New RCT explores the effectiveness of a mentoring program for youth assault injuries

Lindstrom Johnson, S., Jones, V., Ryan, L., DuBois, D. L., Fein, J. A., & Cheng, T. L. (2022). Investigating effects of mentoring for youth with assault injuries: Results of a randomized-controlled trial. Prevention Science. 

https://doi.org/10.1007/s11121-022-01406-z

Summarized by Ariel Ervin

Notes of Interest: 

• Mentorships are known for averting delinquency and crime and can improve behavioral and educational outcomes.
• Despite this, there are still concerns about a) whether mentors have the proficiency to support and maintain relationships with youth who have additional psychosocial and behavioral needs and b) the extent mentoring programs should focus solely on targeted skill development vs. relationship-building.
• This RCT evaluated the effectiveness of a mentoring intervention for youth who are getting treated for assault injuries.
• Intent-to-treat analyses showed increased adult-reported aggression & improved conflict avoidance self-efficacy at nine months and reduced fighting at twenty-one months.
• There were no identified effects for retaliatory attitudes, youth-reported aggression, deviance acceptance, or commitment to learn.
• This research shows that it’s possible to successfully integrate a violence prevention curriculum into the largest and most renowned community-based mentoring organization in the U.S.

Introduction (Reprinted from the Abstract)

Mentoring is considered an evidence-based practice for violence prevention. This study presents a partial replication of the Take Charge! program implemented in partnership with Big Brothers Big Sisters of America (BBBS). One hundred and eighty-eight early adolescents (M age = 12.87; 61.17% male) who were treated for peer-related assault injury in two urban mid-Atlantic emergency departments were randomly assigned to receive a mentor from two BBBS affiliates. Mentors and organization staff were trained in the Take Charge! violence prevention curriculum, which had previously shown evidence of efficacy. Intent-to-treat analyses showed statistically significant improvements in conflict avoidance self-efficacy for the intervention group at 9 months and reductions in fighting at 21 months, but an increase in parental report of aggression at 9 months. Complier average causal effect models revealed evidence of an additional effect for reduced problem behavior at 21 months for intervention adolescents who received a mentor. No effects were found for youth-reported aggression, retaliatory attitudes, deviance acceptance, or commitment to learning. Sensitivity analyses suggested increased aggressive behavior for adolescents in the intervention group who did not receive a mentor (i.e., non-compliers). These findings extend the evidence-base for Take Charge! as a violence prevention curriculum for youth already engaged in violence to “real-world” implementation settings. However, they also suggest that challenges associated with providing youth with mentors can be consequential and that additional supports may be needed for these youth/parents. Clinical trials number: clinicaltrials.gov NCT01770873.

Implications (Reprinted from the Discussion)

This study presents an evaluation of a randomized-controlled trial of a violence prevention curriculum embedded in two BBBS organizations to support the needs of youth treated in the ED for peer assault injuries. Intent-to-treat analyses showed evidence of statistically significant effects of random assignment to Take Charge! on two of the 10 outcome measures at 9 months (improved conflict avoidance self-efficacy but also greater parent-reported aggression) and one of the same 10 measures at 21 months (reduced fighting). Complier average causal effect models indicated reduced problem behavior at 21 months for those receiving a mentor through the intervention relative to their counterparts in the control group as well as differences in the direction of negative effects for those not receiving a mentor again relative to their control group counterparts. These findings extend the evidence base for the Take Charge! curriculum as a violence prevention curriculum for youth already engaged in violence and raise important issues for consideration when moving programs to “real-world” settings.

This study presents a replication study of Take Charge! (Cheng et al., 2008) and shows some consistency of impact despite a different implementation model. Specifically, consistent findings were found for improvements in conflict avoidance self-efficacy in the short term (i.e., 6–9 months) as well as decreases in problem behavior. An additional finding of decreased fighting was identified at 21 months for this study, which was not evident in the original study that had follow-up only at 6 months. A further difference is that parents in the current study reported greater aggression for intervention youth at 9 months, although sensitivity analyses suggest this might have been driven by intervention youth who did not receive mentoring. Taken as a whole, the findings across the two studies suggest that mentoring programs tailored to the needs of youth who are treated for assault injuries can be beneficial for building protective factors associated with reducing violent behaviors. This complements the existing meta-analysis of studies of mentoring for youth at-risk of delinquency, which found effect sizes of 0.11 for aggression and 0.21 for delinquency (Tolan et al., 2014). Unlike previous meta-analyses that have found consistent positive findings for social and psychological outcomes (i.e., Tolan et al., 2014; Christenson et al., 2020), in this study the evidence of significant intervention effects was primarily for outcomes related to violent behaviors, although CACE analyses did identify trends toward improvements in social competence and hopes and goals. This may reflect the curricular nature of the intervention, which while addressing a call for “targeting specific mechanisms underlying particular youth difficulties” (Raposa et al., 2019a, b, p. 438), may reduce impacts on outcomes thought to be supported by social support and modeling (DuBois et al., 2011).

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