AHS Pilot Program Tackles Teen Dating Abuse

In an effort to shed light on the problem of abuse in teen relationships and help health care providers better identify and respond to it, the Alameda High School-Based Health Center recently took part in a pilot project which may have implications nationwide.

Release of the project’s findings coincides with this month's “Teen Dating Violence Awareness Month" in the Bay Area.

The AHS health center used a primer for health care professionals called the "Healthcare Education Assessment and Response Tool for Teen Relationships." It is a resource for health care providers to use to prompt conversation about relationships. (The primer is available here.) 

Elizabeth Miller, M.D., Ph.D., a pediatrician, researcher and the Chief of Adolescent Medicine at Children’s Hospital Pittsburg, PA., led the research project in Alameda.

Of the students who visited Alameda High’s health center and another center in the pilot project, almost 80 percent said that it was helpful for healthcare providers to talk about relationships with them. In addition, participating teens reported a decrease in technological abuse behavior and an increase in awareness of available community resources to help teens avoid or end relationship abuse.

Visitors at the Alameda High health center ranged in age from 14 to 18. Ninety-two percent were female.

Forty percent reported having experienced physical or sexual violence at the hands of a partner.

At the end of the study, 77 percent of the youth who used the teen health center at the campus reported having a conversation with their provider there about healthy relationships and 92 percent said they would bring a friend to the center for help if they were experiencing an unhealthy relationship.

Why the primer for healthcare professionals is critical to the campaign

Dr. Miller said she became interested in teen dating violence 12 years ago when she was volunteering at a teen clinic and treated a 15-year-old girl who came in for a pregnancy test.

She told the patient to come back and see her if she had any problems. But the girl did not, and two weeks later the teen arrived in the emergency room with a severe head injury after she was pushed down the stairs by her boyfriend.

Dr. Miller said she missed the opportunity to have a more targeted in-depth conversation with the girl at her first visit that might have revealed there was violence in the relationship. 

That experience and others encountered by professional colleagues convinced her that health care providers are in a unique position to help teens. What they needed, however, was a tool to help them open up the conversation.

"Teen dating violence is a serious issue, but many young people may be afraid to speak up," said Sandi Goldstein, MPH, Director of the California Adolescent Health Collaborative. 

Dr. Miller says the primer is a low-cost tool that can be easily incorporated into routine adolescent care. She hopes the findings from the pilot project at Alameda High School and other settings will lead to widespread adoption by health care professionals.

Community Awareness Campaign about Teen Relationship Violence

The primer pilot project is part of a wider awareness campaign launched by several groups. The campaign is a  partnership between INOBTR ("I Know Better"), a non-profit organization focused on educating kids through public awareness to keep them safe, and the California Adolescent Health Collaborative (CAHC), a public-private statewide coalition of individuals and organizations that works to increase understanding and support of adolescent health and well-being.

The campaign is funded through a cooperative agreement with the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention (OJJDP).)

According to the campaign’s organizers, “Teen dating violence is defined as a pattern of physically, sexually, verbally, or emotionally abusive actions committed by a partner to establish control over the other. The abusive behavior may occur in a dating or similarly defined relationship where one or both persons are a minor."

In one study cited by the campaign's organizers, nearly one in three teens who have been in relationships have experienced dating violence or abuse, such as extreme jealousy or insecurity, threatening or humiliating emails or text messages, and isolation from family or friends.”

"These numbers are sobering, and far too many teens suffer silently in abusive relationships," said Melodee Hanes, Acting Administrator, Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice.

According to  INOBTR Communications Director Kelly McMahon. "What many people do not realize is that abuse goes beyond just physical violence and that it can be controlling behavior that inflicts emotional harm as well. Our goal is to encourage healthy relationships among teens and to educate about signs of abuse within relationships. We hope teens who are in abusive relationships will reach out to local resources and seek help immediately."

In order to catch teens’ attention, the Bay Area awareness campaign will include educational public service ads that will run on San Francisco MUNI bus lines, BART trains and station platforms and AC Transit buses this month. In addition, grassroots materials such as posters and fact sheets will be distributed and are available to local healthcare providers to use as awareness tools. All materials will be available online here.