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Journal Article

Citation

Ybarra ML. JAMA Netw. Open 2022; 5(11): e2240901.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jamanetworkopen.2022.40901

PMID

36346636

Abstract

The findings of Piolanti et al1 suggest that sexual violence prevention programs may be effective in reducing the perpetration and the experience (ie, as a target of the perpetration) of sexual violence for adolescents age 10 to 19 years. This is one of the first meta-analyses of adolescent sexual violence prevention programs that address behaviors within as well as outside intimate partnerships. More than 35 000 adolescents were represented in the 20 English language studies that were analyzed, of which 11 were conducted in North America, 2 in Europe, and 7 in sub-Saharan Africa. Three of 4 prevention programs were delivered in school-based settings, and 1 of 3 was targeted to a specific gender. Sexual violence outcomes across studies spanned experiences from sexual harassment to forced sex.2,3 Despite these differences in settings, targeted populations, and outcomes, the 12 studies that targeted adolescent perpetration were associated with a 17% reduction in violence, and the 16 studies that targeted adolescent experiences were associated with a 13% reduction in violence. Thus, empowering children and adolescents with the tools to reduce sexual violence before they reach adulthood appears to have a measurable prevention impact.

As noted by the authors, previous meta-analyses have largely found null effects of sexual violence prevention programs. Extant literature has principally examined prevention programs delivered to college-aged youth and adults. Perhaps earlier intervention in childhood and adolescence has a greater impact because sexual behavior is more malleable in these earlier stages of sexual maturity and behavioral development. Once behavioral patterns have emerged and solidified, which is more likely to happen in adulthood, they may be harder to break than had they been intervened upon before they began.

In this regard, it is noteworthy that interventions delivered to high school students and at school appear to have a particularly strong impact. Perhaps this is because the content is being delivered at a teachable moment when the information is most salient and more easily applied. Younger youth are less likely to be in situations where sexual violence might occur and so the content may feel more abstract. This does not mean that prevention programming with adolescents in grade school and middle school should be deprioritized. Indeed, early exposure to information about how to reduce sexual violence has the potential to prime young people such that they may be better able to learn and apply these concepts when they are older. Early exposure could also have secondary effects in areas that are more developmentally relevant, such as bullying. For example, Jemmott et al4 found that an intervention focused on HIV prevention behaviors reduced sexual violence as well. Here, I am suggesting that prevention programs aimed at reducing sexual violence likely also affect secondary outcomes, and this may be particularly true for younger adolescents and children who are less likely to be having sex but are nonetheless tasked with navigating interpersonal relationships. Certainly, analyzing and disseminating findings related to these secondary outcomes is necessary to ensure we have a fuller perspective of the benefit of these prevention programs...


Language: en

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