This cluster randomized controlled trial tested the effectiveness of a brief relationship abuse education and counseling intervention in school health centers.
Data files sharp_abuse_data_archive.sas7bdat and sharp_blt2exit_long_data_archive.sas7bdat: These components were conducted via baseline survey, post-clinic visit exit survey, and follow-up survey three months post-intervention. Participants were recruited from all 8 school health centers (SHCs) from September to December 2012. All follow-up surveys were completed by June 2013.
Baseline assessment: Once assent for the patient survey was secured, study staff set up a laptop computer with the audio computer assisted survey (ACASI) to complete the baseline assessment. It took 15 minutes to complete this assessment on average. Following completion of the survey, patients received SHC services.
Procedures for intervention: The individual-level intervention for patients, described above, was conducted as an integrated component during the patient's visit with health care providers at intervention SHCs. Providers reported that on average, it took a minute or less to complete with most patients, but went longer with patients who disclosed adolescent relationship abuse (ARA).
Post-visit assessment: Immediately following their clinic visit, all participants completed an exit survey. The purpose of the survey was to assess whether or not patients received the intervention. These measures were used to ensure fidelity to the intervention and to perform intensity-adjusted analyses. It took approximately two minutes for patients to complete this survey.
Follow-up assessment: Participants were contacted for the follow-up assessment 3 months after their baseline assessment using patient-provided contact information. Participants were reminded that their participation was voluntary and offered three methods of completing the assessment: 1) same setting as baseline, using ACASI on a laptop in a private room; 2) telephone survey with study staff; and 3) online survey. For those completing the assessment via telephone or the internet, the study staff verified that the participants had a safe and private place in which to answer the survey. Safety protocols were established and communicated to participants (e.g., if interrupted during the phone call, a participant could use a pre-established safety word or simply hang up).
Data file sharp_chart_data_archive_icpsr.sas7bdat: Chart extraction was conducted with medical records for those participants gave permission for reviewing their medical record and who had signed a HIPPA authorization form.
Data file SHARP_Provider Immediate Post_0829 and 0905 training_final-ICPSR.dta: Surveys with providers in the intervention SHCs were conducted prior to their training and six months after the training.
Data file SHARP_Provider Pre and Followup_final.dta-ICPSR.dta: Healthcare provider and staff responses to pre-training, and 4-5 month post-training surveys are included in this data file.
Focus groups: Focus groups were conducted with each student outreach team following the conclusion of data collection. Discussions focused on awareness about ARA, the school-wide campaign, using the SHC as a resource, and what else can be done to prevent ARA in schools. The focus group discussions were audio-recorded, transcribed, and coded iteratively by two members of the investigative team. Codes focused on youth descriptions of student outreach team activities, peer impressions of the ARA prevention activities, and acceptability of the SHARP intervention. The data from these focus groups are not available as part of this collection.
For data files sharp_abuse_data_archive.sas7bdat and sharp_blt2exit_long_data_archive.sas7bdat, eleven school health centers (SHCs) in Northern California already part of the California School-Based Health Alliance were recruited to participate in this study. Several of the SHC schools were participating in the federal Safe and Supportive Schools (S3) project, which involved school climate interventions to reduce bullying and violence, which was accounted for in the randomization via stratification. Two of the clinics shared providers, thus were treated as a single cluster. Cluster randomization was selected as the intervention was available to all patients served by a clinic. Ten clinic clusters were evenly randomized into intervention and control arms by using computer-generated randomization. After randomization and before participant enrollment, 3 schools withdrew when new school administrators determined they did not want the SHC participating in research, leaving 8 SHCs (7 clusters: 4 intervention, 3 control) as the final sample.
For data file sharp_chart_data_archive_icpsr.sas7bdat, chart extraction was conducted with medical records for those participants gave permission for reviewing their medical record and who had signed a Health Insurance Portability and Accountability Act of 1996 (HIPAA) authorization form.
For data files SHARP_Provider Immediate Post_0829 and 0905 training_final-ICPSR.dta and SHARP_Provider Pre and Followup_final.dta-ICPSR.dta, all SHC staff participation in the trial was voluntary. As a condition of participation, all clinics completed a Memorandum of Understanding that clearly stated willingness of the SHC director and staff to participate in the study, and that participating providers would complete an on-line certified educational training on human subjects research. At the intervention sites, participation in the study's intervention training was strongly encouraged but attendance was not a condition of employment at the SHC. Health care providers and staff were told the pre- and post-training surveys were voluntary. At the control sites, providers were told that they may voluntarily receive the study's intervention training after the data collection phase was complete.
For data files sharp_abuse_data_archive.sas7bdat, sharp_blt2exit_long_data_archive.sas7bdat, and sharp_chart_data_archive_icpsr.sas7bdat: Adolescents age 14-19 in northern California in 2012-2013
For data files SHARP_Provider Immediate Post_0829 and 0905 training_final-ICPSR.dta and SHARP_Provider Pre and Followup_final.dta-ICPSR.dta: School health centers in northern California in 2012-2013
For data files sharp_abuse_data_archive.sas7bdat, sharp_blt2exit_long_data_archive.sas7bdat, and sharp_chart_data_archive_icpsr.sas7bdat: Individual
For data files SHARP_Provider Immediate Post_0829 and 0905 training_final-ICPSR.dta and SHARP_Provider Pre and Followup_final.dta-ICPSR.dta: Clinic
School climate data for this study came from staff-reported California School Climate Survey (CSCS) and student-level California Healthy Kids Survey (CHKS) using the Fall 2011-12 (pre-SHARP timepoint) and Fall 2013-14 wave (post-SHARP) data.
audio computer-assisted self interview (ACASI)
Data files sharp_abuse_data_archive.sas7bdat (n=1,011; 272 variables) and sharp_blt2exit_long_data_archive.sas7bdat (n=1,949; 259 variables) contain nearly the same variables. These include questions related to demographics, general self efficacy (how the respondents thought of themselves), recognition of abusive behavior, recognition of sexual or reproductive coercion, and healthy relationships (what was important to the respondents u in a person they were going out with or dating). Respondents were also asked about intentions (what the respondents might do in certain situations), sexual intercourse history, violence victimization, cyber or tech abuse, non-partner violence victimization, and knowledge and use of available services. Additionally there were questions regarding birth control, pregnancy, pregnancy prevention, self efficacy health, reproductive coercion harm reduction self-efficacy, and reproductive coercion harm reduction action. Lastly, respondents answered questions about their clinic visit, disclosure of adolescent relationship abuse (ARA), their provider talk, and their attitudes towards their health care providers and the clinic. The date file sharp_abuse_data_archive.sas7bdat contains additional variables which collapse other variables or create scores.
Data file sharp_chart_data_archive_icpsr.sas7bdat (n=936; 24 variables) includes date of visit, documentation that safety brochure given, documentation of reproductive coercion assessment, documentation of adolescent relationship abuse assessment, disclosure of adolescent relationship abuse, and if positive disclosure, provider documentation of what they did for the patient.
The data file SHARP_Provider Immediate Post_0829 and 0905 training_final-ICPSR.dta (n=38; 21 variables) contains variables related to the respondents' views of how the training increased understanding in certain areas and what actions related to ARA the respondents might take following the training.
The data file SHARP_Provider Pre and Followup_final.dta-ICPSR.dta (n=66; 102 variables) contains variables regarding professional development, professional role, actions related to ARA, and reasons for not addressing ARA. There are also questions related to clinic preparedness for ARA, ongoing support, clinic participation in education, and demographic information. Respondents also answered questions related to post-training ARA confidence, actions related to ARA post-training, and post-training communication.
Ninety-five percent of eligible clients participated in the study.
Several Likert-type scales were used in data files sharp_abuse_data_archive.sas7bdat, sharp_blt2exit_long_data_archive.sas7bdat, SHARP_Provider Immediate Post_0829 and 0905 training_final-ICPSR.dta, and SHARP_Provider Pre and Followup_final.dta-ICPSR.dta.