We conducted a cluster randomized controlled trial to test the a priori hypothesis that students attending an intervention middle school would be less likely to report physical adolescent relationship abuse (ARA) 1 year later compared with students attending a control school. Secondary objectives were to determine if the intervention reduced substance misuse, bullying, and fighting.

Twenty-four Texas public middle schools were matched by the size of student enrollment, number of economically disadvantaged students, and race and ethnicity of the student body and randomly assigned to the intervention (n = 12; 1237 participants) or the control (n = 12; 1531participants) group. The intervention, Fourth R, is a classroom-based curriculum delivered by existing teachers and consists of 21 lessons on injury prevention, substance use, and growth and development.

Participants (50% female) self-reported ethnicity as Hispanic or Latinx (35%), Black or African American (24%), Asian American (17%), White (8%), and multiethnicity or other (16%). Among those who have dated, students in the intervention schools were less likely to report perpetrating physical ARA (intervention = 14.9% versus control = 18.3%) relative to students in the control schools (adjusted odds ratio, 0.66; 95% confidence interval, 0.43–1.00; P = .05). In the overall sample, no significant differences emerged between control and intervention groups with respect to substance misuse, fighting, and bullying.

The middle school version of Fourth R is effective in reducing physical ARA perpetration over at least 1 year. The intervention did not have an effect on bullying perpetration, physical fighting with peers, and substance misuse. Long-term assessment, especially follow-up that covers the transition to high school, is needed to examine the program benefit on key outcomes.

我们进行了一项整群随机对照试验来检验先验假设，即与参加对照学校的学生相比，参加干预中学的学生在 1 年后报告身体青少年关系虐待 (ARA) 的可能性较小。次要目标是确定干预是否减少了药物滥用、欺凌和打斗。

德克萨斯州的 24 所公立中学根据学生入学人数、经济困难学生人数以及学生群体的种族和族裔进行匹配，并随机分配到干预组（n = 12；1237 名参与者）或对照组（n = 12；1531 名参与者）组。干预措施Fourth R是由现有教师教授的基于课堂的课程，包括 21 节关于伤害预防、物质使用以及成长和发展的课程。

参与者（50% 为女性）自称种族为西班牙裔或拉丁裔 (35%)、黑人或非裔美国人 (24%)、亚裔美国人 (17%)、白人 (8%) 和多种族或其他 (16%)。在那些约会过的学生中，相对于对照学校的学生（调整后的比值比为 0.66；95% 置信区间为 0.43），干预学校的学生报告进行身体 ARA 的可能性较小（干预 = 14.9%，对照 = 18.3%） –1.00；P = .05）。在总体样本中，对照组和干预组在药物滥用、打架和欺凌方面没有显着差异。

中学版本的Fourth R可有效减少至少 1 年的身体 ARA 犯罪。干预对欺凌行为、与同龄人的肢体冲突和药物滥用没有影响。需要进行长期评估，尤其是涵盖向高中过渡的后续评估，以检查计划对关键成果的好处。