Global health organizations highlight engaging men and boys in preventing violence against women as a potentially impactful public health strategy. A gender transformative approach involves altering gender and sexuality norms that foster violence against women while promoting bystander intervention (i.e., giving boys skills to interrupt abusive behaviors they witness among peers) to reduce the perpetration of sexual violence (SV) and adolescent relationship abuse (ARA). This study will test, via a two arm cluster randomized controlled trial, a gender transformative SV/ARA perpetration prevention program titled Boys Care implemented in a community-based setting among African American adolescent males ages 14-17. This is a stakeholder- engaged intervention that involves an 18 hour curriculum divided into 3 weekend day sessions delivered over a 2 month period (at 4 week intervals) in community-based youth-serving agencies (YMCA and Urban League). Control sites will implement an evidence-based life skills curriculum. The rationale for focusing on primarily African American youth in socially disadvantaged neighborhoods is two-fold. First, racial/ethnic disparities in health are stark in Pittsburgh, the setting for this study; prevention efforts in communities with high prevalence of poverty, sexual violence, and poor health outcomes are needed. Second, the prevention educators are from these communities and have high degrees of trust and respect fundamental to building positive youth relationships. Innovations are: first, an intersectional approach combining gender theory, adolescent sexual development, and community-partnered research to evaluate the impact of gender transformative programming on SV/ARA perpetration in socially disadvantaged communities; second, a program that integrates education and skills building around gender norms change with sexuality education theorized to target SV perpetration and increase healthy sexual behaviors; third, a stakeholder-engaged approach in design and implementation to ensure local relevance, feasibility, and replicability; and fourth, use of arts-based strategies to encourage youth to explore masculinities. Via a 2-arm cluster-randomized trial in youth-serving agencies (10 clusters, N=960 adolescent males ages 14-17), this study will assess the effectiveness of Boys Care compared to a life skills curriculum. At the end of the 2 month program (Time 2), compared to controls, youth will demonstrate increased positive bystander intervention behaviors (secondary outcome). Intermediate outcomes are: increased condom and contraceptive self-efficacy; increased recognition of abusive behaviors; increased gender-equitable attitudes; and increased intentions to intervene with peers. Six months after the intervention (Time 3), youth will report less perpetration of SV and ARA toward females (Primary Outcome) compared to controls. This study will provide urgently needed information about the effectiveness of a gender transformative program that combines healthy sexuality skills, gender norms change, and bystander skills to interrupt peers' disrespectful and harmful behaviors to reduce SV/ARA perpetration among adolescent males.
NIH ExPorter
NIH ExPorter