Violence Prevention: Primary Prevention Interventions to Reduce Perpetration of Intimate Partner Violence and Sexual Violence Among Youth
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends primary prevention interventions that aim to prevent or reduce perpetration of intimate partner and sexual violence among youth. Evidence shows these interventions decrease the perpetration of intimate partner violence and sexual violence.
The full CPSTF Finding and Rationale Statement and supporting documents for Violence Prevention: Primary Prevention Interventions to Reduce Perpetration of Intimate Partner Violence and Sexual Violence Among Youth are available in The Community Guide Collection on CDC Stacks.
Intervention
Primary prevention programs for youth ages 12 to 24 years aim to prevent or reduce perpetration of intimate partner and sexual violence and promote healthier relationships between peers and partners.
Interventions provide information about warning signs or consequences of intimate partner and sexual violence. They may also include one or more of the following strategies:
- Teach healthy relationship skills
- Promote social norms that protect against violence
- Create protective environments
Interventions may be implemented in schools (middle school, high school, or college), at home, in communities, or in a combination of settings. They may target groups at high risk for violence or the general population, both of which may include youth who have already experienced or perpetrated intimate partner or sexual violence.
This review did not include studies that evaluated programs focused exclusively on reducing the risk of victimization (e.g., self-defense training).
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of 28 studies. Twelve studies came from two existing systematic reviews (Whitaker et al., 2013; DeGue et al., 2014). The remaining studies were identified through an updated search for evidence through June 2016.
Study Characteristics
- Most studies conducted in United States (25); remaining in Canada (2) and Netherlands (1)
- Most implemented in schools (5 middle, 6 high, 1 middle and high, 12 college); some in communities (2) or homes (2)
- Participants: mean age 16.5 years (16 studies), 53.0% female (21 studies)
- Race/ethnicity: Black (median 16.1%, 20 studies), Hispanic (median 10.9%, 17 studies), Asian (median 6.9%, 12 studies), White (median 69.9%, 21 studies), American Indian (2.2%, 6 studies)
Summary of Results
Twenty-eight studies reported results for perpetration (21 studies), victimization (15 studies), and bystander action (9 studies). Below are results from latest follow-up:
- Perpetration: favorable and consistent decreases
- Victimization: inconsistent results
- Bystander action: inconsistent results; consistent increases within six months of intervention
Included studies evaluated interventions that combined educational information with one or more strategies:
- Interventions that taught healthy relationship skills OR promoted social norms to protect against violence reported favorable and consistent decreases in perpetration (7 of 8 studies)
- Interventions that taught healthy relationship skills OR combined teaching with efforts to promote social norms reported favorable and consistent decreases in victimization (10 of 12 studies)
- Interventions that used all three strategies (2 studies) reported decreases in perpetration and victimization
- Interventions that promoted social norms through bystander education and empowerment, engaged men and boys as allies, or both reported favorable and consistent increases in bystander action within six months (9 studies)
Outcomes varied based on the combination of strategies used.
- Interventions that taught healthy relationship skills OR promoted social norms to protect against violence reported favorable and consistent decreases in perpetration (7 of 8 studies).
- Interventions that taught healthy relationship skills OR combined teaching healthy relationship skills with efforts to promote social norms that protect against violence reported favorable and consistent decreases in victimization (10 of 12 studies).
- Interventions that used all three strategies (2 studies) in combination reported decreases in perpetration and victimization.
- Interventions that promoted social norms to protect against violence through bystander education and empowerment, engaged men and boys as allies in prevention, or both reported favorable and consistent increases in bystander action within six months of intervention completion (9 studies).
- While interventions that used other strategy combinations led to favorable results for perpetration and victimization there were too few studies or inconsistent results across studies of those specific strategy combinations to draw conclusions about them.
Summary of Economic Evidence
A systematic review of economic evidence has not been conducted.
Applicability
Findings applicable to interventions for male and female youth from different racial and ethnic backgrounds. Most studies conducted in United States, but findings should be applicable to other high-income countries.
Evidence Gaps
- What combinations of intervention approaches are most effective?
- What are the best measures for the outcomes of perpetration, victimization, and bystander action? More consensus is needed to increase comparability across studies and the ability to synthesize evidence.
- How effective are interventions that seek to create protective environments? More interventions are needed that include components at the community and societal levels.
- How effective are these interventions across different populations, including the following:
- Students in rural settings?
- Lesbian, gay, and bisexual (LGB) youth?
- Youth with intellectual and developmental disabilities?
- High-risk youth?
- How effective are age-appropriate interventions that target younger children (e.g., primary school-age children)? Rates of violence reported in the included studies suggest some students are already experiencing and perpetrating intimate partner violence and sexual violence in middle school. Age-appropriate interventions for elementary school students need to be developed and tested for later impact on SV and IPV outcomes.
Implementation Considerations and Resources
Tailor programs and resources to needs of youth with known risk factors (e.g., family history of violence, hypermasculine attitudes, aggressive peers).
Some intervention effects diminish over time; follow-up may be needed to maintain positive changes, specifically for bystander action (e.g., reminders, intervention boosters).
Successful implementation can be affected by how comprehensive the program is, intervention dosage (intensity), training of staff, and inclusion of multiple teaching methods.
Schools and communities should consider resources (e.g., funding, personnel, community willingness) as they decide which intervention strategies to implement.
School- or community-level changes may be necessary to create environments that support efforts to reduce perpetration and increase bystander action.
The CPSTF recommendation aligns with and supports strategies and approaches described by CDC’s Violence Prevention program on intimate partner violence and sexual violence.
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.