The Fourth R Reduces Dating Violence and Increases Condom Use 2.5 Years Later.

This study utilized a cluster randomized controlled trial (RCT) design with a 2.5 year follow up with 1,722 students aged 14 to 15 years. The intervention condition was the Fourth R Grade 9 Physical and Health Education program – a 21-lesson curriculum delivered during 28 hours by teachers with additional training in the dynamics of dating violence and healthy relationships. Control schools targeted similar objectives without the training or materials. Results indicated that physical dating violence was about 2.5 times greater among control versus intervention students. The Fourth R intervention had a stronger impact on reducing physical dating violence among boys than girls, and it improved condom use in sexually active boys when compared to students in the control condition. Thus, teaching youth about healthy relationships as part of their required health curriculum reduced physical dating violence and increased condom use 2.5 years later at a low per-student cost (average $16 per student).

Wolfe, D.A., Crooks, C.V., Jaffe, P.G., Chiodo, D., Hughes, R., Ellis, W., Stitt, L., & Donner, A. (2009). A universal school-based program to prevent adolescent dating violence: A cluster randomized trial. Archives of Pediatric and Adolescent Medicine, 163, 693-699. 

Teachers and Administrators Find the Program Easy to Implement and Identify Significant Benefits for all Stakeholders.

Surveys were sent to 75 stakeholders in 7 provinces to identify specific factors that promote the adoption of the Fourth R, as well as possible barriers. Of the 25 decision-makers who responded, the most important factors in their decision to adopt the Fourth R were the research base of the Fourth R and the perception of the program’s potential to have a positive impact on students, followed by the curriculum-based nature of the program. Teacher data were collected from 40 teachers. Results indicated a high level of satisfaction and identified clearly written lesson plans as the best feature. The biggest implementation barrier was timeframes, for both teachers and decision-makers. Educators identified the provision of accurate information coupled with skills practice as the most important benefits for students. The majority of respondents indicated they had enjoyed benefits as well, ranging from learning more about relationship violence to having students who are more engaged with the course material. 

Crooks, C. V., Wolfe, D. A., Hughes, R., Jaffe, P. G., & Chiodo, D. (2008). Development, evaluation and national implementation of a school-based program to reduce violence and related risk behaviors. Institute for the Prevention of Crime Review, 2, 109-135.

A related study surveyed approximately 200 educators from 6 provinces who were trained in a Fourth R program between 2 and 8 years previously. Results from this retrospective study demonstrated that educators continue to be highly satisfied with the programming, but that higher implementation fidelity was predicted by 1) perceived readiness after training and 2) perceived support and accountability. 

Crooks, C.V., Chiodo, D., Zwarych, S., Hughes, R., & Wolfe, D.A. (2013). Predicting implementation success of an evidence-based program to promote healthy relationships among students two to eight years after teacher training. Canadian Journal of Community Mental Health, 32, 125-138.

The Fourth R Produces a School-Wide Buffering Impact for Maltreated Youth in Reducing Violent Delinquency. 

Child maltreatment constitutes significant risk for adolescent delinquency. Our previous research demonstrated that the Fourth R could provide a protective impact for youth at risk for violent delinquency due to child maltreatment history. In this study, we conducted a follow-up to determine if participation in the Fourth R program in grade 9 continued to provide a buffering effect on engaging in acts of violent delinquency for maltreated youth two years post-intervention. Individual- and school-level factors predicting violent delinquency in grade 11 replicated previous findings from grade 9: being male, experiencing child maltreatment, being violent in grade 9, and attending a school with a lower perceived sense of safety among the entire student body increased violent delinquency. However, in non-intervention schools, youth with maltreatment in their background were increasingly likely to engage in violent delinquency in comparison to maltreated youth in intervention schools. Therefore, the Fourth R creates a protective effect for maltreated youth with respect to lowering their likelihood of engaging in violent delinquency. 

Crooks, C.V., Scott, K., Ellis, W., & Wolfe, D.A. (2011). Impact of a universal school-based violence prevention program on violent delinquency: Distinctive benefits for youth with maltreatment histories. Child Abuse & Neglect, 35, 393-400.

Youth in the Fourth R Demonstrate Better Peer Resistance and Communication Skills Compared to Control School Youth.

This study examined peer resistance skills following a 21-lesson classroom-based intervention to build healthy relationships and decrease abusive and health-risk behaviours among adolescents. The Fourth R instructs students in positive relationship skills, such as negotiation and delay, for navigating challenging peer and dating scenarios. Observational data from 196 grade 9 students participating in a cluster randomized controlled trial (98 per condition) were used to evaluate post-intervention acquisition of peer resistance skills. Pairs of students engaged in a role play paradigm with older student actors, where they were subjected to increasing pressure to comply with peer requests related to drugs and alcohol, bullying, and sexual behaviour. Role plays were videotaped and coded by two different sets of coders, blinded to condition. Research assistants coded the observations for five specific behavioural responses (negotiation, delay, yielding to pressure, refusal, and compliance), and 11 teachers rated half of the observations on four global indices (i.e., thinking / inquiry, application, communication, and perceived efficacy). Students who received the intervention were more likely to demonstrate negotiation skills and less likely to yield to negative pressure relative to controls. Intervention girls were much more likely to use delay than control girls; control girls were more likely to use refusal. The number of times students complied with peer requests did not differ. Teacher ratings demonstrated significant main effects favouring intervention youth on all measures. 

Wolfe, D. A., Crooks, C. V., Chiodo, D., Hughes, R., & Ellis, W. (2012).  Observations of adolescent peer resistance skills following a classroom-based healthy relationship program: A post-intervention comparison. Prevention Science, 13, 196-205.

The Fourth R Parent Media Violence Workshop Improves Parents’ Monitoring of their Children’s Media Use and Reduces their Children’s Media Consumption. 

This study evaluated the Fourth R Parent Media Violence Workshop. Workshop participants were surveyed immediately following a workshop to gauge their perceptions of what they learned and to understand the extent to which they monitored their children’s media use pre-workshop. A subsample of these same participants was surveyed 6 months later to examine whether parents implemented the strategies they learned during the workshop and, if so, to understand what specific strategies they used. The results indicated that parents engaged in enhanced appropriately restrictive and active monitoring practices following the workshop. Furthermore, following the workshop parents seemed to re-evaluate potentially problematic parenting norms that encourage decreased monitoring as children mature, countering the notion that adolescents are capable of navigating the media world on their own. Finally, a significant decrease in children’s media consumption was observed following the workshop. The results provide preliminary evidence to suggest that even short, one-time intensive workshops for parents can move parents’ behaviours in the intended direction and positively impact their monitoring strategies. 

Broll, R., Crooks, C.V., Burns, S., Hughes, R., & Jaffe, P.G. (2013). Parental monitoring, media literacy, and media violence: A preliminary evaluation of the Fourth R Parent Media Violence Workshop. International Journal of Child, Youth and Family Studies, 4, 301-319.

For a list of additional research studies evaluating the Fourth R click here.