State laws addressing teen dating violence in US high schools: A difference-in-differences study

Teen dating violence (TDV) remains a substantial public health problem for adolescents, families, and communities (Smith et al., 2018). Approximately one in eight U.S. high school students experience physical and/or sexual violence by someone they are dating each year (Basile et al., 2020). One nationally-representative survey in 2013–2014 of 12 to 18-year-old dating youth found that >60% experienced psychological/emotional abuse (Taylor and Mumford, 2016). These experiences of TDV can have negative physical health, mental health, and social consequences, including depression, anxiety, suicidal ideation, increased substance use, decreased academic achievement, subsequent intimate partner violence, and in extreme cases, death (Exner-Cortens et al., 2013; Adhia et al., 2019; Banyard and Cross, 2008). Although TDV is widespread with lifelong adverse consequences, it is preventable, and strategies to reduce the burden of TDV are needed (Niolon et al., 2017; Ragavan and Miller, 2022).

Schools provide an important, structured setting for TDV prevention and response, by creating caring climates, providing support for student well-being, and implementing prevention programs (De La Rue et al., 2017). Over the past couple decades, states have increasingly recognized the seriousness of TDV, the central role schools can play, and have enacted laws requiring schools to address TDV. These laws are structural interventions that lay a foundation for a range of activities in schools, including education for students and training for school staff (Hatzenbuehler et al., 2015; Srabstein et al., 2008; National Association of State Boards of Education (NASBE), 2024). They can facilitate scaling up the use of multilevel strategies, including implementing educational programs that have been shown to reduce violence but are often not widely used (Rothman et al., 2015; Adhia et al., 2022; Niolon et al., 2019; Flannery et al., 2016; Leen et al., 2013). Importantly, these laws respond to calls to prioritize societal strategies that affect the outer layers of the social ecology to increase population-level impact (Rothman et al., 2015; Centers for Disease Control and Prevention (CDC), 2024).

As of September 2020, 29 states had at least 1 law related to TDV requirements in schools, with variability in the requirements across states (Adhia et al., 2022). These laws are often similar to anti-bullying laws, which have been shown to be effective in reducing school bullying (Hatzenbuehler et al., 2015; Sabia and Bass, 2017; Nikolaou, 2017). Both TDV and anti-bullying laws can include, for example, definitions of the behaviors, prevention education requirements, and requirements for districts to have written policies and detailed response procedures (Adhia et al., 2022; Cascardi et al., 2018). States with TDV laws all require schools to provide prevention education to students, most commonly including content on healthy relationships and awareness-raising of TDV (Adhia et al., 2022). Despite the proliferation of TDV laws, significant gaps remain in understanding their effectiveness. To our knowledge, only one prior cross-sectional study examined these laws and found no relationship between the presence of a TDV law and TDV prevalence among high school students (Harland et al., 2021). We build on the limited existing literature by capitalizing on between-state variation in the enactment of TDV laws paired with repeated cross-sectional data to estimate the association between TDV laws and TDV victimization using a difference-in-differences approach. While we are unable to measure implementation of the laws, we assess whether the enactment of state TDV laws is associated with changes in physical TDV victimization among high school students. These results can inform policymakers and assess whether enacting laws may serve as an effective population-level prevention strategy for TDV.

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