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Program Profile

4th R Curriculum

Evidence Rating: Promising - One study Promising - One study

Program Description

Program Goals/Target Population

The 4th R is an interactive classroom curriculum that aims to reduce youth dating violence by addressing youth violence and bullying, unsafe sexual behavior, and substance use. The program is given to 9th grade high school students in a classroom setting.

 

Program Activities

The curriculum consists of 21 lessons integrated into existing health and physical education curriculum requirements and is administered in sex-segregated classrooms. It does not require additional class time, scheduling, or human resources. The 21 lessons are composed of three units of seven 75-minute classes. The three units focus on the following topics:

 

·         Unit 1: Personal safety and injury prevention

·         Unit 2: Healthy growth and sexuality

·         Unit 3: Substance use and abuse

 

Lessons and activities include teaching youth negotiation, delay, and refusal skills; helping youth define and rehearse responsibilities associated with healthy relationships; and role-playing instructions designed to increase interpersonal and problem-solving skills. Teachers use examples of dating and peer conflicts commonly faced by youth. Detailed lesson plans, video resources, role-playing exercises, rubrics, and handouts are provided for all lessons.

 

Key Personnel

Teachers with specialization in health and physical education deliver the curriculum. Teachers receive a 6-hour training workshop on teen dating violence and healthy relationships as part of the program.

 

Program Theory

The program aims to achieve its goals by emphasizing core relationship issues and pressures in early adolescence and by teaching skills to promote safer decision-making with peers and dating partners. The program targets health promotion through capitalizing on youths' interest in learning about lifestyle issues. It also takes a gender-specific approach to dating violence by emphasizing gender-specific patterns and factors and matching activities accordingly; therefore, the curriculum content is slightly different for boys and girls.

Evaluation Outcomes

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Study 1
Physical Dating Violence
When evaluating results of the 4th R Curriculum, Wolfe and colleagues (2009) found that the rate of physical dating violence (PDV) at follow-up (at the end of grade 11) had increased from 1.1 percent to 8.5 percent for the study sample. PDV was significantly higher for students in the control group versus those in the intervention group (9.8 percent versus 7.4 percent). It should be noted that for the subset of students who were dating in the previous year, the difference between the control and intervention groups was not significant. However, boys in the intervention group were significantly less likely than boys in the control group to engage in dating violence (2.7 percent, compared to 7.1 percent). Girls in both groups showed the same rates of PDV (11.9 percent versus 12 percent). This was also true when the previously dating subsample was analyzed.

Physical Peer Violence
There were no significant differences on physical peer violence between the control and intervention groups (17.1 percent versus 18.4 percent).

Substance Use
There were no significant differences in substance use between the control and intervention groups (47.8 percent versus 52.4 percent).

Condom Use
There were no significant differences in overall condom use between the control and intervention groups (54.1 percent, compared to 55 percent). When broken down by gender, condom use by boys in intervention schools was significantly greater than in the control group (67.9 percent, compared to 58.6 percent). Condom use by partners, however, was significantly less for girls in the intervention group than in the control group (43.9 percent versus 50.7 percent).
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Evaluation Methodology

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Study 1
Wolfe and colleagues (2009) used an experimental design to evaluate the 4th R Curriculum. Thirty rural and urban high schools in Southwest Ontario in Canada were recruited for the study, based on general school populations and the agreement of principals to conduct randomization, teacher training, delivery of the assigned intervention, and evaluation; and to restrict similar programs during delivery. The participants were all students enrolled in the ninth grade Health and Physical Education curriculum within those schools. Schools were randomly assigned to the intervention or control group.

Students in the experimental schools received the 21-lesson intervention curriculum, “Fourth R: Skills for Youth Relationships.” The program was implemented for one-year prior to the evaluation. Students in the comparison schools received a standard Health and Physical Education curriculum in sex-segregated classrooms. Teachers in the comparison schools were required to cover the topics of the three units being taught in the intervention schools, but without any background or training on these topics or access to a structured curriculum.

All participating schools (20 total) had a large student body, were split equally between urban and rural locations, and had comparably experienced teachers. The control and experimental groups were similar in characteristics. More than 80 percent of students’ parents were married and employed, and more than half of the parents had a college degree. Both groups had similar levels of risk behaviors, with 1 percent of participants in both groups showing physical dating violence in the past year. A total of 1,722 students participated in the study (754 in the control group and 968 in the intervention group). Intervention schools had higher consent rates, possibly due to teachers’ efforts in these schools to obtain consent as a result of greater familiarity with the program from the previous pilot year.

Participating students filled out information sheets, consent forms, and a demographic form for parents. A confidential, online survey was given in school at baseline and 2.5 years later, at follow-up. Peer Dating Violence was assessed using eight items from the Conflict in Adolescent Dating Relationships Inventory, an established self-report measure. Students answered “yes” or “no” to questions regarding their actions during fights or arguments with their significant other. Respondents who did not have any dating partners were included in the study, but were give a score of 0 at baseline. Physical peer violence was self-reported, using the National Longitudinal Survey of Children and Youth delinquent behavior inventory. Students were counted if in the last 3 months they injured someone as a result of fight; had used an object other than their hands in a fight; or had hit, slapped, or physically hurt another teen with the intention of scaring or humiliating them. Substance use was assessed using the National Longitudinal Survey of Children and Youth guidelines, and classified to substance abuse if 1 of 4 criteria was met: drinking alcohol 1 or 2 days a week or more, having 5 or more alcoholic drinks at 1 time in the past 30 days, using marijuana 1 to 2 days a week or more, or having tried any other illicit drugs in the past 3 months. Students were not told the objective of the study and completed other health-related survey questions to mask the primary outcome. Condom use was defined as always using a condom during sexual intercourse in sexually active participants.

Categorical data for primary and secondary outcomes were analyzed using two-level hierarchical models to account for clustering of students in schools. Separate analyses were conducted using the subsample of students who were dating the year before follow-up. Eighty-eight percent of students provided data at follow up. Students who had missing data on baseline scores or who were not located for follow-up were omitted from the results. It should be noted that those lost to follow-up versus those who completed the study were more likely to be male and to have reported alcohol problems in grade 9 (25 percent, compared to 16 percent of those who completed the study). A 95 percent confidence interval was used to estimate effect size. Separate analyses were conducted to determine if the intervention had a differential effect for boys and girls.
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Cost

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The cost of the program was calculated by accounting for teacher release time for training and reusable classroom materials. These one-time costs translate to $16 per student in the first year.
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Implementation Information

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The curriculum packet can be purchased online and includes teacher friendly lessons, including lesson objectives, learning expectations, teaching and learning strategies, handout and overhead masters, marking rubrics, DVDs and CD ROMs. A training day can also be arranged to assist teachers with implementation. Online training will be available in January 2012.
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Other Information

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The 4th R Curriculum is also offered, in revised forms, to Health and Physical Education students in grades 8 and 10, ninth through twelfth grade students in English classes, students in alternative education programs, and Aboriginal students. This evaluation was only done on ninth grade students in Health and Physical Education class.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1

Wolfe, David A., Claire Crooks, Peter Jaffe, Debbie Chiodo, Ray Hughes, Wendy Ellis, Larry Stitt, and Allan Donner. 2009. “A School-Based Program to Prevent Adolescent Dating Violence.” Archives of Pediatrics & Adolescent Medicine 163(8):692–99.


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Additional References

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These sources were used in the development of the program profile:

CAMH Centre for Prevention Science. N/d. “Curriculum Resources.” Accessed March 14, 2011.
http://www.youthrelationships.org/curriculum_resources.html

Crooks, Claire V., Peter Jaffe, David A. Wolfe, Ray Hughes, and Debbi Chiodo. 2011. “School-Based Dating Violence Prevention: From Single Events to Evaluated, Integrated Programming.” In Claire M. Renzetti, Jeffrey L. Edleson, and Raquel Kennedy (eds.). Sourcebook on Violence Against Women (2nd edition). Thousand Oaks, Calif.: Sage, 327–49.

Crooks, Claire V., K. Scott, Wendy E. Ellis, and David A. Wolfe. 2011. “Impact of Universal School-Based Violence Prevention Program on Violent Delinquency: Distinctive Benefits for Youth With Maltreatment Histories.” Child Abuse & Neglect 35:393–400.

Wolfe, David A., Claire V. Crooks, Ray Hughes, and Peter Jaffe. 2008. “The Fourth R: A School-Based Program to Reduce Violence and Risk Behaviors Among Youth.” In D. Pepler and W. Craig (eds.). Understanding and Addressing Bullying: An International Perspective. Bloomington, Ind.: AuthorHouse, 184–97.
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Program Snapshot

Age: 14 - 15

Gender: Both

Geography: Rural, Urban

Setting (Delivery): School

Program Type: Classroom Curricula, Conflict Resolution/Interpersonal Skills, School/Classroom Environment, Violence Prevention

Current Program Status: Active

Listed by Other Directories: Model Programs Guide, National Registry of Evidence-based Programs and Practices

Program Developer:
David Wolfe
Program Developer/Director
CAMH Centre for Prevention Science
100 Collip Circle, Suite 100
London N6G 4X8
Phone: 519.858.5144
Fax: 519.858.5149
Website
Email

Researcher:
Claire Crooks
Associate Director/National Coordinator for Aboriginal Projects
CAMH Centre for Prevention Science
100 Collip Circle, Suite 100
London N6G 4X8
Phone: 519.858.5144
Fax: 519.858.5149
Website
Email

Training and TA Provider:
Ray Hughes
National Education Coordinator
Fourth R Project
100 Collip Circle, Suite 100
London N6G 4X8
Phone: 519.858.5144 ext: 25508
Fax: 519.858.5149
Website
Email