An interventional study of Fourth R in Violence, sponsored by The University of Texas Health Science Center, Houston. Completed at 2 sites in United States. Open to participants aged 11 Years to 15 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-18.
Sponsored by The University of Texas Health Science Center, Houston · Not applicable, Interventional, and Prevention
This study is a school-based trial of the 7th grade version of Fourth R, a promising teen dating violence prevention program, with 24 ethnically diverse middle schools in one of the nation's largest school districts to determine the impact of the program by comparing students in intervention schools with those in control schools.
The prevalence of teen dating violence (TDV), as well as the adverse mental, physical, and relationship health outcomes associated with it, underscores the need for effective TDV prevention programs, of which there are few.
The study will evaluate a new 7th-grade version of Fourth R, which has been rewritten to be developmentally appropriate and correspond to national health standards for this younger age. The 7th-grade version of Fourth R is innovative because it emphasizes socio-emotional learning, includes lessons on mental health, and addresses technology and cyber TDV. These additional components will strengthen the core social-emotional competencies of youth, competencies that are critical for the creation of healthy relationships and avoidance of unhealthy ones. A TDV prevention program aimed at promoting healthy relationships at this developmentally important age holds tremendous promise.
The primary aim is to determine whether Fourth R reduces students' TDV, as indexed by less perpetration and victimization of physical, sexual, and psychological TDV, relative to students in control schools.
The secondary aims are to determine whether Fourth R, relative to control, 1) improves students' [relationship quality], emotional well-being, and increases their acquisition and use of healthy relationship skills, as indexed by improved problem-solving, communication, and conflict resolution skills; 2) ameliorates the modifiable cognitive and behavioral correlates associated with the perpetration and victimization of TDV, as indexed by fewer attitudes justifying dating violence, decreased substance use, risky sexual behavior, fighting, and bullying, increased school connectedness, improved academic performance, and decreased psychological symptoms; and [3) improves school climate as indexed by student, teacher, and staff reports of school environment as it relates to healthy relationships and TDV; and by reductions in school disciplinary actions related to violence, substance use, and academic failure]. Prespecified differences by gender and ethnicity will be examined, as well as the acquisition and utilization of various program components.
305 studies on the registry are indexed under Adolescent Behavior; 47 are open to participants now.
This study's enrollment of 3,028 is above the median of 172 across 256 interventional studies indexed under Adolescent Behavior.
Browse Adolescent Behavior studies →The University of Texas Health Science Center, Houston is the lead sponsor of 897 studies on the registry; 214 are open to participants now.
Of its 173 completed or terminated interventional studies of FDA-regulated products, 142 (82%) have results posted.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Fourth R: 27 lesson curriculum addressing youth risk and health promoting behaviors
Behavioral: Fourth R
Control: Treatment as usual (standard health class curriculum)
Fourth R integrates the promotion of healthy relationship skills and prevention of teen dating violence into existing school curricula so that students receive regular course credit in health. Fourth R is grounded in social cognitive theory in which youth learn to formulate and choose behavior strategies, which translate into knowledge and practice in decision-making, non-aggressive conflict resolution skills, and self-efficacy..
Number of Participants With Perpetration of Physical Teen Dating Violence (TDV)
Determine whether Fourth R reduces students' TDV, as indexed by less perpetration of physical TDV, relative to students in control schools.
Time frame: 1 year
Number of Participants Reporting Alcohol/Marijuana Use
Provides the number of participants reporting alcohol/marijuana use.
Time frame: 1 year
Number of Participants Reporting Physical Fights
Provides the number of participants reporting physical fights.
Time frame: 1 year
Bully Perpetration
Bully perpetration was measured on a scale from 1 to 5, where higher on the scale indicates increased perpetration.
Time frame: 1 year
| Milestone | Intervention Group | Control Group |
|---|---|---|
| Started | 1461 | 1567 |
| Completed | 1237 | 1531 |
| Not completed | 224 | 36 |
| Withdrew: Did not meet inclusion criteria | 129 | 29 |
| Withdrew: Surveys lost by scanner | 95 | 2 |
| Withdrew: Tracking info missing | 0 | 5 |
Determine whether Fourth R reduces students' TDV, as indexed by less perpetration of physical TDV, relative to students in control schools.
| Participants | Intervention Group | Control Group |
|---|---|---|
| Number of Participants With Perpetration of Physical Teen Dating Violence (TDV) | 58 | 103 |
Provides the number of participants reporting alcohol/marijuana use.
| Participants | Intervention Group | Control Group |
|---|---|---|
| Number of Participants Reporting Alcohol/Marijuana Use | 122 | 204 |
Provides the number of participants reporting physical fights.
| Participants | Intervention Group | Control Group |
|---|---|---|
| Number of Participants Reporting Physical Fights | 227 | 283 |
Bully perpetration was measured on a scale from 1 to 5, where higher on the scale indicates increased perpetration.
| score on a scale | Intervention Group | Control Group |
|---|---|---|
| Bully Perpetration | 1.23 ± 0.46 | 1.21 ± 0.45 |
Collected over Participants could self-report any adverse events over the course of the 5-year study. Participants were contacted and took surveys at baseline, when students were in 7th grade and at 12-, 24-, and 36-months post-intervention, when students were in 8th, 9th, and 10th grade, respectively. Participants were given study contact and resource information at each data collection and could contact study staff at any time to report any adverse events.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Intervention Group | 0/1,237 (0%) | 0/1,237 (0%) | 0/1,237 (0%) |
| Control Group | 0/1,531 (0%) | 0/1,531 (0%) | 0/1,531 (0%) |
The number of students who were included in the baseline survey analysis.
| Age, Customized(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Categorical Age — 12 years or Under | 558 | 573 | 1131 |
| Categorical Age — 13 years | 599 | 799 | 1398 |
| Categorical Age — 14 years | 73 | 147 | 220 |
| Categorical Age — 15 years | 4 | 5 | 9 |
| Categorical Age — Unknown/non Response | 3 | 7 | 10 |
| Sex/Gender, Customized(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Sex — Female | 655 | 739 | 1394 |
| Sex — Male | 581 | 792 | 1373 |
| Sex — Unknown/ Non Response | 1 | 0 | 1 |
| Race/Ethnicity, Customized(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Race/Ethnicity — Hispanic | 402 | 623 | 1025 |
| Race/Ethnicity — Non-Hispanic White | 65 | 135 | 200 |
| Race/Ethnicity — Non-Hispanic Black | 342 | 367 | 709 |
| Race/Ethnicity — Asian | 231 | 158 | 389 |
| Race/Ethnicity — American Indian | 14 | 15 | 29 |
| Race/Ethnicity — Multiple | 58 | 71 | 129 |
| Race/Ethnicity — Unknown/Other | 125 | 162 | 287 |
| Physical Dating Violence (DV) Perpetration(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Physical DV Perpetration | 109 | 163 | 272 |
| No Physical DV Perpetration | 1093 | 1330 | 2423 |
| Non Response | 35 | 38 | 73 |
| Living Situation(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Living with both parents | 769 | 903 | 1672 |
| 1 parent and 1 stepparent | 141 | 194 | 335 |
| Mother only | 220 | 304 | 524 |
| Father only | 16 | 30 | 46 |
| Grandparent(s) | 30 | 44 | 74 |
| Other/unknown | 61 | 56 | 117 |
| Parent Education(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Did not graduate from high school | 87 | 158 | 245 |
| Finished high school or GED | 105 | 158 | 263 |
| Some college or training | 109 | 145 | 254 |
| College graduate | 574 | 632 | 1206 |
| Unknown | 362 | 438 | 800 |
| Number of Sexually Experienced Participants(Participants) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Count of participants | 46 | 65 | 111 |
| Total Student Enrollment in Study School, mean (SD)(Students enrollment) | Intervention Group | Control Group | Total |
|---|---|---|---|
| Mean | 1069 ± 280 | 1052 ± 405 | 1060.5 ± 348.15 |
4 further baseline measures are reported on the registry.
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Jan 2018 to primary completion in Oct 2021, 44 months.
Results were first posted in Dec 2025, 4 years 2 months after primary completion.
Of 195 non-industry interventional studies with no phase under Adolescent Behavior, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 43. This study's 44 months is above that.
Counting every sponsor, half of 198 studies reached it within 20 months; a quarter within 8 and three quarters within 40.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
The University of Texas Health Science Center, Houston →