Cyber dating abuse victimization has been correlated with physical, sexual, and psychological adolescent relationship abuse. What This Study Adds: This is the first clinic-based study of cyber dating abuse.
Forty-one percent of youth reported cyber dating abuse victimization, female more than male respondents. Compared with nonexposed youth, abuse victims reported more sexual assault; female victims reported more contraceptive nonuse and reproductive coercion.
Recent research has shown that cyber dating abuse and other forms of ARA frequently overlap. This may be particularly relevant for clinicians uncertain about the extent to which cyber dating abuse potentially contributes to the behaviors they are addressing in the clinical setting. Possibly related to the health consequences of ARA, adolescents seeking care in confidential adolescent health settings have a higher prevalence of ARA than general population-based studies.
School-based health centers SHCs represent a particularly unique setting in which to examine the clinical correlates of cyber dating abuse and ARA. SHCs reduce barriers to health care faced by adolescents, such as concerns about confidentiality, lack of health insurance, and limited knowledge of the health care system.
Understanding the prevalence and correlates of cyber dating abuse in this clinic-based sample may guide prevention and intervention efforts to reduce such abuse and improve adolescent health. Eleven SHCs in Northern California were randomly assigned to intervention or a delayed-intervention control condition.
Subsequent to randomization but before participant enrollment, 3 health centers 1 intervention, 2 control withdrew from the study because of changes in school administrators who would not allow the SHCs to participate in research. During the — school year, youth aged 14 to 19 years seeking services at any of 8 participating SHCs were invited to participate. Over a 7-month enrollment period, all students were screened at clinic entry for age eligibility by trained research staff.
Eligible students interested in participating were escorted to a private area in the clinic for consent or assent and survey administration. Because participants were receiving confidential clinical services, parental permission for participation was waived for minors. Youth who chose not to participate reported not having enough time or being unavailable for the follow-up survey as the primary reason for nonparticipation.
Before the clinical encounter, youth used a laptop with headphones to complete a minute audio computer-assisted survey about ARA and other forms of violence victimization, sexual behavior, and care seeking for sexual and reproductive health. Study procedures were approved by institutional review boards at Public Health Institute and the University of Pittsburgh and were reviewed by administrators at respective schools and SHCs.
Measures All measures were self-reported. Single items assessed demographic characteristics, including gender, age, race, US nativity, relationship status, and sexual orientation. In factor analyses conducted with the entire study sample, these items divided into 2 domains: All items assessed frequency: Sexual Behaviors Single items assessed all participants for any oral, vaginal, and anal sex defined by using anatomic terms and number of sex partners in the past 3 months.
Pregnancy Risk Female participants were presented a list of 12 contraceptive methods and asked to endorse all methods used in the past 3 months. Any positive response was coded as positive for reproductive coercion. Prevalence of each of the 7 cyber dating abuse behaviors was calculated for the total sample and by sex. Logistic regression models for clustered survey data were specified to assess the relationship of cyber dating abuse frequency with physical or sexual ARA, nonpartner sexual violence, and sexual behavior for the full sample and, for females only, having an older male sex partner, pregnancy risk, and reproductive coercion.
Statistical analyses were conducted by using the survey data analysis procedures in SAS v9. Respondents reporting exposure to recent cyber dating abuse tended to be female; older; African American or multiracial; bisexual, gay, lesbian, or unsure; and not single.