Student response to a healthy relationship intervention in school based health centers

Background Adolescent relationship abuse (ARA) is prevalent and associated with poor physical, sexual and mental health outcomes. School based health centers (SBHC) offer a unique opportunity to address this serious public health problem. Purpose The School Health Center Healthy Adolescent Relationships Program trained SBHC providers to discuss healthy relationships and to respond to ARA among their adolescent patients. This cluster randomized controlled trial examined the effectiveness of a brief safety card intervention among adolescents ages 14-19 seeking care at SBHCs. Methodology Before a SBHC visit, students (n=793, 76% female) completed a computer-based survey about their ARA experiences and their knowledge of harm reduction strategies. A post-visit survey assessed for healthy relationship discussions during the visit. Results Approximately 27% (n=197) of students experienced ARA, 63% experienced technology-based abuse, and 10% of females experienced reproductive coercion. A majority of students (87%, n=688) identified their SBHC as an ARA resource at baseline. Post-visit, intervention SBHC students were significantly more likely to have discussed ARA with their provider compared to control students, controlling for group differences in abuse history and demographics (aOR 3.01, 95% CI 2.21, 4.10). Among those who had experienced ARA, intervention SBHC students were more likely to disclose this history of abuse to a provider compared to controls, but this did not persist in adjusted analysis (aOR 2.09, 95% CI 0.92, 4.77). Conclusions/Recommendations Given the prevalence of ARA, findings indicate the utility of a brief safety card intervention in SBHCs to improve discussion of ARA and promote healthy and safe relationships.