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Program Profile: School Health Center Healthy Adolescents Relationships Program (SHARP)

Evidence Rating: No Effects - One study No Effects - One study

Date: This profile was posted on August 10, 2015

Program Summary

A high school-based, relationship abuse prevention program. The goal of the program was to identify students’ knowledge of abusive behaviors and teach them about relationship abuse and resources for its prevention. The program was rated No Effects. There was no significant impact on recognition, use, and knowledge of adolescent relationship abuse resources, and intentions to intervene, but participants had significantly greater increases in recognition of sexual coercion.

Program Description

Program Goals
School Health Center Healthy Adolescents Relationships Program (SHARP) was a universal intervention that addressed adolescent relationship abuse (ARA) in high school settings. The aim of the program was to determine students’ knowledge about ARA and ARA resources, and to teach them about relationship abuse and the availability of ARA resources. 

 Target Population
The program targeted high school students between the ages of 14 and 19 who visited the school health center (SHC). SHARP targeted all students, exclusive of gender, sexual orientation, and reason for clinic visit.

Program Components
The intervention was delivered during routine SHC visits. The intention of the program was to train students on the impact of ARA on their health. The intervention addressed a range of abusive behaviors including cyber-dating abuse and abuse through social media.
Providers were trained on introducing the information and materials, conducting an assessment, and making referrals to advocates. The staff engaged students in very brief discussions on healthy and unhealthy relationships, while going over a palm-sized brochure that they provided to each student, regardless of the reasons for the visits. The brochure, shared with every student, provided information on heathy relationships, ARA resources, and how to help friends. Discussions typically lasted less than a minute, but went longer when ARA was disclosed.

Youth advisory boards organized schoolwide outreach events that provided ARA information, and encouraged students to come to the SHCs. 

Evaluation Outcomes

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Study 1
Recognition of ARA
Miller and colleagues (2015) assessed the baseline to follow-up differences in recognition of adolescent relationship abuse (ARA) between the School Health Center Healthy Adolescents Relationships Program (SHARP) intervention participants and control group students. No significant differences were found between the groups on recognition of ARA.

Recognition of Sexual Coercion
Results indicated that when compared with controls, intervention participants demonstrated significantly greater increases in recognition of sexual coercion from baseline to follow up.

Intentions to Intervene in ARA
No significant differences were found between the SHARP intervention participants and control group students on intentions to intervene in ARA.

Knowledge of ARA Resources
No significant differences were found between the SHARP intervention participants and control group students on knowledge of ARA resources.

Use of ARA Resources
No significant differences were found between the SHARP intervention participants and control group students on their use of ARA resources.
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Evaluation Methodology

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Study 1
Miller and colleagues (2015) evaluated the School Health Center Healthy Adolescents Relationships Program (SHARP) program at 11 school health centers (SHCs) in the California School Based Health Alliance in Northern California. Schools were randomized into clusters, and the final sample comprised 7 clusters: 4 intervention schools and 3 control schools. The intervention was delivered to patients aged 14 to 19 years old in grades 9 through 12 seeking care in any of the SHCs of the participating schools. Although the survey was delivered in both English and Spanish, all students opted for English.

Participants were recruited between September and December 2011 (N=1062), and follow-up surveys were completed 3 months postintervention in 2013. Upon their first visit to the SHC during the timeframe of the study, patients were informed about the study, screened if interested in participating, and (if eligible) escorted to a private area to give consent and participate in the study. A total of 1011 patients completed baseline surveys during their first visits to the SHCs. The pool included students of both genders (females=771, males=240), and the majority were in 12th grade (N=326). Nearly all of the students identified as nonwhite (5% white), with no significant differences between intervention and controls by race/ethnicity. The full sample included students who were Asian (15%), African American (27%), Hispanic or Latina/Latino (36%), Native American or Pacific Islander (5%), white (5%), and multiracial/other (11%). Survey data was collected via computer with questions read through headphones. Follow-up surveys were given at the SHCs at times that were convenient for the participating students (N=939).

Staff at the intervention schools were trained on the SHARP intervention process and required to report the time allocated for reviewing the brochure with the patients during their first SHC visits. Students at the control schools (N=516) were provided the usual care received at the SHCs. In instances in which there was a disclosure of abuse, schools followed traditional protocol, including referring patients to advocacy services.

Existing and researcher-developed scales were used to assess recognition of adolescent relationship abuse (ARA), recognition of sexual coercion, intentions to intervene, and knowledge and use of ARA resources. 
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Cost

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There is no cost information available for this program.
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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
Miller, Elizabeth, Sandi Goldstein, Heather McCauley, Kelley Jones, Rebecca Dick, Johanna Jetton, Jay Silverman, Samantha Blackburn, Erica Monasterio, Lisa James, and Daniel Tancredi. 2015. “A School Health Center Intervention for Abusive Adolescent Relationships: A Cluster RCT.” Pediatrics 135(1):76–85.
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Related Practices

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Following are CrimeSolutions.gov-rated practices that are related to this program:

School-Based Interventions to Reduce Dating and Sexual Violence
This practice includes universal-level prevention and intervention programs in schools that aim to reduce or prevent teen dating violence perpetration and victimization. The practice is rated Effective for reducing perpetration of teen dating violence and improving dating violence knowledge and attitudes. The practice is rated No Effects for reducing teen dating violence victimization.

Evidence Ratings for Outcomes:
Effective - One Meta-Analysis Crime & Delinquency - Violent offenses
Effective - One Meta-Analysis Attitudes & Beliefs - Teen Dating Violence Knowledge
Effective - One Meta-Analysis Attitudes & Beliefs - Teen Dating Violence Attitudes
No Effects - One Meta-Analysis Victimization - Domestic/intimate partner/family violence
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Program Snapshot

Age: 14 - 19

Gender: Both

Race/Ethnicity: Black, American Indians/Alaska Native, Asian/Pacific Islander, Hispanic, White, Other

Geography: Urban

Setting (Delivery): School

Program Type: Crisis Intervention/Response, Leadership and Youth Development, School/Classroom Environment, Children Exposed to Violence, Violence Prevention

Targeted Population: Children Exposed to Violence

Current Program Status: Not Active

Listed by Other Directories: Child Exposure to Violence Evidence Based Guide, Model Programs Guide