Date Available
12-15-2017
Year of Publication
2016
Degree Name
Doctor of Philosophy (PhD)
Document Type
Doctoral Dissertation
College
Public Health
Department/School/Program
Epidemiology and Biostatistics
First Advisor
Dr. Heather M. Bush
Abstract
Community (or cluster) randomized trials are trials in which communities or groups of individuals (clusters) are randomized to receive the intervention of interest. Community randomized trials frequently more closely resemble a natural experiment than a randomized controlled trial (RCT) following intervention allocation. In particular, the effects of non-compliance can pose methodologic challenges in estimating the intervention effect which may require a quasiexperimental approach in order to minimize bias.
The motivating example to illustrate these issues is the Green Dot High School (GDHS) study. The GDHS study was a longitudinal, cluster-randomized controlled trial designed to assess the effectiveness of a bystander prevention program, the Green Dot (GrDt) (www.livethegreendot.com), on reducing sexual violence (SV) among high school students. One SV outcome examined by the GDHS study was Reproductive Coercion (RC), a form of SV in which control or manipulation of contraception or pregnancy outcomes is the tool utilized to perpetrate violence. RC often co-occurs with other forms of intimate partner violence (IPV), but has not been as widely studied as other forms of IPV. In particular, although there is evidence that RC occurs among adolescents, very little research has been conducted into either the prevalence or prevention of RC among adolescents and there are no published studies on a community-based prevention strategy for RC.
The purpose of this dissertation has been to examine and propose solutions to the analytical challenges in assessing the effectiveness of the GrDt program. Specifically, this dissertation seeks to (1) identify and contrast methodological strategies for evaluating prevention programs aimed at community-level change, (2) to describe the burden of RC among Kentucky high school students, and (3) to assess the impact of the GrDt program on RC.
Digital Object Identifier (DOI)
https://doi.org/10.13023/ETD.2016.507
Recommended Citation
Starnes, Catherine P., "EVALUATING A BYSTANDER INTERVENTION PROGRAM ON REPRODUCTIVE COERCION: USING QUASI-EXPERIMENTAL DESIGN STRATEGIES TO ADDRESS METHODOLOGIC ISSUES IN RANDOMIZED COMMUNITY PREVENTION TRIALS" (2016). Theses and Dissertations--Epidemiology and Biostatistics. 10.
https://uknowledge.uky.edu/epb_etds/10
