The Impact of Mandated Healthy Relationship Curriculum on Physical Teen Dating Violence: A Difference-In-Differences Analysis

Background

Teen dating violence (TDV) is linked to poor health outcomes including depression, anxiety, suicidality, and substance use. Between 13-20% of US adolescents experience physical TDV; disparities exist, with cisgender girls and LGBTQ+ youth experiencing higher rates of victimization compared to cisgender boys. Longitudinal studies show stability in TDV victimization and perpetration, illustrating the lasting effects. Early intervention is imperative to achieving the Grand Challenge for Social Work: building healthy relationships to end violence.

Given the adverse outcomes, numerous interventions have been developed and tested, most of which are delivered in schools. School-based TDV interventions are significantly associated with reductions in TDV victimization and perpetration; however, implementation is inconsistent. In an effort to ensure all students receive TDV education, 32 states and DC enacted policies that mandate the delivery of healthy relationship curricula in schools. This study examined the impact of mandated healthy relationship curricula policies on experiences of physical TDV overall and by sex.

Methods

We linked the state-representative Youth Risk Behavior Surveillance System (YRBS) 2013-2023 surveys (N=816,222 adolescents from 39 states) to state-level education policies that mandated healthy relationship curricula. Policies were identified via the Guttmacher Institute, which we cross-referenced and obtained from state legislative websites. We conducted quasi-experimental difference-in-difference models to evaluate the impact of mandated healthy relationship curricula on TDV. First, we conducted a probit regression model to examine whether mandated healthy relationship curricula was associated with experiences of physical TDV among adolescents who reported dating in the previous 12 months, adjusting for demographic and policy controls (mandated sex education, mandated consent education), state, and year. We then used a Wald test to examine whether the effects varied by sex. To support the interpretability of our findings, we calculated average marginal effects.

Results

There was no overall effect of mandated healthy relationship curricula on physical TDV experiences (p=.71). However, we found a significant interaction between mandated curricula and sex (adjusted Wald F(1, 4056)=4.97, p=.03). Female students in states with mandated healthy relationship curricula had a 1.5 percentage point decrease in the likelihood of experiencing physical TDV than those living in states without mandated curricula (p=.055). For male adolescents, mandated healthy relationship curricula did not have a significant effect on experiencing physical TDV (p=.71).

Conclusions

Mandated healthy relationship curricula may lead to significant decreases in physical TDV experiences among female adolescents. These findings underscore the importance of school-based healthy relationship curricula and offer critical implications for school social work (SSW). Specifically, SSW practitioners in states with these policies can provide support in the implementation and delivery of healthy relationship curricula; practitioners in states without mandates should advocate for and support similar legislation. SSW researchers should further investigate the mechanisms that drive positive outcomes for female adolescents and identify adaptations to improve outcomes for males. Future research should also examine whether mandated healthy relationship curriculum has an impact on outcomes for transgender and LGB adolescents, as current YRBS data limitations precluded these analyses.