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RWJF Program Evaluations

An RWJF Collection

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Evaluation of Start Strong: Building Healthy Teen Relationships

A four-year, teen dating violence (TDV) prevention program

A young man with his arm around a girl, as they talk.

What is Teen Dating Violence (TDV)?

Teen dating violence is a growing public health concern. It includes both physical (e.g., hitting, pushing, kicking) and psychological abuse (e.g., criticizing, dominating, controlling) either in person or electronically, as well as unwanted sexual activity.

According to the Centers for Disease Control and Prevention, approximately 1 in 11 high school students (9.4%) report being hit, slapped, or physically hurt on purpose by a boyfriend or girlfriend. In addition to undermining individual growth and academic potential, dating violence and abuse puts young people at risk for serious injury and even death. TDV also increases likelihood to engage in risky sexual behavior, substance abuse, unhealthy dieting behaviors, and suicidal ideation/attempts.

In collaboration with the Blue Shield of California Foundation (BSCF) and Futures Without Violence, the Robert Wood Johnson Foundation (RWJF) established the Start Strong program, which focused from 2008 to 2012 on promoting healthy relationships among middle school students (ages 11 to 14), before the incidence of dating violence reaches levels seen in older teens.  

RWJF and BSCF commissioned the research firm RTI International to conduct an independent evaluation of the Start Strong program, which resulted in one of the largest studies to look deeply at healthy relationship development and TDV prevention efforts involving middle school students

The evaluation examined the effectiveness of the program among students and teachers, and the adoption, implementation, and sustainability of TDV prevention policy efforts in Start Strong sites. The baseline findings of the student outcome evaluation were released in March 2011 in a report called “Middle School Matters”.


Key Findings

  • Start Strong had a sustained positive impact on middle-school students’ attitudes towards teen dating violence and gender equality, two key factors linked to the prevention of TDV.

  • By fall 2012, six of the 11 Start Strong communities achieved significant policy wins.  As a direct result of their work, five sites secured important changes to TDV-related school district policies. Sites also provided technical assistance and awareness-building to inform changes to state legislation. State legislation was strengthened in three states.

  • In addition, all 11 sites established one or more practice changes that remained in place in the school year after the completion of Start Strong funding. Practice changes included TDV education, staff training and parent education.

Preventing Teen Dating Violence: Lessons Learned
Prevention in middle school matters.
There is a critical window of opportunity to teach young adolescents about healthy relationships and prevent TDV. Start Strong influenced two key factors related to attitudes toward TDV and gender equality. We can speculate that continued and strengthened emphasis on improving attitudes towards gender equality and challenging the acceptance of TDV might ultimately decrease TDV behaviors among the Start Strong middle school students.  

We need to better understand adolescents who experience TDV at a young age.
While there is a growing body of knowledge on TDV among older adolescents in high school, we need to better understand this young age group, especially adolescents who experience TDV at a young age. Start Strong students with prior TDV experiences showed more positive results on some outcomes than students who did not report TDV victimization or perpetration. These positive results, however, were inconsistent across measures and data collection waves.

Greater emphasis on engaging teachers in school-based TDV prevention is needed.
These results suggest that teachers at Start Strong schools may not have heard about, participated in, or remembered Start Strong programming in their schools. Findings also suggest a greater emphasis on engaging teachers in school-based TDV prevention to further reinforce desired messages in the school setting. Examples of potential school-wide efforts include: generating communication campaigns on how students can best respond to TDV behaviors, educating all school staff about the core messages of a school-based curriculum in order to generalize effects, and providing administrative support to teachers on school-wide policies and practices related to TDV.

There is more to learn on how best to prevent teen dating violence.

Start Strong evaluation results suggest that further refinement of TDV programming would be beneficial, as would ongoing programming or booster sessions to maintain program effects. We can also speculate that dating relationships among middle school students are less stable than those found later in adolescence, which may explain the lack of findings for TDV behaviors.


Building Healthy Teen Relationships

Teen dating violence is a major public health problem in this country. An online toolkit from Start Strong, RWJF's national program to prevent teen dating violence offers facts, tips, and resources to help put young people on the road to healthy relationships.

Learn more