Snapshot

Intervention Coach-delivered healthy relationships education for male middle and high school student athletes.

Key populations Adolescent boys to prevent the perpetration of intimate partner violence, specifically adolescent relationship violence.

Outcomes studied Behaviours, gender-based violence, and knowledge, beliefs and attitudes.

Impact of the intervention From the 3 studies, 4 outcomes received an effectiveness rating on our Effectiveness Estimate Tool

Australian evidence 0 studies presented findings from Australia 0 studies reported on the experiences of Aboriginal and Torres Strait Islander people

Risk of bias Of the 3 studies, 2 received ratings of low or medium and 1 received a rating of high risk of bias as determined by our Risk of Bias tool

Intervention description

What are the key characteristics of the intervention?

Coach-delivered healthy relationships education aims to prevent adolescent boys from perpetrating intimate partner violence, specifically adolescent relationship violence.

Approaches target adolescent boys and generally follow a set program of approximately 12 weeks that focuses on healthy versus harmful relationship behaviours, disproving myths surrounding male sexual aggression, and promoting gender-equitable attitudes and positive bystander intervention.

The intervention is delivered by school athletic coaches who receive training and check-ins with violence prevention advocates, as well as a Coaches Kit with educational strategies, resources and lesson guides. All interventions are delivered face-to-face in school settings.

Where is the intervention set? Primarily delivered in middle and secondary school settings.

How is the intervention delivered? This intervention is primarily delivered by a professional athletic coach in a group format. It is usually delivered face-to-face.

How frequently is the intervention delivered? Usually delivered in 12 weekly lessons of approximately 15 minutes each.

What resources and costs are involved? 0 studies comment on costs associated with the intervention.

Theory of change

How is the intervention designed or theorised to work?

The intervention builds on social change theory to increase bystander behaviours by engaging athletic coaches as positive role models to deliver violence prevention strategies and tools to young male student athletes.

Impact

This section speaks to the effectiveness of the studies.

The outcomes measured by the included studies include gender-based violence (specifically intimate partner violence and non-partner sexual violence), attitudes and knowledge (towards gender-based violence and sexual assault) and bystander intervention.

Two studies with very low, low, or moderate risk of bias with appropriate outcome data were used for the effectiveness estimates. The outcomes that these studies measured are intimate partner violence, attitudes towards gender-based violence, knowledge about sexual assault, and bystander intentions to intervene.

✅ = Most systematic reviews and studies show effectiveness
🟢 = Most studies show effectiveness
🟨= Most systematic reviews and studies show no effect
🟡 = Most studies show no effect
⛔= Potentially harmful
🔵 = Mixed evidence
✖ = Insufficient causal evidence
🕓 = Not yet rated

Effectiveness rating

Outcome

Description

Attitudes towards gender-based violence

Exercise caution! Potential for increased negative attitudes towards gender-based violence. One study showed a statistically significant negative effect for attitudes towards gender-based violence.

Bystander intention to intervene

Exercise caution! Potential for decreased bystander intention to intervene. One study showed a statistically significant negative effect for bystander intention to intervene.

IPV

Exercise caution! Potential for increased IPV. One study showed a statistically significant negative effect for IPV.

Key populations

Has the impact of this intervention been tested with certain key populations?

This review assessed the impact of the evaluation on adolescent boys to prevent intimate partner violence, specifically adolescent relationship violence, perpetration.

The interventions were not targeted towards any specific cultural or ethnic groups. The interventions were not targeted towards people with physical or mental disabilities or health conditions.

The table below gives an overview of whether or not the intervention was examined with some key populations. The inclusion of these populations was guided by the National Plan to End Violence against Women and Children 2022-2032 and Australia’s National Research Agenda to Reduce Violence against Women and their Children: 2020-2022.

Population	What do we know about this group?	Degree of knowledge
Aboriginal and Torres Strait Islander communities	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population.
Sexuality and gender diverse / LGBTIQA+	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population.
Specific age groups	All studies were conducted with teenage participants. One study used slightly younger (middle school) participants, while the others used participants in high school (14-18 years)
Culturally diverse, migrant and refugee background	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population
Disability	0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Key considerations

This section summarises factors that may contribute to study results, factors that may be considered to facilitate better outcomes, and the transferability of the intervention to an Australian context.

What do we know about the intervention in Australia?

• None of the studies presented findings from Australia. Both studies were based in the United States. Further research and evaluation would be required to determine the effectiveness and acceptability of the intervention in an Australian context.

• Australia and the United States share a similar sporting culture, as sport is both an important component of national identity and an industry with a history of violence against women allegations.

• Further research is required to determine effectiveness and acceptability in an Australian context.

What should Australian stakeholders consider?

• Study locations were restricted to racially and economically diverse urban public-school districts, therefore the findings may not generalise to private, suburban or rural school students.

• The intervention does not address sexual violence outside of relationships. Further evaluations should explore whether this intervention could also apply to the prevention of non-partner sexual violence.

• The studies included in this intervention review did not comment on intervention or implementation costs. However, the following resourcing considerations may be taken:
  • Implementation of this intervention may involve some training of athletic coaches in schools, as well as the creation and provision of training kits.
  • Lesson frequency is approximately 15 minutes once per week for 12 weeks, meaning this intervention may not be time-intensive to implement.

Included studies

Characteristics of primary studies included in the Intervention Review

References and further reading

Included Studies

Quantitative impact evaluations:

• Abebe, K. Z., Jones, K. A., Ciaravino, S., Ripper, L., Paglisotti, T., Morrow, S. E., Grafals, M., Van Dusen, C., & Miller, E. (2017). A cluster-randomized trial of a middle school gender violence prevention program: Design, rationale, and sample characteristics. Contemporary Clinical Trials, 62, 44136. https://doi.org/10.1016/j.cct.2017.08.007


• Jaime, M. C. D., Stocking, M., Freire, K., Perkinson, L., Ciaravino, S., & Miller, E. (2016). Using a domestic and sexual violence prevention advocate to implement a dating violence prevention program with athletes. Health Education Research, 31(6), 679-696. https://doi.org/10.1093/her/cyw045


• Jones, K. A., Tancredi, D. J., Abebe, K. Z., Paglisotti, T., & Miller, E. (2021). Cases of sexual assault prevented in an athletic coach-delivered gender violence prevention program. Prevention Science 22, 504-508.https://doi.org/10.1007/s11121-021-01210-1


• Miller, E., Tancredi, D. J., McCauley, H. L., Decker, M. R., Virata, M. C. D., Anderson, H. A., Stetkevich, N., Brown, E. W., Moideen, F., & Silverman, J. G. (2012). “Coaching Boys into Men”: A cluster-randomised controlled trial of a dating violence prevention program. Journal of Adolescent Health, 51(5), 431-438. https://doi.org/10.1016/j.jadohealth.2012.01.018


• Miller, E., Tancredi, D. J., McCauley, H. L., Decker, M. R., Virata, M. C. D., Anderson, H. A., O’Connor, B., & Silverman, J. G. (2013). One-year follow-up of a coach-delivered dating violence program: A cluster randomised controlled trial. American Journal of Preventive Medicine, 45(1), 108-112.https://dx.doi.org/10.1016/j.amepre.2013.03.007


• Miller, E., Jones, K. A., Ripper, L., Paglisotti, T., Mulbah, P., & Abebe, K. Z. (2020). An athletic coach-delivered middle school gender violence prevention program: a cluster randomized clinical trial. JAMA Pediatrics, 174(3), 241-249. https://doi.org/10.1001/jamapediatrics.2019.5217

Additional evidence on the intervention

This list contains other evidence that was not eligible for the Intervention Review based on our selection criteria but may provide further information regarding the intervention.

• Fields, A. D., Fenn, M., Ripper, L., Hill, A., Mulbah, P., Kass, N. M., & Miller, E. (2022). A Coach-Delivered Dating Violence Prevention Program: Coach Perspectives on Implementation. Journal of Interpersonal Violence, 37(13–14), NP10594–NP10617. https://doi.org/10.1177/08862605221092073


• Hill, A. L., Miller, E., Switzer, G. E., Abebe, K. Z., Chang, J. C., Pulerwitz, J., Brush, L. D., & Hill, A. V. (2021). Gender equitable attitudes among adolescents: A validation study and associations with sexual health behaviors, Adolescent Research Review. https://doi.org/10.1007/s40894-021-00171-4


• Jaime, M. C. D., McCauley, H. L., Tancredi, D. J., Decker, M. R., Silverman, J. G., O’Connor, B., & Miller, E. (2018). Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes. Prevention Science, 198), 1113-1122. https://doi.org/10.1007/s11121-018-0909-2


• Miller, E., Das, M., Tancredi, D. J., McCauley, H. L., Virati, M. C. D., Nettiksimmons, J., O’Connor, B., Ghosh, S., Verma, R. (2014). Evaluation of a gender-based violence prevention program for student athletes in Mumbai, India Journal of Interpersonal Violence, 29(4), 758-78. https://dx.doi.org/10.1177/0886260513505205


• Miller, E., Jaime, M. C. D., & McCauley, H. M. (2016). “Coaching Boys into Men”: A social norms change approach to sexual violence prevention. Sexual Violence, 1186, 227-248. https://dx.doi.org/10.1007/978-3-319-44504-5_13


• Munoz, R. B. (2022). Sexual violence prevention work: engaging men while encouraging gender inclusivity [Masters dissertation, Northern Arizona University]. OpenKnowledge@NAU. https://openknowledge.nau.edu/id/eprint/5911