminality. Arrest data were collected from official records when the full sample was a mean age of 31.8, having ample opportunity for involvement with the criminal justice system. Overall, out-of-home placement showed a neutral or slightly positive effect on adult criminality compared to no placement, consistent with earlier findings. However, prior delinquency and placement instability were significant risk factors for adult criminality. Gender, not race, was identified as a significant moderator of the relationship between placement and adult criminality, with different patterns of response to placement for males and females. Thus, whether placement experiences influence adult criminal consequences of child maltreatment might depend on prior delinquency, placement stability, and gender.
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