Evaluation of Start Strong: Building Healthy Teen Relationships

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

What is Teen Dating Violence?

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. It 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 violence 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 violence prevention policy efforts in Start Strong sites.  

Key Findings

  • Increase in Positive Attitudes and Behaviors: Compared with students in comparison schools, by spring 2011, students in Start Strong schools reported decreased acceptance of teen dating violence, more positive attitudes toward gender equality, increased parent-child communication about relationships, and increased support and satisfaction in their boyfriend/girlfriend relationships.

  • Sustained Changes in Attitudes: Results persisted over time (from fall 2010 to spring 2012) for two key factors linked to the prevention of teen dating violence. Students at Start Strong schools reported decreased acceptance of teen dating violence, and more positive attitudes toward gender equality.

  • More Positive Results for Students with Prior Dating Violence Experiences: Start Strong students who reported dating violence victimization, perpetration or both in fall 2010, classified as high-risk, showed more positive results on some outcomes than students who did not report such victimization and/or perpetration. For at least one follow-up (between fall 2010 and spring 2012), high-risk students reported a reduction in bullying behaviors, a more positive school climate, more positive attitudes towards gender equality, and increased parent-child communication.

  • Policy Changes Achieved: 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.

  • Efforts Sustained: All 11 sites established one or more practice changes that remained in place in the school year after the completion of Start Strong funding, such as providing TDV education for all middle school students, staff training and parent education.

Middle school provides a critical window of opportunity to teach young adolescents about healthy relationships and prevent teen dating violence. The Start Strong program utilized a multi-faceted approach to rally entire communities to promote healthy relationship behaviors among middle school students.

Program components included: i) educating and engaging youth in schools and out of school settings; ii) educating and engaging teen influencers, such as parents, older teens, teachers and other mentors; iii) changing policy and environmental factors in schools and communities; and iv) implementing effective communications/ social marketing strategies to change social norms.

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 violence among teens. Start Strong influenced two key factors related to attitudes toward teen dating violence and gender equality. We can speculate that continued and strengthened emphasis on improving attitudes towards gender equality and the acceptance of teen dating violence might ultimately decrease incidence among middle school students.  

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

More emphasis on engaging teachers in school-based violence prevention is needed.
Findings suggest a greater emphasis on engaging teachers in school-based violence prevention is needed 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 teen dating violence 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 teen dating violence.

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

Start Strong evaluation results suggest that further refinement of programming related to teen dating violence 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.


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