Toolkit to Incorporate Adolescent Relationship Abuse Prevention Into Existing Adolescent Pregnancy Prevention Programming

Three teens sitting at desks in a classroom

Introduction

The link between teen pregnancy and violence has been documented by researchers for two decades. Understanding the dynamics of adolescent relationship abuse and working to prevent it can help adolescent pregnancy prevention projects meet their mission of promoting the sexual health and overall well-being of young people.

This toolkit, prepared by the Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project for the Family and Youth Services Bureau, will walk sexual health educators and other youth workers through the steps of making relationship violence prevention an integral part of their adolescent pregnancy prevention work.

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Getting Started

This toolkit is designed to help staff of adolescent pregnancy prevention (APP) projects who want to incorporate adolescent relationship abuse (ARA) prevention into their existing programming.  Whether projects are new or established, this toolkit provides practical tools for youth workers to choose from and adapt to best fit their projects and participants.

This toolkit also provides guidance about selecting from the available tools and ensuring high-quality implementation of ARA prevention approaches. Different tools may be useful at different stages of a project and for programs with different goals and levels of funding. This toolkit describes when, how, and why tools should be used if ARA is being addressed. APP projects are encouraged to share this toolkit with their partners.

This toolkit is designed to guide projects that want to incorporate ARA prevention into their programming through this process from start to finish. It is structured in four sections, as depicted in the flowchart below.

ARA Flowchart, showing the process from organizational readiness and planning, selection and adaptation materials to address ARA, Preparation and Implementation, and successful incorporation of ARA prevention into APP projects. All processes are part of Monitoring and Evaluation.

The first section, Organizational Readiness and Planning, is devoted to organizational readiness and planning steps to address ARA, which are especially important for projects that have never addressed ARA before. Youth workers will find information on developing a project plan, strengthening partnerships with relevant organizations, and developing policies and procedures related to ARA prevention and response.

The second section, Selection and Adaptation of Materials, provides tools and practical guidance about selecting materials, including specific lessons and multi-session curricula, to address ARA.  Strategies for selecting materials, as well as guidance about making adaptations to existing APP programs or selected ARA prevention materials to best meet project needs, are also included.

The third section, Preparation for Implementation, includes tools to help projects prepare for implementation of ARA prevention approaches, including orientation and training of selected staff. This section also provides resources related to ARA prevention and response that projects can use and adapt for their target audiences, including youth and parents. 

The fourth section, Monitoring and Evaluation, provides tools that can be used to monitor or evaluate ARA prevention approaches, including those related to evaluation planning and assessment of potential outcomes for participants who receive ARA prevention activities.

The appendix offers additional resources that projects can use for reference and to enhance their staff’s knowledge about ARA. 

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.

1. Organizational Readiness and Planning

Who should use this section:

  • projects that have never worked on ARA prevention;
  • projects that have new staff who need to be educated on ARA prevention; and
  • projects that have not formalized their policies and procedures related to ARA and prevention.

Successfully incorporating ARA prevention into APP programming will largely depend on the readiness of the organization and its partners. For example, the following elements should be assessed when projects want to address ARA: willingness to accept a new ARA prevention approach, the buy-in of key leaders, the buy-in of staff, and a favorable history with similar efforts (e.g., previous project success). An implementation plan is always an important first step. It is also critical to connect with organizations in the community who have expertise in ARA prevention and develop clear policies and procedures for handling cases of disclosure, including questions of confidentiality and mandatory reporting.

1.1. Plan an Approach

Youth workers who choose to begin planning their organization’s or project’s approach to incorporating ARA prevention into APP programming should clearly identify the issues and specific behaviors and topics they want to address, set achievable goals and define success upfront, establish a clear budget, determine the type and extent of activities they will incorporate, and create a realistic timeline. Drafting a written implementation plan or revising an existing implementation plan can help ensure that all stakeholders are informed about selected activities and the rationale for the planned approach. Implementation plans are best developed at the beginning of the process, even if all details are not clear yet; the implementation plan may include information about involving a partner organization with expertise to help with further planning. The plan should be updated as changes or improvements are made.

  • Intimate Partner Violence and Teen Pregnancy Prevention
    Young people look at a laptop computer with an adult helping.Kan, M. L., Ashley, O. S., Strazza, K., Vance, M. M., LeTourneau, K. L., & Martin, S. L. (2012, December). Washington, DC: Administration on Children, Youth and Families, Family and Youth Services Bureau.

    This tool is designed to give practical guidance on incorporating ARA prevention content and materials into APP projects. It will be most useful to projects that choose to address ARA and are in the early stages of planning what their ARA prevention programming will look like. It outlines key planning steps, including reviewing community data related to ARA, using registries of evidence-based programs to identify ARA prevention materials, recruiting and training staff, and identifying community partners and referral resources.

To illustrate ways APP programs could put these tips into practice, two sample project plans are provided below. Programs are encouraged to adapt elements of these plans to fit their process of planning ARA prevention activities.

  • Raising Teen Dating Violence Prevention as a Public Health Priority (PDF, 282KB)
    Pennsylvania Department of Health. (n.d.).
    This report outlines recommendations from the Pennsylvania Department of Health and its partners for building partnerships, instituting programming and policy, and strengthening capacity related to ARA prevention. On pages 10 and 11, the authors describe the methods they used to arrive at their recommendations; APP projects can use similar strategies to develop and prioritize specific goals for their ARA prevention efforts. The work plan (on pages 15-22) shows project goals and objectives, and it outlines strategies (with accompanying personnel, timelines, and resources) for accomplishing them; APP projects can use this section as a template for mapping out their own plan to accomplish goals related to building ARA prevention infrastructure.
     
  • Implementation Plan for ABCD PREP for Adolescent Pregnancy Prevention Project (PDF, 107KB)
    This tool is a hypothetical plan that shows how an APP program might document the proposed implementation plan for addressing both APP and ARA prevention. Programs may use this example plan to consider how their needs assessment findings inform their implementation approach, partnerships, project logic model, and local evaluation plans. Sections of the example plan pertaining to ARA prevention may be adapted by programs for their own use.

1.2. Invest in Relationships

Organizations that choose to incorporate ARA prevention into APP programming may need to partner early in the process with other organizations, including domestic violence (DV) and sexual assault (SA) organizations in the community. 

Strong partnerships with DV/SA organizations will benefit projects by

  • providing experts to consult at every step of the process;
  • giving the project a ready source of trainers and speakers for staff trainings and community events;
  • keeping staff up to date on developments in the DV/SA field; and
  • creating the foundation for referrals when youth or parent participants need them.

Getting Acquainted

Partnering with other organizations involves two phases: getting acquainted and then deepening the relationship in order to work together to implement ARA prevention activities. Successful collaborations involve creating connections between people and organizations toward shared goals, sometimes where none previously existed. 

APP programs addressing ARA should invite ARA experts from the community to participate in discussions or planning. When APP projects are state-wide or multi-site, the state or Tribal domestic and sexual violence coalition might be the logical first contact. These coalitions can also help identify the community-based DV/SA organizations that should be included in early and ongoing collaborative efforts.

  • List of U.S. State/Territory & Tribal Domestic and Sexual Violence Coalitions 
    National Resource Center on Domestic Violence. (n.d.). VAWnet.org. 
    This tool includes a list of state/territory and Tribal domestic and sexual violence coalitions. Youth workers can search by state to identify contact information for coalitions.  This tool is likely to be most useful for organizations that do not already have connections with statewide or local DV/SA organizations or that want to seek out additional partners for implementation of ARA prevention.

Organizations that partner with coalitions or their member programs should spend time sharing information about the APP project. It is important to make time to answer questions about the APP project, including the specific activities that are planned or are already offered in the community.

Coalitions and their member programs can help APP projects learn more about the scope and impact of ARA in the community. APP programs working with partners should make an effort to learn from partners about not only the impact of ARA in their communities, but also the intervention and prevention systems in place.

Deepening the Relationship

When APP programs and their partners begin planning joint activities that have agreed upon objectives, the relationship can be formalized through a written document such as a letter of support, Memorandum of Understanding (MOU), or contract.

A letter of support is the least formal type of written document but signals good will and intent to participate in the project. In contrast, an MOU expresses the specifics of how organizations will work together. It is not a legally binding document, but helps both parties understand their roles and commitments.

  • Brief Instructions for Creating an MOU, a Sample MOU, and a Sample Letter of Support
    Author unknown. (2013). Freepdfz.com. 
    This tool outlines the recommended content for an MOU, including project goals and outcomes, timeline, roles and responsibilities for both lead and partnering agencies, and signatures. The tool then provides a sample MOU between a non-profit agency and a community-based organization; APP projects could adapt this text and tailor it to their projects and partnerships. Finally, for projects that would prefer to make a less formal agreement with partners, the tool provides a sample letter of support. This letter can be adapted for use in enlisting any type of partner in ARA prevention efforts.

1.3. Develop Policies and Procedures

Discussing issues related to ARA will likely result in disclosures from youth participating in APP projects. Before that happens, APP programs should have policies and procedures in place to address these situations, and staff should be trained on these policies.

The tools provided in this section will help APP programs proactively develop or amend policies and procedures related to ARA. Clear, concise organizational policies and procedures

  • take the guesswork out of decision making during stressful moments;
  • ensure a consistent set of actions and response across the organization;
  • educate staff on legal duties and the impact of the law on their work; and
  • communicate organizational values.

APP programs should have policies in place about responding to disclosures, mandated reporting of suspected child abuse and neglect, confidentiality and information sharing, and parental notification and involvement before providing ARA prevention content to project participants.

For each clearly defined policy, there must be corresponding procedures or protocols on how to apply the policy, how it is enforced, whom it affects, and who is in charge. For example:

  • A policy may state that staff must respond promptly and sensitively to any youth disclosing an incident of relationship abuse.
  • The corresponding procedures may explain the necessary steps, from assessing the youth’s immediate safety, to connecting the youth to the staff or referral agency who will discuss the youth’s options, to explaining whether and how parents will be involved and working with the youth to create a safety plan.

APP projects that choose to incorporate ARA prevention may find that they need to develop or reassess their organization or project policies to protect youth receiving services. 

  • Youth Services Policy Development Tool (PDF, 378KB) 
    Break the Cycle. (2012). 
    This tool provides general guidance on policy development and a step-by-step process for building comprehensive, coherent, and youth survivor-centered organizational policies, including which policies a project team addressing ARA should have, why those policies are important, and how to develop those policies effectively. This tool can be used when planning or implementing ARA prevention to ensure that organizational policies are tailored to serve and protect youth who may have experienced ARA. This tool provides information on basic legal definitions and abuse-related terms; different types of policies affecting youth-serving organizations; and confidentiality, mandatory reporting, and minors’ consent to services. It also shows what policies can look like from a youth point of view (page 27) and includes several templates of release forms (pages 29-32).
     

Legal Resources for Mandatory Reporting and Confidentiality

APP programs may have an obligation under their state or Tribal community laws to report incidents of suspected child abuse or neglect.  Mandated reporting laws vary from state to state but generally apply to teachers, mental health counselors, clergy, health care providers, and legal professionals. Frontline staff need to understand laws regarding mandatory reporting and proper reporting protocols, including who is responsible for reporting suspected child abuse or neglect, imminent harm, sexual coercion, or statutory rape, and what kinds of disclosures require a report.

Reporting requirements raise unique concerns for service providers who work with youth experiencing ARA, particularly around the issue of confidentiality. When youth seek assistance and information about ARA, they may assume the information they share will remain confidential. Therefore, staff should be trained to notify youth and parents up front about these reporting requirements and their potential consequences before disclosures occur, so that youth and parents do not feel that their trust has been violated if such reporting occurs.

Tools in this section should be used to inform organizational policy about addressing ARA so that clear policy and procedures are in place; staff are trained on them; staff and their supervisors are knowledgeable about what is expected before information about ARA incidents is learned; and staff inform youth and parents in advance about limitations on confidentiality.

  • Confidentiality and Information Sharing Issues for Domestic Violence Advocates Working with Child Protection and Juvenile Court Systems (PDF, 1.2MB) 
    Davies, J. (n.d.). San Francisco, CA: Family Violence Prevention Fund.
    This publication includes a worksheet for basic legal considerations (pages 22-23). The worksheet includes questions that organizations may need to answer as they develop their policies about responding to ARA when it happens.
  • Summary of Domestic Violence/Sexual Assault Advocate Confidentiality Laws (PDF, 164KB)
    American Bar Association Commission on Domestic Violence. (2007).
    This 2007 state-by-state summary of DV/SA advocate confidentiality laws identifies what information is protected from being shared in court or other proceedings, qualifications necessary for a professional to be considered to be a counselor or advocate, and exceptions to such protections. Youth workers should check for updated laws since 2007.
  • Mandatory Reporters of Child Abuse and Neglect(PDF, 493KB)
    Child Welfare Information Gateway. (2012).
    This report summarizes for each state the professionals and other persons required to report suspected child abuse or neglect; when a report is required; when communication is privileged; whether reports can be made anonymously; and, if not, whether the reporter’s name can be disclosed. Youth workers should check for updated information since 2012.
  • Statutory Rape: A Guide to State Laws and Reporting Requirements (PDF, 1.7MB) 
    Glosser, A., Gardiner, K., & Fishman, M. (2004).
    This report summarizes for each state criminal laws about statutory rape and reporting requirements. Youth workers should check for updated information since 2004. In addition to informing organizational policies, information about the legal age of consent for sexual activity may also be important to share with youth to encourage them to make informed decisions about sexual activity and potential legal consequences.

Tips for Discussing Conditional Confidentiality
adapted from “Understanding Confidentiality and Minor Consent in California”

  • Be direct: Discuss confidentiality and the conditions under which it might be breached before a young person has an opportunity to disclose potentially reportable information.
  • Keep it simple: Tailor the discussion to the youth’s age and context.
  • Communicate caring and concern: Frame the need to breach confidentiality in the context of “getting them help that they might need” or “making sure they are safe,” rather than using the law, policy, or a phrase like “I am a mandated child abuse reporter” as a reason to breach confidentiality.
  • Assure two-way communication: Let the youth know if you are going to share information that they told you.
  • Know the law.
  • Check for understanding: Ask the youth to explain what they understand about conditional confidentiality.
 
Document all communications, understanding, and actions.

Sample Mandatory Reporting Policies and Protocols

APP projects implementing ARA prevention should develop reporting policies and protocols prior to training staff and implementing programming with youth. They should update their policies and protocols when laws change or when the original policies or protocols are found to be unclear or insufficient.

  • Mandatory Reporting and Keeping Youth Safe 
    Broner, N., Embry, V. V., Gremminger, M. G., Batts, K., & Ashley, O. S. (2013). Washington, DC: Administration on Children, Youth and Families, Family and Youth Services Bureau.

    This FYSB Webinar provides tools that can help APP programs develop mandatory reporting policies and protocols.
    • Slide 50 features a list of key elements that should be included in written mandatory reporting policies and procedures, including what, when, and to whom to report. Programs can use this as a checklist when developing their policies and procedures.
    • Slide 42 presents key elements in a protocol for supervising staff throughout the reporting process, including training and documentation. Programs should incorporate these elements into their procedures and review them during staff training and supervision meetings.
    • Slide 43 provides a list of suggested elements to include in a staff mandatory reporting checklist. This may be useful when programs are developing materials for staff. Staff should be reminded to call local numbers regularly to ensure they are in service.
    • Slides 51-53 provide six steps for the mandatory reporting process. These steps can be incorporated into policies and procedures and corresponding staff training.
       
  • Photograph of a young woman looking distressed.Identifying and Responding to Requests for Help, Disclosures, and Distress
    Ashley, O. S. (2012). Presented at the Family and Youth Services Bureau Adolescent Pregnancy Prevention West Regional Training.

    APP programs that choose to address ARA should develop simple, manageable procedures for dealing with disclosures related to ARA. These procedures should be supportive of the youth and should link youth to appropriate services but should also address any legal or compliance issues. This tool will help facilitators and other project staff identify what types of disclosures they may experience and match each to an appropriate response. 

Helping Youth

An important step in responding to disclosure is to connect the youth to appropriate resources and services. Organizations should develop policies and procedures for making referrals when disclosure occurs, including specific organizations to which referrals are made, how referrals are documented, and procedures for follow-up contact with the youth and/or the organizations to which referrals are made. Local referral resources are best. 

  • Teen Dating Violence: Resources for Victims of Teen Dating Violence
    FindYouthInfo. (n.d.).
    APP programs addressing ARA are encouraged to provide resources proactively to all youth, even if youth are not yet in dating relationships or have not reported a problem. In this tool, organizations can find national resources that can be added to handouts provided to youth. It is important for APP programs addressing ARA to work with their partners to add local community resources, including phone numbers or websites, to any lists they distribute. Referral contacts should be tested regularly (e.g., by calling a helpline number) to ensure that they are up to date.

Here is an example of a teen safety card from Futures Without Violence. The card can be provided to all youth participants and includes resources.

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.

2. Selection and Adaptation of Materials to Address ARA

Who should use this section:

  • APP programs that have never worked on ARA prevention;
  • APP programs that would like to use different materials to address ARA than they have in the past; and
  • APP programs that want to adapt existing ARA prevention approaches to better fit their needs.

APP programs vary widely in their implementation structures, available resources, settings, and partners. Therefore, it is important that programs that have chosen to address ARA are thoughtful in selecting an approach and materials that are appropriate. This section offers tools and practical guidance about how to select materials as well as registries that list programs addressing ARA, including individual- and multi-lesson programs. APP programs may choose to select specific lessons or activities to best meet their needs, rather than implementing an entire ARA prevention program.  Involving partners in choosing programs and materials before staff selection and training begins is highly recommended.

Programs will likely want to make adaptations to the selected materials to best suit their unique needs and the needs of their communities. This section provides resources to inform the adaptation process, which may involve adapting existing evidence-based APP programs to integrate ARA prevention content or tailoring existing ARA prevention programs to meet the needs of the target population, project structure, or implementation setting.

2.1. Consider Relevant Selection Criteria

APP programs may want to consider selection criteria for materials to address ARA. Youth workers should use the tools in this section to determine which criteria are important to their project so that they can assess ARA prevention activities against these criteria.

  • Vision for Healthy Relationships Education (PDF, 322KB)
    Futures Without Violence. (n.d.). 
    Using the National Health Education Standards, the National Sexuality Education Standards, and expertise in the area of ARA, Futures Without Violence developed this brief checklist of criteria for healthy relationships content. The checklist can be used to determine whether materials address important risk and protective factors for ARA.
     
  • Training Professionals in the Primary Prevention of Sexual and Intimate Partner Violence: A Planning Guide (page 62) (PDF, 1.6MB) 
    Fisher D., Lang, K. S., & Wheaton, J. (2010). Atlanta, GA: Centers for Disease Control and Prevention.
    This document includes a tool on page 62 that offers a broader perspective, distilled from a large literature review on characteristics of effective prevention programs that target a variety of problem behaviors. This tip sheet on nine principles of effective prevention programs may be helpful to APP projects considering the pros and cons of various programs or activities to address ARA. It provides an at-a-glance summary of each characteristic that programs may want to learn more about and then prioritize among their options.
     
  • An Evaluation of Safe Dates, an Adolescent Dating Violence Prevention Program (PDF, 1.5MB)
    Foshee, V. A., Bauman, K. E., Arriaga, X. B., Helms, R. W., Koch, G. G., & Linder, G. F. (1998). American Journal of Public Health, 88, 45-50.
    Another element to consider when selecting ARA prevention materials is whether they address mediators, or the risk and protective factors that have been shown to account for changes in ARA behavior. In this article, researchers reported that exposure to an ARA prevention curriculum resulted in less psychological abuse, sexual violence, and violence perpetrated against a current dating partner. They determined that changes in ARA norms (changing youth norms or acceptance that ARA is okay), gender stereotyping (changing youth beliefs about roles that boys and girls should have), and awareness of services for helping youth who are victims in abusive and violent relationships accounted for most program effects. To best impact behavior change, APP programs addressing ARA should include activities or approaches that address one or more of these risk and protective factors. Sections 2.3 and 2.4 of this toolkit provide information about programs, and Sections 3.3 and 3.4 include resources that address these mediators.  

    Programs addressing ARA should also consider materials that address the risk and protective factors or abusive behaviors that are salient in their communities and target populations. Staff should use needs assessment or other data to identify which factors are important to address. For instance, an organization might find that alcohol use is a common precursor to abusive behavior among youth in their community. This organization could then choose at least one ARA prevention activity that addresses alcohol use.
     
  • Organize and Match Information Tool (PDF, 1.8MB) in “The Adaptation Guide: Adapting HIV Behavior Change Interventions for Gay and Bisexual Latino and Black Men”
    Centers for Disease Control and Prevention. (2010). Atlanta, GA: Centers for Disease Control and Prevention.
    This tool, found on page 119 of this guide, may help APP programs organize needs assessment data and match potential interventions to this information. Although this tool was originally developed to help organizations select HIV behavior change interventions for another population, it provides a format that could be used by APP programs to match their own needs assessment data to potential ARA interventions. This tool could be used early in a planning stage when selecting an ARA intervention or when adapting an intervention to better fit a project or target population.

2.2. Identify Potential Materials

During the planning stage for ARA prevention activities, and through review of relevant criteria, APP projects may decide that implementing an ARA prevention program is (or possibly is) a suitable approach to meeting their goals. An important next step is to review existing programs to determine which might be appropriate to implement. Some governmental and nonprofit organizations maintain lists of programs that have been proven effective in preventing risk behaviors, including ARA. APP projects can use these lists to learn more about whether programs and approaches are suitable for the project’s target population; whether programs have been effective at addressing the risk and protective factors or outcomes that are important to the project; and whether programs can be implemented with available resources. Several of these lists are included below.

  • National Registry of Evidence-Based Programs and Practices (NREPP) 
    Substance Abuse and Mental Health Services Administration. (n.d.).
    This tool provides a summary for every intervention it reviews and includes a research description of outcomes reviewed, ratings of the quality of the research, ratings of readiness for dissemination, information about studies and materials reviewed, information about program costs, and contact information.  
     
  • Prevention Strategies Guide (PDF, 7.7MB)
    Communities That Care. (n.d.). 
    To identify the programs that fit the target community needs, pages 16-34 of the introduction summarize programs, along with the risk and protective factors addressed, domain(s) in which the program operates (family, school, community, or individual), the target age range of youth served, and the target audience.  Additional information about the programs is found in the Tested Programs (PDF, 195MB) section of this guide, which includes references, contact information, detailed information about how each program works, and information about program effectiveness. 
     
  • FindYouthInfo Substance Abuse, Violence, and Other Risk Behavior Program Directory  
    Interagency Working Group on Youth Programs. (n.d.). 
    This database reflects input from 18 federal agencies. Each program has a quality rating based on the conceptual framework, program fidelity, evaluation design, and empirical evidence. Details provided about each program include target population ages, a brief description of the intervention, evaluation specifications and findings, targeted risk and protective factors, references, and contact information. A page about Preventing Teen Dating Violence also provides brief descriptions of selected ARA prevention programs that have been evaluated.
     
  • Model Programs Guide 
    Office of Juvenile Justice and Delinquency Prevention. (n.d.). 
    This tool categorizes programs based on evidence of effectiveness. The database provides a brief description of each curriculum, the evaluation methodology, the findings, other information (such as cost), and references. Selection of programs can be made by filtering by various characteristics, including program type, ethnicity, gender, age, problem behaviors, target setting, and risk and protective factors. 
     
  • Blueprints for Healthy Youth Development Program Search 
    Center for the Study and Prevention of Violence at the University of Colorado. (n.d.). 
    This tool can be used to search for effective programs by keyword or by selecting among categories of program outcomes, target population, program type and setting, and risk and protective factors. Programs in this database are classified according to the strength of evidence of effectiveness.
     
  • What Works  
    Child Trends. (n.d.). 
    This database allows searches for evidence-based programs based on target population, program characteristics, and outcomes (“dating violence” is one option). The program descriptions provide an overview of the program, target population, detailed description of the program, evaluation approach and findings, and additional sources of information.

Students reading study materials with a teacher.2.3. Choose Materials: Individual Modules or Lessons

Identified below are individual lessons on various topics related to ARA prevention. Each lesson is approximately 45-60 minutes in length. APP programs addressing ARA should consider sequencing of activities and how each lesson is related to the existing APP curriculum or project activities being implemented. For instance, the lessons on gender stereotypes could be implemented early in an APP project because they provide a foundation for thinking about sexuality, sexual decision-making, and relationships.  Programs addressing ARA should choose lessons based on their fit with the target population and planned implementation context (e.g., classroom subject).

Gender Stereotypes

Gender stereotypes are beliefs about roles that boys and girls should have. Beliefs in gender equality are important for youth to prevent ARA. The following tools offer different approaches to this important subject.

  • High School FLASH: Family Life and Sexual Health Grades 9-12, Second Edition 
    Reis, B. Aby, C., Casey, E., Gerber, A., Kesler, K., Lewis, M., et al. (2011). Public Health – Seattle & King County. 
    Lesson 4 (Gender Stereotypes) is a 45-minute lesson in which students learn to define and identify gender stereotypes and how stereotypes impact healthy decision-making and relationships, including the potential for ARA. The session is mapped to the National Health Education Standards and the Washington State Health Education Standards; it is therefore ideal for programs that want to address gender stereotypes in health classes. The lesson provides individual and family homework assignments to encourage thoughtful reflection. It also provides ideas for related activities in other subjects such as art and humanities. 
     
  • The Hunger Games: Gender Empowerment Lesson Plan (PDF, 667KB)
    Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (2012).
    This lesson plan uses the popular young adult novel “The Hunger Games”  to provide an engaging method for exploring concepts of gender, gender stereotypes, and gender equality.  
     
  • It’s All One Curriculum, Volume 2: Activities for a Unified Approach to Sexuality, Gender, HIV, and Human Rights Education (PDF, 2.2MB)
    International Sexuality and HIV Curriculum Working Group (2009). New York: The Population Council, Inc.
    For programs that want a lesson or lessons that delve deeper into the topic of gender, Unit 2 (pages 32-53) is an excellent resource from which to develop an effective unit geared toward local settings or target populations. This curriculum uses a human rights framework and focuses on fostering critical thinking skills. It is intentionally comprehensive, so youth workers can select the content and activities that meet the needs of their project and time constraints. 

Relationship Violence

The lessons below provide in-depth exploration of the dynamics of various forms of ARA, including physical, sexual, and psychological abuse. The modules rely heavily on scenarios to help participants understand how various forms of abuse manifest in relationships.

  • High School FLASH: Family Life and Sexual Health Grades 9-12, Second Edition   
    Reis, B. Aby, C., Casey, E., Gerber, A., Kesler, K., Lewis, M., et al. (2011). Public Health – Seattle & King County.
    Lesson 6 (Sexual Violence) teaches youth to recognize sexual violence, including rape, sexual assault, child sexual abuse, voyeurism, child pornography and exploitation, sexual harassment, and sexting (i.e., using text messages to share sexual content). It devotes considerable time to the issue of consent.  Through scenarios, the lesson explores the impact of alcohol and other drugs, body language, and force. The session is mapped to the National Health Education Standards and the Washington State Health Education Standards and is therefore ideal for APP programs that want to address ARA in health classes. The lesson provides individual and family homework assignments to encourage thoughtful reflection. 
     
  • Safe Dates: An Adolescent Dating Abuse Prevention Curriculum (Lesson 2) (PDF, 797KB)
    Foshee, V., & Langwick, S. (2010). Center City, MN: Hazelden Publishing.
    Lesson 2 (Defining Dating Abuse) explores the issue of ARA by having students list physically and emotionally harmful behaviors, discuss scenarios, and review statistics. As described in Section 2.4, Safe Dates is an evidence-based ARA prevention program designed for 8th and 9th grade students. This lesson is available for free through Hazelden Publishing. 
     
  • Dating Violence 101 Single Day Lesson Plan (PDF, 565KB)
    Break The Cycle. (n.d.). 
    This lesson uses a series of videos (available on YouTube) as the basis for group discussion about different forms of ARA. It provides participants with strategies for safely ending a relationship and for seeking resources for themselves or friends. 

Digital and Electronic Abuse

Digital abuse is a growing form of ARA, particularly among youth. Such abuse can include unwanted, repeated calls or text messages, privacy violations such as breaking into e-mail or social networking accounts, and pressure to send nude or private pictures or videos.

Youth workers should select modules that will resonate with their target populations. Knowledge about which technologies youth are using—and how—will help youth workers to select appropriate lessons.

  • Digital Technology & Teen Relationships – High School Curriculum (PDF, 756KB) 
    Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.). 
    This lesson helps participants identify digital abuse, provides strategies for coping with abusive or inappropriate digital behaviors, and supports helping others who may be in an abusive relationship
     
  • High School FLASH: Family Life and Sexual Health Grades 9-12, Second Edition 
    Reis, B. Aby, C., Casey, E., Gerber, A., Kesler, K., Lewis, M., et al. (2011). Public Health – Seattle & King County.
    Lesson 19 (Sexual Violence: Digital Communication and Safety) primarily utilizes written scenarios to help youth identify online behaviors that can put them at risk of experiencing sexual abuse. The session is mapped to the National Health Education Standards and the Washington State Health Education Standards and is therefore ideal for APP programs that want to address ARA and technology in health classes. The lesson provides individual and family homework assignments to encourage thoughtful reflection.  

If programs do not have time to address digital or electronic abuse with project participants, they should consider sending participants to That’s Not Cool, a national public education campaign to prevent ARA. That’s Not Cool uses digital examples of controlling behavior online and by cell phone to encourage youth to set boundaries about what is, or is not, acceptable relationship behavior.

Other Lessons and Activities

  • Teacher’s guide: Interesting, Fun, and Effective Classroom Activities to Influence Teen Dating Violence Awareness and Prevention (PDF, 53KB)Logo, that's not cool dot com
    American Bar Association. (2006).
    This guide provides suggestions for class activities that increase awareness of ARA and are appropriate for each school subject. It provides ideas for interesting projects and ways to extend an APP program’s efforts to address ARA. 
     
  • Start Relating Before They Start Dating: A Workshop For Parents and Caregivers, and their Teens (PDF, 1.3MB)
    Start Strong Idaho: Building Healthy Teen Relationships. (n.d.).
    This is a 2.5-hour family dinner model where youth and parents separately learn about ARA and strategies for improving parent/caregiver-youth communication, including communication about ARA. Youth and parents then share a meal and practice communication skills. Targeted to parents and youth in middle school, it can be adapted for older audiences.  APP projects may want to use this program if they are interested in engaging parents in ARA prevention efforts but have had or anticipate difficulties in recruiting parents to attend activities in a group setting.  
     
  • Moving from a Relationship Bystander to a Relationship Upstander Workshop Guide (PDF, 1.3MB)
    Start Strong Boston—Boston Public Health Commission and Futures Without Violence. (n.d.). 
    This guide is geared toward parents of middle school youth but is also appropriate for parents of older teens. The goal of the 80-minute workshop is to help parents and caregivers encourage youth to respond to ARA and promote non-violent relationships among their peers. APP programs that already involve parents and caregivers in group activities or are seeking a way to engage parents in a one-time session may be interested in adding this workshop.

2.4. Choose Materials: Multi-session Programs

This section summarizes multi-session ARA prevention programs, including several evidence-based programs. These programs are designed to be implemented through a variety of methods for specific populations and in various settings. They each focus on particular risk and protective factors for ARA. APP programs may not be able to use entire multi-session programs, but may decide to incorporate select sessions or activities from a program. Youth workers should consider the fit of the program with the target population, implementation setting and resources, and community needs; the ease of integration of the program with APP project activities; and whether the program has evidence of effectiveness for the population(s) targeted.

Name Target audience Targeted domains Number of sessions/time Cost and training information Evidence of effectiveness

 

Safe Dates: An Adolescent Dating Abuse Prevention Curriculum
 HTML(2nd ed.) 
Foshee, V., & Langwick, S. (2010).
Center City, MN: Hazelden Publishing.

 

Male and female middle and high school students

Evaluated with 8th and 9th graders

 

Defining healthy relationships and ARA

Understanding and reducing acceptance of ARA

Helping friends, including awareness of available services

Gender stereotypes

Understanding emotions and managing anger

Communication skills

Preventing sexual assault

10 50-minute sessions, poster contest, play

$225 per curriculum manual with CD-ROM

Training not required, but recommended to maintain fidelity of the program; training costs vary by region

Randomized controlled trial over 4 years (2) demonstrated:

Reduced psychological, physical, and sexual ARA perpetration

Reduced physical ARA victimization

Same effects regardless of prior ARA involvement

Same effects for males and females, and for white and non-white youth

 

Families for Safe Dates
 PDF (2 p.)
Hazelden Foundation. (2010).

 

Male and female teens and their caregivers

Evaluated with families of 13- to 15-year-olds

 

Understanding and reducing acceptance of ARA

Comfort and skills communicating about dating and ARA

Anger and conflict management

Recognizing and responding to ARA

Recognizing and preventing date rape

Planning for safe and healthy relationships

6 booklets for teens and parents to complete together at home

Sold as part of Safe Dates curriculum (see box above)

Training not required, but may be included in Safe Dates training

Randomized controlled trial over 3 months (3) demonstrated:

Reduced beliefs that ARA is acceptable

Increased caregiver engagement in ARA prevention

Reduced physical ARA victimization

 

The Fourth R: A Relationships-Based Program for Students
 HTML
Wolfe et al. (2008).

 

Male and female students in 7th through 12th grades

Evaluated with 9th graders

Alternative versions of curriculum are available to meet the needs of different populations

 

The 9th grade curriculum includes:

Personal safety and injury prevention

Healthy growth and sexuality

Substance use and abuse

Varies per grade level. For example:

7th grade: 4 units totaling 27 lessons

8th grade: 4 7-lesson units

9th grade: 3 7-lesson units

Each lesson is 75 minutes long

 

The cost varies by curriculum

9th grade Comprehensive Kit is $695 Canadian, approximately $675 U.S.

Training not required, but available through the developers

Randomized controlled trial over 2.5 years (4) demonstrated:

Reduced ARA perpetration among boys

Higher condom use among sexually active boys

 

The Youth Relationships Manual: A Group Approach with Adolescents for the Prevention of Woman Abuse and the Promotion of Healthy Relationships
 HTML 
Wolfe, D.A., Wekerle, C., Gough, R., Reitzel-Jaffe, D., Grasley, C. et al. (1996).
Sage Publications, Inc. 

 

14- to 16-year-olds with histories of child maltreatment

Information about healthy relationships, power dynamics, and ARA

Communication skills

Conflict resolution skills

Community resources

Social action

18 2-hour sessions delivered in a community-based setting

Curriculum manual available for $118.

Training is not required; the manual includes implementation instructions.

Randomized controlled trial over 2 years (5) demonstrated:

Reduced physical ARA perpetration

Reduced emotional ARA victimization and (for boys) physical ARA victimization

Reduced symptoms of emotional distress

 

Coaching Boys into Men
 HTML
Futures Without Violence. (2008).

 

Male athletes in grades 9 to 11

 

Recognizing and responding to ARA

Gender stereotypes

Personal responsibility for intervening when ARA is witnessed

Weekly, 10 to 15-minute discussions implemented by coaches throughout the sports season

 

Free for download; no training requirements

Randomized controlled trial over 1 year (6) demonstrated:

Reduced ARA perpetration

Reduced negative bystander behaviors (i.e., laughing and going along with peers’ abusive behaviors)

 

Building A Lasting Love
HTML
Langhinrichsen-Rohling, J., & Turner, L. A. (2012). Prevention Science, 13(4), 384-394.

 

The full text of this article is available for purchase through the publisher’s website.

Inner-city, expectant adolescents

Developed and evaluated with African American youth from disadvantaged neighborhoods

Understanding healthy relationships and ARA

Safety planning

Anger and emotion management

Communication and conflict management skills

Stress management skills

4 90-minute sessions

Contact program developer

Randomized controlled trial over 6 weeks (7) demonstrated:

Reduced perpetration of psychological ARA perpetration

Reduced physical ARA victimization

 

Love U2®: Relationship Smarts PLUS
 HTML
Pearson, M. (2008). Berkeley, CA: Dibble Institute. 

 

Male and female students in grades 9 through 12

Healthy relationships, including love and intimacy

Personal values and identity

Peer pressure

Recognizing ARA

Communication skills

Conflict management skills

Parent-teen relationships

Personal responsibility

 

13 1-hour sessions

Instructor’s manual costs $360

Student workbooks cost $75/pack of 10

Training is recommended but not required; training can be customized to staff needs

Quasi-experimental evaluation (8) demonstrated:

Increased relationship knowledge

Reduced verbal aggression

Increased realistic relationship beliefs

Randomized controlled trial over 1 year (9), (10) demonstrated:

Improved relationship beliefs

Increased conflict management skills

 

Expect Respect: A School-Based Program for Preventing Teen Dating Violence and Promoting Safe and Healthy Relationships
 PDF (32 p.)
Ball, B., & Rosenbluth, B. (2010).
Austin, TX: SafePlace. 

 

Male and female middle and high school students

Vulnerable youth who have experienced ARA or violence in their homes

Understanding healthy relationships and ARA

Recognizing and responding to ARA

Gender stereotypes

Expressing and managing emotions

Communication and conflict management skills

Personal responsibility

Youth leadership and peer education

School-wide awareness of ARA and responsibility for ARA prevention

 

Program for vulnerable youth includes 24 sessions in a support group format

Program for youth leadership includes 8 1-hour sessions 

School-wide strategies include a school climate survey, school policies addressing interpersonal violence, and an awareness campaign.

$160 for four books and a CD of resources

No training requirements; training is available and can be customized to staff needs

 

Qualitative data (11) showed:

Increased knowledge about abuse warning signs and abusive behaviors;

Improved skills in building healthy relationships

Single group pre-post evaluation (12) demonstrated:

Increased healthy relationship skills

Reduced ARA perpetration and victimization among a subgroup of students who reported high pre-program levels of ARA perpetration and victimization

 

Love Is Not Abuse: High School Edition
 PDF (80 p.)

 

Male and female high school students

A version for college students is also available

Understanding and reducing acceptance of ARA

Helping friends and family members, including awareness of resources

Help seeking for ARA

Promoting healthy relationships

Digital abuse

 

4 45-minute lessons

Free for download

No training requirements

Not evaluated

 

Lessons from Literature
 HTML
Futures Without Violence, formerly Family Violence Prevention Fund.

 

Male and female middle and high school students

Understanding and reducing acceptance of ARA

Power and control in relationships

Responding to ARA

Personal boundaries and respectful behavior

Integrating ARA into Literature curricula

 

2 lessons are included in the manual, and teachers are encouraged to develop their own lessons using the provided template.

The 2 lesson plans included with the manual each take 3 weeks to complete using daily 55-minute sessions.

Free for download

Not evaluated



For projects that are hoping to implement ARA prevention programming in schools, a document that maps a program to national, state, or district educational standards can be a persuasive school recruitment tool.

Mapping Safe Dates to GA Education Standards
This tool shows how one ARA prevention program, Safe Dates, corresponds to six different Georgia state educational standards.

Projects that are interested in creating a similar document for their school district and ARA prevention program of choice should do the following:

  • Identify relevant educational standards.
  • Standards may exist at multiple levels (national, state, or district).
  • Standards may cover a variety of topics: health, social-emotional learning (e.g., communication, decision-making, conflict resolution), or core academic subjects.
  • Review curriculum manual session by session and page by page to identify goals, objectives, and content that corresponds with educational standards.
  • Create document that summarizes correspondence between educational standards and program.

Share document with school administrators, school prevention and health education coordinators, teachers, or any other individuals whose buy-in is essential for program adoption and success.

2.5. Adapt Materials as Needed

It is unlikely that any one ARA prevention program will be the perfect fit for incorporation into APP programming. A project may not have the resources to implement an ARA prevention curriculum as designed, or program content may overlook or contradict important cultural or logistical considerations for the APP target population. In these situations, APP projects may need to make program adaptations.

Even if ARA prevention programming itself does not need to be adapted, it is possible that the implementation of ARA prevention programming will constitute an adaptation to APP programming. For example, a project might want to implement an ARA prevention lesson between two lessons of an evidence-based APP curriculum. 

Regardless of whether it is an APP or ARA prevention program that is being adapted, adaptations should be made without compromising core components (i.e., key messages, content, and implementation requirements). Core components are not always made explicit in program materials, so youth workers should strive to learn as much as they can about the intent of activities or programs they are using.

The tools in this section will guide APP programs through the process of assessing the need for adaptation, planning for adaptation, implementing and evaluating adapted programming, and refining adaptations if needed.

  • The Adaptation Guide (PDF, 1.8MB)
    Centers for Disease Control and Prevention. (2010). Atlanta, GA: Centers for Disease Control and Prevention. 
    This adaptation guide was designed to help organizations adapt HIV behavior change interventions for another population. However, it provides a number of tools that can be useful for adapting virtually any type of health intervention for any target population, including ARA interventions.
    • The adaptation process diagram on page 16 of the guide graphically represents how a project moves through the process of program selection, adaptation, testing, revision, implementation, and evaluation. It provides a useful overview of the steps that should be included in adaptation work plans and timelines.
    • The chart on page 121 can be used as a template to document the characteristics of a particular program, compare those with project needs, and describe any necessary adaptations. Most of the fields in this chart can be applied to ARA prevention programs, with the exception of the “HIV Transmission Behavior” row, which could be changed to “ARA Behavior.” The checklist on pages 100-101 provides additional suggestions for the kinds of information that can be included in the adaptation chart.
    • The adaptation decision tool (pages 62, 63, 125, and 137) can help projects document the characteristics of specific intervention activities, describe adaptations that will take place, and provide justification for the adaptations, all while maintaining the intent of activities. This can be a useful template not only for planning adaptations, but also for describing adaptations in a process evaluation.
    • Pages 102-105 present various methods to collect data, for instance, on population needs or on outcomes of adapted programs. This section describes surveys, in-depth interviews, focus groups, and observations; it presents the advantages and disadvantages of each.
    • The monitoring and evaluation decision tree (page 73) provides a framework for thinking through, and acting on, monitoring and evaluation data. If a program or adaptation was not effective, the decision tree suggests a series of actions that may improve effectiveness.
  • The ADAPT-ITT Model: A Novel Method of Adapting Evidence-Based HIV Interventions
    Wingood, G. M., & DiClemente,  R. J. (2008). Journal of Acquired Immune Deficiency Syndromes, 47(Suppl 1), S40-S46.
    This article describes the Assessment Decision Adaptation Production Topical experts Integration Training Test (ADAPT-ITT) model phases and methodology. A graphic representation is available in a table on page S42. This adaptation process involves using an innovative pretesting methodology known as theater testing to adapt evidence-based interventions. Theater testing is a type of pretesting methodology that is commonly used to test products such as television advertisements. 

    Using this methodology, participants who are typical of the intended audience (the new target population) are invited to a central location to respond to a product demonstration (i.e., the adapted intervention activities). At the end of the demonstration, participants receive a questionnaire and answer questions designed to gauge their reaction to the product. 

    An example application of ADAPT-ITT to the Sisters Informing, Healing, Living, and Empowering (SIHLE) evidence-based APP program is shown on page S44, and an example adaptation plan for SIHLE is shown on page S45. Regardless of the adaptation process APP programs use, they may need to complete similar tables for their projects to help with planning the adaptation process.  

An APP project may be interested in implementing an ARA prevention program with a racial/ethnic group for whom that program has never been used or evaluated; the project may choose to make cultural adaptations prior to widespread implementation.

Several complementary frameworks are useful in planning cultural adaptations. First, cultural adaptation can involve modification to both surface structure(incorporating the observable characteristics of the target culture, like language or clothing) and deep structure (considering the unique ways that social forces impact health behavior within a particular culture).(13) Second, cultural adaptation comes in two basic forms: modifying program content and modifying the source, mode, or location of program delivery.(14) In order to take a balanced and complete approach to cultural adaptation, projects should consider all of these possible types of adaptations; examples are shown in chart below.

Form of adaptation
Structural level of adaptation Content Source, mode, location
Surface structure Present ARA statistics specific to the target population.
Re-create visual aids (e.g., handouts, posters, videos) to include images of representatives from the target population.
Revise program text to use terms commonly used by the target population.
Tailor program for delivery in a setting that is easily accessible for the target population.
Deep structure Discuss cultural values that may relate to ARA (e.g., related to masculinity/femininity, dating, helping and help-seeking).
Incorporate stories, analogies, and traditions from the target population.
Target population may be more receptive to receiving ARA prevention messages from individuals with particular demographic characteristics, backgrounds, or professions; hire these individuals as implementers.


  • The Cultural Adaptation of Prevention Interventions: Resolving Tensions Between Fidelity and Fit 
    Castro, F. G., Barrera, J., M., & Martinez, J., C. R. (2004). Prevention Science, 5, 41-45.
    This journal article discusses key challenges in implementing evidence-based programming within various cultural contexts. Table 1 (page 42) lists a variety of ways that program participants, program delivery staff, and target communities may differ from those in which programs were originally tested; APP programs could identify their adaptation needs by filling in information about their “program validation group(s)” (found in research literature about the ARA prevention program that they have selected) and “current consumer group” (i.e., APP project target population). The authors also discuss the dimensions and forms of cultural adaptation, which can be a source of ideas for ways to adapt an ARA prevention program to better align with target population characteristics.

  • Finding the Balance: Program Fidelity and Adaptation in Substance Abuse Prevention: A State-Of-The-Art Review (PDF, 593KB)
    Backer, T. E. (2002). Rockville, MD: Center for Substance Abuse Prevention.
    This report reviews research evidence on how fidelity and adaptation relate to program effectiveness. Several sections of this report can serve as useful tools for APP programs planning to adapt ARA prevention programming. Pages 45-46 present six key steps for adapting programs while maintaining fidelity. Page 50 presents unresolved issues in adaptation/fidelity for program implementers; this list can help to make APP program staff aware of challenges that they may face, so that they can be proactive in securing the resources and support that will promote ARA prevention program success.

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.

 

3. Preparation for Implementation

Who should use this section:

  • APP programs that have not conducted staff training on ARA prevention;
  • APP programs that need to re-train staff on their ARA prevention approaches; and
  • APP programs seeking useful resources for project participants.

After selecting an ARA prevention program or materials to be incorporated in their project, youth workers who want to address ARA should prepare for the implementation or use of those materials.  There are several steps that need to take place to ensure successful implementation, including orienting all staff involved in decision-making or planning around the project, selecting and training staff who will implement the new material, and ensuring that the project has adequate resources to distribute. This section will provide APP programs with helpful tools to not only orient staff broadly on concepts related to ARA but also to build their confidence to implement materials. 

Photo of a teacher orientation session.3.1. Orient Staff on ARA Issues

All staff who will be involved in planning and decision-making about an organization’s approaches to address ARA should receive education and orientation regarding ARA issues. Staff should understand the dynamics of ARA, its consequences, and how to address it with youth before planning and implementing ARA prevention content. Increasing staff knowledge about ARA content will benefit APP projects by

  • allowing staff to develop and implement policies and procedures that are sensitive to the dynamics of ARA;
  • giving staff a framework for making decisions about incorporating ARA prevention activities into their projects; and
  • addressing common challenges that arise when discussing ARA with youth.

The tools below can be used to provide universal education to staff when necessary.

  • Dating Matters: Understanding Teen Dating Violence Prevention 
    Centers for Disease Control and Prevention. (2010). 
    This is a 1-hour, free online course for educators, school personnel, youth leaders, and other youth-serving professionals. The course provides an overview of ARA, including statistics, examples, and the impact of violence; information about risk and protective factors for ARA, such as early warning signs; an overview of healthy relationships and guidelines on an educator’s role in teaching about healthy relationships; and a resource center that provides ARA information, curricula, strategies, and other tools. This course can help APP programs provide their staff with a comprehensive overview of ARA as well as ways that they can facilitate respectful relationships in the classroom and respond to a student who confides to them about an unhealthy relationship. Participants can complete the course from any location. Educators can also obtain continuing education units for the course.
     
  • Promoting Healthy Relationships Among Youth: Reducing Teen Pregnancy by Recognizing and Responding to Dating Violence and Reproductive Coercion
    Futures Without Violence. (2012). Presented at the Annual Family and Youth Services Bureau Adolescent Pregnancy Prevention Grantee Conference.
    This presentation includes information on the relationship between ARA and condom/birth control interference, the likelihood of pregnancy among female victims of ARA, and the difficulty of negotiating the use of birth control with abusive partners. The presenters also provided ways to define healthy relationships and to strengthen project activities in defining both ARA and healthy relationships. Lastly, the presenters provided an intervention education tool to help youth identify whether they are in a healthy relationship. APP programs can use this PowerPoint presentation to present the issue of ARA to staff, their board, and volunteers. They should customize it with local information and statistics whenever possible.

3.2. Select and Train Staff on ARA Prevention Approach

Once APP projects have selected a program or activities to address ARA, they will need to select staff to implement those activities. Here are several tips for selecting and screening staff:

  • Select program delivery staff who agree with program messages, for example:
  • ARA is a serious problem.
  • Victims should not be blamed.
  • Both boys and girls can be perpetrators or victims of ARA.
  • Gender stereotypes (expecting boys to act in a certain way and girls to act in a certain way) can be harmful.
  • Select program delivery staff who are willing and comfortable presenters of content, including messages above and sensitive content (e.g., about sexual relationship abuse).
  • Be mindful of the kind of professional background, if any, that a program requires (e.g., school teacher, nurse, police officer).
  • To reduce staff turnover, make logistics (e.g., time commitment, travel, payment) clear at the outset of the recruitment process.
  • Consider planning for staff turnover by selecting more than a bare minimum number of implementers.
  • Selecting staff that are supportive of, and motivated by, your project will help promote sustainability (15).

Selecting and training staff on the chosen ARA prevention approach are important steps in incorporating ARA prevention approaches into APP programming.  The goal of such efforts is to ensure that staff not only agree with the content of ARA prevention programming, but also have the knowledge and tools they need to successfully implement policies and programs. 

All staff, but especially staff facilitating ARA prevention content, should be trained in the dynamics of ARA, its consequences, and how to address it with youth. Training should be an ongoing effort, not a onetime event.  Staff skills will need to be refreshed, new research and best practices will emerge, new partners can offer new ideas, and staff turnover may occur. A detailed training plan should be developed and reviewed on an annual basis. 

Training staff allows them to feel invested in organizational policies and approaches to ARA prevention.  The following tools can be used to develop a training plan for incorporating ARA topics into APP projects as well as to build the confidence and competence of staff who will be implementing ARA prevention programming. In-person training for staff is ideal, and often local or state domestic and sexual violence organizations can help arrange such trainings.  If in-person training is not possible, the tools in this section can still help APP programs to educate their staff. 

Training on ARA and implementation of ARA prevention content can trigger painful memories and feelings for staff. Talking about the sensitive topics of DV, relationship abuse, reproductive coercion, and the effects of ARA on youth can be emotional regardless of whether a person has had any direct experiences with abuse.  Project managers should be sensitive to possible trauma history when screening, training, and providing supervision and support to staff for implementation.

  • Training Professionals in the Primary Prevention of Sexual and Intimate Partner Violence: A Planning Guide (PDF, 1.6MB)
    Fisher, D., Lang, K. S., Wheaton, J. (2010). Atlanta, GA: Centers for Disease Control and Prevention.
    This guide is intended for state-level entities and local community-based organizations that provide training to professionals within and outside of their own organizations on sexual and intimate partner violence. This guide may assist APP programs in developing and implementing a training plan that promotes staff knowledge about sexual and intimate partner violence and builds their skills and practices to prevent ARA. 

    Tip sheets on who to train (pages 52-61), which include suggested training content and example participant outcomes, may be useful for deciding which community partners to involve in training. Programs that intend to deliver multiple trainings to a variety of audiences can also use this tool to identify appropriate tailored content for each training.

    The worksheet on background information for training plan development (page 64) can be used to guide planning discussions about training, including what the training will cover, who will participate, and what resources are needed. This tool can help programs identify information gaps that they can work with organization partners to fill in while planning training. Pages 68-69 provide a case study example of the completed tool.

    Youth workers can complete the worksheet on criteria for selecting trainers (page 63) as they interview candidates for trainer positions or consider existing project staff for roles in training other staff on ARA content.

    The tip sheet on expert solutions to the 12 most common training delivery problems of novice trainers (page 80) can be used to select qualified trainers, to provide training of trainers, and to evaluate trainers’ performance and provide ongoing supervision and support.
     
  • Safe Dates: An Adolescent Dating Abuse Prevention Curriculum (2nd ed.) 
    Foshee, V., & Langwick, S. (2010). Center City, MN: Hazelden Publishing.
    As described in Section 2.4, Safe Dates is a 10-session, interactive school-based curriculum that targets attitudes and behaviors connected with ARA. In addition to the lessons, the curriculum includes tips for program delivery staff that APP programs may want to incorporate during staff training about implementation of ARA prevention programs. 

    These tips include establishing ground rules; making sure participants do not use real names when talking about other people’s experiences; being aware that some participants may be experiencing ARA or other abuse; remembering that some participants will feel comfortable talking about sexual violence and others may not; warning participants that complete confidentiality is not guaranteed in a classroom environment; ensuring that participants maintain respect during discussions; prohibiting participants from acting out violent behavior in role plays; and being aware of the important role that culture plays in addressing ARA. 

    Programs whose staff have not had recent experience implementing ARA prevention activities may find these tips particularly useful to prompt discussions and capacity building during staff training.
     
  • Avoiding Victim Blaming 
    Center for Relationship Abuse Awareness. (2013).
    This Website quickly and concisely defines victim blaming, why people do it, and why it is dangerous. It also includes a brief exercise that illustrates how victim blaming feels. This standalone exercise illustrates how it might sound if a robbery victim were subjected to the kind of victim blaming that rape victims sometimes encounter. This information and exercise could be incorporated into staff training and/or ARA prevention programming.
     
  • Hanging Out or Hooking Up: Clinical Guidelines on Responding to Adolescent Relationship Abuse: An Integrated Approach to Prevention and Intervention (PDF, 8.9MB) 
    Miller, E., & Levenson, R. (2013). San Francisco, CA: Futures Without Violence.
    This guide was developed for health care providers who work in youth-serving health care settings, such as school-based health centers, adolescent or pediatric health clinics, and family planning clinics. Organizations whose APP projects involve activities in health care settings can use this guide to train youth-serving health care providers on best practices for preventing, identifying, and addressing ARA. For example, APP staff may want to train health care staff on how to integrate prevention and assessment messages into clinic visits with adolescent patients. 

    Several tools, including the guide’s sample provider scripts, sample safety cards, and all of the provider tips could be used to develop staff training. The guide also offers tips related to sensitive and challenging topics, such as how clinicians can discuss conditional confidentiality with their patients and how to practice patient-centered reporting if a patient discloses abuse for which reporting to authorities is mandated. 

3.3. Provide Resources to Youth

This section provides tools and resources programs can offer to youth and parents who participate in their projects.

Healthy Relationships

The materials below are appropriate for youth. They help promote healthy relationships by focusing on what healthy relationships should be. These resources can be used as-is or adapted to programs’ specific needs.

  • Healthy Teen Relationships Manifesto (PDF, 677KB) 
    Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.).
    This half-page, double-sided resource  describes youth’s rights and responsibilities to have healthy relationships and avoid ARA. It contains a quiz to help youth determine if their relationships are healthy and provides national ARA prevention resources for youth.  This is good to give out when using the Center for Healthy Teen Relationships lesson plans referred to in Section 2.3.
     
  • Healthy Relationship Bookmark (PDF, 483KB) Spanish (PDF, 950KB) 
    Start Strong Idaho: Building Healthy Teen Relationships. (n.d.).
    This is a resource to go along with various curriculum modules. It describes characteristics of healthy relationships and signs of ARA. 
     
  • Healthy Relationship Safety Card for Tribal Communities (PDF, 4MB)

National Indigenous Women’s Resource Center and Futures Without Violence. (2012).
Website for ordering the card for free

This safety card aims to help Native and Indigenous women recognize healthy and unhealthy relationship dynamics and identify how their relationship may impact their health as well as the lives of their children. The card lists specific health issues that may be the result of chronic stress from an abusive relationship, offers suggestions to improve health and safety outcomes, and describes typical services provided by domestic violence and sexual assault advocacy programs. The card may be appropriate to distribute to female participants in APP projects. It contains a list of questions about unhealthy relationships and provides resources.

  • Hanging Out or Hooking Up Safety Card 
    Futures Without Violence. (n.d.). 
    This safety card challenges all youth to consider how their boyfriend/girlfriend treats them by identifying dynamics of healthy relationships and signs that may indicate abuse.  The card also explores how to address excessive text messaging and identifies dynamics of consensual versus pressured sex, including the ability to use birth control. Tips are provided to support friends who may be facing ARA. The card is written in gender-neutral terms and may be used by females or males in either heterosexual or lesbian, gay, bisexual, transgendered, and queer (LGBTQ) relationships. The card may be distributed directly to youth or stocked in specific locations, such as bathrooms or health care exam rooms, and is available for free in English and Spanish.  

How to Recognize ARA

Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.).
This brochure provides information about warning signs for abusive relationships, strategies for responding to the abuse and helping a friend, and resources.  This tool is appropriate for teens who might be afraid their or a friend’s relationship is abusive. 

Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.).

This brochure defines sexual harassment and provides information about warning signs of sexual harassment, strategies for responding to sexual harassment, and helping a friend. 

The National Dating Abuse Helpline is a key resource to provide to participants in APP programs.

  • Call 1-866-331-9474
  • Text “loveis” to 77054
  • Chat on loveisrespect.org

How to Help a Friend

These tools, developed by Break the Cycle, offer advice to young people who want to either discuss healthy relationships with their friends or reach out to a friend who is experiencing ARA. They can be used with all participants.

  • Help a Friend (PDF, 251KB)
    Break the Cycle. (n.d.).
    This brochure gives practical tips on supporting a friend who is experiencing ARA and starting a conversation about healthy relationships safely and sensitively.  
     
  • How Would You Help? Quiz (PDF, 712KB)
    Break the Cycle. (n.d.).
    This quiz provides scenarios reflecting on the best approach to helping a friend who is in an abusive relationship. 

Communicating

  • How Can I Communicate Better? (PDF, 251KB)
    Break the Cycle. (n.d.).
    This brochure gives young people tips for improving communication in their relationships, which may prevent abusive behavior.  
     
  • Conflict Resolution (PDF, 269KB)
    Break the Cycle. (n.d.).
    This brochure describes the difference between conflict in healthy and unhealthy relationships. The two-page handout provides young people with examples of communication and conflict resolution in healthy relationships. It also provides tips for ensuring healthy disagreement as well as examples of how conflict can really be unhealthy or abusive relationship behavior.  
     
  • Healthy Break Ups (PDF, 377KB)
    Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.).
    This brochure provides a quiz for teens to determine when they should break up with a dating partner, strategies for breaking up in a respectful way, and resources if the teen fears breaking up might be dangerous. 

Digital and Electronic Abuse

Digital dating abuse is the use of technologies such as texting and social networking to bully, harass, stalk, or intimidate a partner. Often this behavior is a form of verbal or emotional abuse perpetrated online. In a healthy relationship, all communication is respectful whether in person, online, or by phone. 

  • Cellular Relationship Bookmark (PDF, 1MB)
    Social Netiquette Bookmark (PDF, 424KB)
    Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.).
    These bookmarks reinforce appropriate cellular behavior (like texting) and appropriate social networking behavior. Both bookmarks stress the positive—what good behavior looks like—but also address inappropriate behavior. The bookmarks are available in English and Spanish.  

Safety Planning

A safety plan is a personalized, practical plan that can help a young person identify and avoid dangerous situations and know the best way to react when they are at risk of being abused.  Youth who disclose potential or actual abuse may not be ready to leave the relationship, but staff can help empower the youth with the knowledge of how to act in different scenarios. The tools below can be used to help the youth create a safety plan.

  • Love is Respect Safety Planning Guide 
    Break the Cycle. (n.d.). 
    This interactive Web-based or hardcopy tool provides a comprehensive set of questions for high school or college victims to create a thorough safety plan. This tool can be offered to participants to use on their own (there are helpful informational icons along the way) or with a staff member. It is an interactive Web-based or hardcopy tool that provides a comprehensive set of questions for high school or college victims to create a thorough safety plan. This tool can be offered to participants to use on their own (there are helpful informational icons along the way) or with a staff member.
     
  • Create a Teen Safety Plan (PDF, 35KB)
    Futures Without Violence (n.d.). 
    This is a one-page guide that can be given to a participant for reference if they experience ARA. It provides tips about how to prepare to leave a relationship safely.
     
  • Teen Dating Abuse Safety Plan (PDF, 244KB)

End Domestic Abuse Wisconsin: The Wisconsin Coalition Against Domestic Violence (n.d.).  
This safety planning guide provides questions for teens to answer if they are in a relationship or if they plan to break up with a partner. It walks teens through various scenarios and helps them prepare to respond. 

3.4. Provide Resources to Parents

The resources in this section can be given to parents or caregivers any time, but they are especially helpful when APP programs are beginning to implement ARA prevention activities. The more youth workers can help parents discuss ARA with their children and reinforce the information young people receive through project activities, the more the information will be understood and utilized.

General Comprehensive Handbooks

  • A Parent's Handbook: How to Talk to Your Children About Developing Healthy Relationships (PDF, 123KB)
    Love is Not Abuse. (n.d.).
    This booklet was developed to help parents of pre-teens lay the foundation for healthy decision-making patterns and relationships. It includes tips for "starting the dialogue," an interactive quiz, and additional resources.
     
  • Navigating Teen Relationships: A Parent’s Handbook (PDF, 1.3MB)
    Idaho Coalition Against Sexual & Domestic Violence Center for Healthy Teen Relationships. (n.d.).
    This comprehensive handbook for parents of high school students provides information about healthy relationships, appropriate online behavior, warning signs of ARA, and strategies for helping youth understand the issues. Some of the information, such as the description of the laws, is Idaho-specific but could be adapted for any community.  This is a comprehensive guide that would be good to provide to parents and caregivers following a parent education session on related topics.

    There is a similar handbook for parents of middle school students (PDF, 6MB).

Conversation Starters

The resources below are brief and are meant to provide parents and caregivers with ideas about to talk to children so they will listen. Specifically, these resources provide ideas about how to start conversations on healthy relationships and ARA.

  • Jane’s 20 Questions (PDF, 115KB)
    Family Violence Law Center. (n.d.). 
    This  is a list of conversation starters for a parent/caregiver and a youth.  Even if the parent/caregiver does not follow the game format, it provides a list of questions that can enhance communication and provide opportunities to discuss their values on a variety of difficult topics, including ARA. 
     
  • Conversation Cards 
    Futures Without Violence. (n.d.). 
    These are cards with witty prompts that encourage parents to be involved in their teens’ lives and talk to them about ARA. With conversation starters and strategies to help parents help their teens, these are light-hearted reminders for parents. They can be ordered for free.  
     
  • A Parent’s Guide to Teen Dating Violence: 10 Questions to Start the Conversation (PDF, 142KB)

Love is Not Abuse. (n.d.).
This tool provides suggestions to parents and guardians on how they can initiate a conversation with their teens about dating, ARA, and healthy relationships. 

LoveisRespect and Blue Cross/Blue Shield. (2013).

This handout offers answers to tough questions that youth often ask when learning about ARA for the first time. These questions and answers give adults an opportunity to prepare for conversations with teens and to give teens real answers to their difficult questions. This handout can be shared with parents, teachers, and other adults working with youth. 

 

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.

4. Monitoring and Evaluation

Who should use this section:

  • programs that have never monitored or evaluated their ARA prevention efforts; and
  • programs that are planning to implement ARA prevention and are considering ways to monitor their approaches.

As part of their overall planning process, APP programs that want to address ARA should consider plans to monitor program implementation and evaluate participant outcomes. Programs could also make decisions to initiate or improve monitoring and evaluation efforts after program implementation has begun. Regardless of the timing, the tools in this section will help with the process of planning for monitoring and evaluation of ARA prevention activities. The sample evaluation plan is the most general of the tools, presenting the various types of decisions that programs should make prior to beginning their monitoring and evaluation efforts. The remaining tools can help programs make decisions about specific measurement tools to use.

  • The Adaptation Guide (PDF, 1.8MB)
    Centers for Disease Control and Prevention. (2010). Atlanta, GA: Centers for Disease Control and Prevention.
    Pages 107-110 of this tool provide guidelines for developing a monitoring and evaluation plan. 

    Pages 111-112 of the tool show a planning table that APP programs could complete as they finalize specific elements of their plan. Although the examples provided were developed for projects adapting HIV interventions for another population, they can be used as a general guide to how APP programs could complete this table.
     
  • Implementation Plan for ABCD PREP for Teen Pregnancy Prevention Project 
    The example APP evaluation plan on pages 8-10 shows how a program might document the proposed plan for evaluating ARA prevention activities. Programs may adapt this example plan for their own use. The evaluation plan may include information about involving a local evaluator with expertise to help with further planning. A written evaluation plan is critical for communicating with staff, partner organizations, stakeholders, and the FYSB project officer about the proposed approach; the plan should be updated as changes or improvements are made.
     
  • Adolescent Health Programs ARA and Sexual Assault Quality Assessment/Quality Improvement Tool (PDF, 8.9MB)
    Miller, E., & Levenson, R. (2013). San Francisco: Futures Without Violence.
    This tool, found in Appendix B (pages 49-53), is designed to provide project managers and trainers with a guide to assess ARA prevention efforts. The tool uses a checklist format and addresses topics such as assessment method, intervention strategies, project networking and training, self-care and support, data and evaluation, education and prevention, and environmental resources. This tool can be used as an initial assessment for project services and to measure ongoing project progress. It can be administered to program staff or administrators as part of monitoring or process evaluation efforts.           

APP programs can use the tools below to identify survey items to administer to youth as part of outcome evaluation surveys. Here are some tips for how to decide between the many potential youth survey items:

  • Choose measures that directly correspond to the project's ARA prevention goals, objectives, and logic model.
     
  • Choose measures that have been tested with respondents who are similar to the project's target population; correspondence on age group and literacy level are particularly important.
     
  • Keep validated scales intact if possible; minimize deletions and wording changes. Choose shorter scales if time is limited.
     
  • Pilot or pre-test tools to ensure comprehension and honest reporting.
     
  • Use data collection best practices to maintain respondent confidentiality during survey administration.
     
  • Measuring Intimate Partner Violence Victimization and Perpetration: A Compendium of Assessment Tools (PDF, 499KB)
    Thompson, M. P., Basile, K. C., Hertz, M. F., & Sitterle, D. (2006). Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
    This compendium includes more than 20 measurement tools that are designed to measure intimate partner violence perpetration and victimization. The measures assess various types of intimate partner violence, including physical, psychological/emotional, and sexual abuse, as well as stalking. The compendium provides target group, reliability/validity, and source information for each measure, so that users can assess their fit and quality and know where to go for additional information. Note that it is particularly important for APP projects to consider the target population for measures of interest, given that some measures are designed for individuals not in the general adolescent population, but rather for specific groups such as college students, adults, married individuals, and partners of inmates. 

    If an APP project decides to include outcomes of ARA prevention efforts in their local evaluation, this compendium can be used to identify established ways to measure violent behavior. These measures can also be used for needs assessment or surveillance purposes. One ARA prevention goal might be to advocate for widespread ongoing assessment of ARA prevalence in their community; certain measures from this compendium might be appropriate for inclusion in a school district’s recurring youth risk behavior assessment survey.
     
  • Measuring Violence-Related Attitudes, Behaviors, and Influences Among Youths: A Compendium of Assessment Tools, 2nd ed. (PDF, 6MB)
    Dahlberg, L. L., Toal, S. B., Swahn, M., & Behrens, C. B. (2005). Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
    This compendium includes more than 170 measurement tools that can be used to assess attitudes, beliefs, behaviors, and contextual factors related to various forms of youth violence, including ARA. The compendium provides target group, reliability/validity, and source information for each measure so that users can assess their fit and quality and know where to go for additional information. 

    If an APP project decides to include outcomes of ARA prevention efforts in their local evaluation, this compendium can be used to identify established ways to measure short-term outcomes (also known as mediators or risk/protective factors) and long-term outcomes. These measures can also be used for project needs assessment or surveillance purposes. For example, during the planning stage of their ARA prevention efforts, an APP project might choose to measure several possible risk and protective factors among a sample of youth in their community to determine which have the most room for improvement through intervention. 
     
  • Research Findings: Tech Abuse in Teen Relationships Study (PDF, 351KB)
    Picard, P. (2007).
    The above compendia are comprehensive but do not include measures of electronic aggression (i.e., the use of technology or electronic media—such as cell phones, texting, instant messaging, social network sites, e-mail, Web chat, or blogs—to perpetrate psychological abuse), which has increased in visibility in recent years. Research has shown that electronic aggression is associated with other types of ARA, such as psychological, physical, and sexual abuse, as well as stalking.(16

    APP programs that wish to assess electronic aggression among their project participants (e.g., to determine the prevalence in their communities or to assess the impacts of ARA prevention activities targeting electronic aggression) can use some of the same items that were used in this national study on tech abuse in teen relationships. The questions are shown at the bottom of each slide. In particular, slides 11 through 14 show questions that assess electronic aggression perpetration and victimization. Programs interested in collecting data from parents about adolescent electronic aggression can also find useful items in this document.

 

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.

References

  • Duplessis, V., Goldstein, S., & Newlan, S. (2010). Understanding confidentiality and minor consent in California: A module of adolescent provider toolkit. Adolescent Health Working Group, California Adolescent Health Collaborative.
     
  • Foshee, V.A., Bauman, K.E., Arriaga, X.B., Helms, R.W., Linder, G.F. (1998). An evaluation of Safe Dates, an adolescent dating violence prevention program.American Journal of Public Health, 88(1), 45-50.
     
  • Foshee, V. A., Reyes, H. L. M., Ennett, S. T., Cance, J. D., Bauman, K. E, & Bowling, J. M. (2012). Assessing the effects of Families for Safe Dates, a family-based teen dating abuse prevention program. Journal of Adolescent Health, 51(4), 349-356.
     
  • Wolfe, D. A., Crooks, C. V., Jaffe, P. G., Chiodo, D., Hughes, R., Ellis, W., Stitt, L., & Donner, A. (2009). A universal school-based program to prevent adolescent dating violence: A cluster randomized trial. Archives of Pediatric and Adolescent Medicine, 163, 693-699.
     
  • Wolfe, D. A., Wekerle, C., Scott, K. Straatman, A. L., Grasley C., & Reitzel-Jaffe, D. (2003). Dating violence prevention with at-risk youth: A controlled outcome evaluation. Journal of Consulting and Clinical Psychology, 71, 279-291.
     
  • Miller, E., Tancredi, D .J., McCauley, H. L., Decker, M. R., Virata, M. C., Anderson, H. A., O'Connor, B., & Silverman, J. G. (2013). One-year follow-up of a coach-delivered dating violence prevention program: A cluster randomized controlled trial. American Journal of Preventive Medicine, 45(1), 108-112.
     
  • Langhinrichsen-Rohling, J., & Turner, L. A. (2012). The efficacy of an intimate partner violence prevention program with high-risk adolescent girls: A preliminary test. Prevention Science, 13(4),384-394.
     
  • Adler-Baeder, F., Kerpelman, J. L., Schramm, D. G., Higginbotham, B., & Paulk, A. (2007). The impact of relationship education on adolescents of diverse backgrounds. Family Relations, 56, 291-303.
     
  • Kerpelman, J. L., Pittman, J. F., Adler-Baeder, F., Eryigit, S., & Paulk, A. (2009). Evaluation of a statewide youth-focused relationships education curriculum.Journal of Adolescence, 32(6), 1359-1370.
     
  • Kerpelman, J. L., Pittman, J. F., Adler-Baeder, F., Stringer, K. J., Eryigit, S., Saint-Eloi Cadely, H., et al. (2010). What adolescents bring to and learn from relationship education classes: Does social address matter? Journal of Couple and Relationship Therapy, 9, 95-112.
     
  • Ball, B., Kerig, P., & Rosenbluth, B. (2009). Like a family but better because you can actually trust each other: The Expect Respect dating violence prevention program for at-risk youth. Health Promotion Practice, 10(1), 45S-58S.
     
  • Ball, B., Teten, A., Noonan, R., Valle, L., Hamburger, M., & Rosenbluth, B. (2012). Expect Respect support groups: Preliminary evaluation of a dating violence prevention program for at-risk youth. Violence Against Women, 18(7), 746-762.
     
  • Resnicow, K., Soler, R., Braithwaite, R. L., Ahluwalia, J. S., & Butler, J. (2000). Cultural sensitivity in substance use prevention. Journal of Community Psychology, 28(3), 271-290.
     
  • Castro, F. G., Barrera, M., Jr., & Martinez, C. R. Jr. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit.Prevention Science, 5, 41-45.
     
  • Mihalic, S., Irwin, K., Fagan, A., Ballard, D., & Elliott, D. (2004). Successful program implementation: Lessons from Blueprints (PDF, 415KB). Juvenile Justice Bulletin; Office of Juvenile Justice and Delinquency Prevention.
     
  • Cutbush, S. L., Ashley, O. S., Kan, M. L., Hampton, J., & Hall, D. M. (2010, November). Electronic aggression among adolescent dating partners: Demographic correlates and associations with other types of violence. Poster presented at American Public Health Association, Denver, CO.
     

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.

Appendix: Additional Information and Research about Adolescent Relationship Abuse

This section provides more in-depth information about ARA. Broadly defined as a pattern of abuse or threat of abuse against adolescent dating partners, ARA occurs across diverse groups and cultures. Although the dynamics of ARA are similar to adult DV, what makes ARA a unique problem are the forms and experience it takes as well as the challenges it poses in seeking and providing services. ARA occurs in different forms, including verbal, emotional, physical, sexual, and digital; and the experience of ARA may have both immediate and long-term effects on young people.

The documents included in this section highlight the widespread problem of ARA, the different types of ARA, and its impacts on young people. These documents draw from various studies that use different measures. Therefore, data presented in these documents vary. These resources can enhance staff understanding and can provide the basis from which to develop project materials.

Photograph of diverse young women.Specific Populations

  • Dating Violence in Communities of Color (PDF, 203KB)
    Women of Color Network, National Resource Center on Domestic Violence. (2008).
    This "Facts & Stats Collection" paper describes specific issues and distinguishing dynamics that confront teens and young adults of color, highlighting types of abuse and warning signs.
     
  • Teen Dating Violence among Lesbian, Bisexual, and Transgendered Girls (PDF, 39KB) 
    Gunner Gurwitch, The Network/La Red. (n.d.).
    This fact sheet compares violence in lesbian, bisexual, and transgendered (LBT) relationships with violence in heterosexual relationships; discusses tactics of power and control within LBT relationships; highlights barriers faced by LBT youth; and suggests ways to create a welcoming and affirming response.
     
  • Domestic Violence and LGBTQ Youth (PDF, 33KB) 
    Break the Cycle. (2008).
    This fact sheet presents information on dating and domestic violence among LGBTQ young people and the obstacles faced by LGBTQ youth in seeking help.
     
  • Transgender Youth and Dating Violence (PDF39KB)
    Break the Cycle. (2008).
    This fact sheet explains what being transgender means and how transgender youth may experience ARA differently. This fact sheet also discusses barriers transgender youth face in seeking help.
     
  • Runaway and Homeless Youth and Relationship Violence Toolkit 
    National Resource Center on Domestic Violence in collaboration with the Family Violence Prevention and Services Program, Department of Health and Human Services. (2010).
    This toolkit was developed by and for advocates in the runaway and homeless youth and domestic violence and sexual assault prevention fields to help programs create partnerships, meaningful services, and effective intervention and prevention strategies for working with at-risk youth. This toolkit includes many resources that can be used by programs working with runaway and homeless youth.

ARA and Pregnancy

It is important for staff to understand the link between ARA and unintended pregnancy for project participants.

Reproductive coercion includes a spectrum of controlling behaviors that interferes with a person’s reproductive choices such as

  • explicit attempts to impregnate a partner against her wishes;
  • controlling outcomes of a pregnancy;
  • coercing a partner to have unprotected sex; or
  • interfering with birth control methods.

Programs addressing ARA should consider integrating the topic of reproductive coercion into their APP projects. For instance, when defining different types of ARA, programs can include an example of a partner poking holes in a diaphragm or flushing pills down the toilet. Likewise, discussions of contraceptive options can include information about reproductive coercion and pregnancy pressure and how such behavior may impact the choice of contraceptive method.

Digital or Electronic Abuse

  • Technology and Teen Dating Violence (PDF, 130KB)
    Break the Cycle. (2008). 
    This document discusses the challenges service providers face because of advanced technology when working with young people who experience ARA. It also provides suggestions for teaching young people to use technology safely. 
     
  • Emerging Issues Facing Tweens and Teens (PDF, 112KB) 
    Futures Without Violence. (2013).
    This fact sheet provides facts and statistics about electronic abuse including sexting, cyberbullying, and sexual coercion.  

General

  • Understanding Teen Dating Violence Fact Sheet (PDF, 177KB) 
    Centers for Disease Control and Prevention. (2008).
    This fact sheet notes three types of ARA—physical, emotional, and sexual—and draws on research to show that ARA is a public health problem. This fact sheet also presents CDC’s approach to ARA prevention.
     
  • The Connection between Dating Violence and Unhealthy Behaviors (PDF, 453KB) 
    Futures Without Violence. (2010).
    This fact sheet presents data from various studies to show the connection between ARA and unhealthy behaviors. It includes information on risks associated with witnessing violence as well as mitigating factors.

Disclaimer: Educational or instructional materials referenced in this toolkit are for informational purposes only. References to these materials do not constitute endorsement by FYSB.

Suggested citation: Kan, M.L., Arndorfer, E., Ashley, O.S., Palen, L., Krieger, K., Gallopin, C., Menard, A., Keene, C., Vance, M.M., Gragg, F., LeTourneau, K.L., & Gremminger, M.G. (2013).Toolkit to incorporate adolescent relationship abuse prevention into existing adolescent pregnancy prevention programming. Washington, DC: Administration on Children, Youth and Families, Family and Youth Services Bureau.

 

 

The Adolescent Pregnancy Prevention Program’s Training and Technical Assistance and Meeting Logistical Support project led by RTI International for the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau, under Contract No. HHSP23320035651WC developed this toolkit.