Teen Dating Violence Awareness Month 2026: Give young people confidential, respectful routes to safety and healthier relationships

Evidence review

The evidence supports a route, not a slogan

Teen dating violence includes psychological, physical, sexual, and technology-facilitated forms of harm within adolescent relationships. It can involve coercion, monitoring, threats, humiliation, isolation, pressure, or violence. A young person may not use the language of abuse. They may ask about jealousy, password demands, repeated messaging, location tracking, pressure to share images, fear of ending a relationship, or a partner controlling who they see. A safe system recognizes these concerns without forcing a label before the young person is ready.

Longitudinal evidence shows why early, respectful access matters. Campo-Tena and colleagues screened 1,838 records and included 14 prospective publications in a systematic review. Across those studies, adolescent dating-violence victimization was associated over time with internalizing symptoms, externalizing behaviors, poorer well-being, substance use, and revictimization. Associations were not consistent across every form of violence or gender, and the review identified limited longitudinal evidence, uneven attention to different violence types, and insufficiently diverse samples.¹² Executives should communicate the seriousness of the issue while resisting deterministic claims about any individual young person.

Prevention evidence is promising but bounded. Russell and colleagues identified nine randomized controlled trials and concluded that prevention programs may reduce emotional, physical, and sexual perpetration and emotional and physical victimization.¹⁵ A later review covering 2011–2021 included 28 controlled studies and found modest improvement in programs’ ability to change dating-violence behaviors, with resistance to change still evident. More effective programs often aligned with gender-transformative principles and used time-intensive, multilevel, multicomponent skill development, although some shorter approaches also showed promise.¹⁴

Secondary prevention is especially relevant to healthcare organizations because it focuses on early intervention when risk or harm is already present. A 2024 systematic review screened 3,645 articles and included 31 reports covering 24 interventions. The authors found encouraging evidence for secondary approaches, particularly for adolescents at higher risk, but only one included study addressed a tertiary intervention and that study focused on program development.¹¹ The gap matters. A campaign cannot end with recognition. Young people who have experienced harm need routes that address immediate safety, health needs, emotional consequences, continuing contact, and the practical realities of school, family, transportation, housing, and digital access.

Policy text and training are not the same as reliable implementation

Figure 1 shows an evidence-base problem that leaders can recognize from other safety initiatives: many studies examine what a policy says or how it is introduced, while fewer examine outcomes. That does not make policy unimportant. It means adoption should be paired with implementation measures, youth experience, and outcome review. A policy that promises privacy but cannot produce private time is not implemented. A referral policy that has no live receiving service is not a pathway. A documentation standard that exposes sensitive information through a portal may work technically while failing clinically.

Implementation research also demonstrates that delivery mode changes the work. Flicker and colleagues reflected on 269 school workshops reaching 951 students. In-person delivery helped facilitators build rapport and manage disclosures but limited anonymous participation. Online delivery supported technology-based engagement but created privacy and time challenges. Hybrid delivery improved some access while introducing technology-equity and classroom-management problems.³ The study was an autoethnographic self-study rather than an effectiveness trial. Its value is operational: every channel changes who can participate, who can overhear, how a disclosure appears, and what staff must be ready to do next.

Safety route

Build a disclosure-ready process before increasing awareness

A disclosure-ready process begins before a question is asked. Registration, rooming, portal messages, interpreter workflows, caregiver access, billing communications, and after-visit materials can all affect safety. Leaders should map where privacy may be lost and assign owners to the points that can be redesigned. The purpose is not to guarantee secrecy that law, safety, or system architecture cannot support. The purpose is to explain limits honestly and prevent avoidable exposure.

The first response matters. Adolescents often turn to friends before formal services. In a 2026 vignette study involving 655 adolescents, supportive relational intentions such as listening, helping a friend decide what to do, reassurance, and encouraging contact with trusted others were endorsed more often than institutional responses. Responses varied in selective ways by relationship configuration, with some scenarios less likely to elicit active intervention or more likely to create uncertainty.⁴ The study measured intended responses, not observed behavior, and took place in secondary schools in Southern Italy. It still underscores a core design principle: validation and social recognizability influence whether a young person reaches further help.

Healthcare teams should not turn that insight into a rigid interrogation. A supportive response can be brief: thank the young person for sharing, state that the harm is not their fault, ask what feels most urgent, check immediate safety, explain available choices, and identify the safest way and time to follow up. If a mandatory action is required, staff should explain what will happen, who will be told, and what choices remain. Scripts should be reviewed by legal counsel, privacy leaders, clinicians, advocates, and youth advisors in the relevant jurisdiction.

Separate private opportunity from coercive screening

Private access and supportive inquiry are not identical to universal use of a risk-prediction tool. Cohen and colleagues studied 584 adolescents and evaluated factors associated with concurrent and prospective dating-violence perpetration. Hostility best classified concurrent and prospective physical perpetration, and exposure to domestic violence best forecast prospective psychological perpetration, with reported area-under-the-curve values above 0.70. The authors found machine-learning models added minimal incremental validity.⁹ This study concerns prevention risk classification for perpetration. It does not validate a victimization-screening script, dictate a clinical response, or justify punitive action.

If an organization uses any standardized inquiry or screening approach, leaders should define the purpose, eligible population, setting, privacy conditions, staff role, response to a positive answer, response to a declined answer, documentation rule, equity review, and reassessment process. A tool should not be introduced merely because it is easy to add to an electronic form. The system must be able to act safely on the information it collects.

Design for identity, context, and recognition

Teen relationship harm does not occur in one kind of couple. A systematic review focused on sexual and gender-minority youth identified six risk domains: demographic and identity-related factors; psychological and behavioral factors; violence and bullying; family and sexual abuse; relational and social factors; and school and community conditions. The review highlighted risks that may be missed by conventional measures, including family rejection, exclusion, identity-based abuse, and threats of outing. Most included studies were cross-sectional, U.S.-based, and reliant on nonvalidated or inconsistent measures, limiting causal inference and comparability.⁸

In a 2025 qualitative study, 24 caregivers of sexual and gender-diverse youth described both strengths and difficulty when discussing relationships and abuse prevention. They recommended education, communication-skill building, caregiver affirmation, experienced facilitators, multiple delivery modes, and direct involvement of sexual and gender-diverse youth in program design.¹⁰ Caregiver support can be protective, but caregiver involvement must not be assumed safe in every case. Young people need options that recognize family context without making disclosure dependent on family acceptance.

Family context also appears in a 2026 mixed-methods systematic review of 17 studies examining pathways from intra-familial childhood victimization to later relationship violence. The review proposed roles for attachment, early maladaptive schemas, and aspects of sense of self, while identifying major gaps: the three factors had not been studied together, age effects had not been examined, and gender findings were inconclusive.² A separate 2026 study of parental perspectives adds to the developing caregiver-focused evidence base.⁶ These sources support careful family-aware design, not a rule that family involvement is always protective, appropriate, or safe.

A 2026 study of 304 sexual and gender-minority youth aged 15–18 found generally high bystander-helping intentions, with different correlates for proactive and reactive responses. LGBTQ+ community connectedness was associated with stronger reactive helping intentions in dating-violence situations.⁵ The cross-sectional baseline data do not show that connectedness causes intervention or that intentions become behavior. They do support investment in affirming peer and community connections as part of a broader prevention system.

Operating system

Protect the young person across clinical, digital, and community boundaries

The most visible part of a response may be a clinician conversation, but the route spans more than the clinical team. Registration staff may need a neutral way to request private time. Interpreters need clear privacy procedures. Health-information leaders must determine where sensitive details appear. Portal teams need to understand proxy access and notification behavior. Compliance and legal leaders need a jurisdiction-specific interpretation of reporting duties and adolescent consent. Advocates and community partners need a closed-loop connection process. Executives must ensure these decisions are coherent.

Digital channels require special caution. In interviews with 35 staff members at organizations serving teens affected by domestic or dating violence, technology was described as both lifesaving and potentially harmful. It could expand connection while also creating safety concerns and deepening the digital divide.¹³ A text, email, portal notification, calendar entry, browser history, or app installation may be visible to another person. “Digital access” is not automatically “safe access.” Teams should ask the young person whether a channel is safe, what words may appear, when contact is safest, and whether any message should be sent at all.

Documentation also needs a purpose test. Record what is clinically and legally necessary, use objective language, distinguish the young person’s words from staff observations, and avoid unnecessary detail that increases exposure without improving care. Leaders should review where notes, diagnoses, orders, bills, and after-visit summaries surface to patients and proxies. Local policy must address information blocking, minor-consent rules, mandatory reporting, access requests, and organizational risk. This article cannot resolve those legal questions. It can insist that they be resolved before a campaign invites disclosure.

Make advocacy connection real

A resource list is useful only if it is current, accessible, and safe to receive. Before February, confirm each partner’s eligibility rules, hours, languages, disability access, geographic coverage, digital-safety practices, caregiver requirements, emergency limits, and after-hours plan. Decide how staff will make a warm connection, how consent will be recorded, what happens if the service is unavailable, and whether completion can be confirmed without exposing the young person.

Do not evaluate the route by the number of handouts distributed. A young person may accept information but decline a call. They may need time before contacting a service. They may choose one safe adult rather than formal advocacy. They may need medical care without making a report. A respectful system distinguishes an offered choice, an accepted connection, a completed contact, and a youth-defined safe outcome.

Prepare staff for the moment after “yes”

Training should include explanation, rehearsal, observation, and feedback. Staff need to practice how to create privacy, introduce confidentiality, respond to ambiguous language, handle a disclosure, pause when a companion returns, use an interpreter, contact an advocate, document minimally, and arrange safe follow-up. Scenario-based rehearsal should include varied genders, sexual orientations, relationship configurations, disabilities, languages, family contexts, and digital-safety concerns.

A 2025 overview of prevention research concluded that healthcare-provider training can improve knowledge and screening practice, while implementation barriers remain. The review also noted that attitude and norm changes are often more evident than changes in violent behavior and that the evidence base is predominantly U.S.-focused.⁷ Training completion is therefore a readiness measure, not an outcome measure. Leaders should examine observed performance and the safety of actual handoffs.

Measurement

Measure whether the route is available, accepted, safe, and completed

A measure should answer a decision. Leaders need denominators that separate opportunity from disclosure and disclosure from referral. Counts should be interpreted with caution because a safer environment may initially increase disclosures, while a low disclosure count may reflect low exposure, low recognition, low trust, poor access, or incomplete documentation. No single measure represents success.

Use equity review without creating another privacy risk

Stratification can reveal where private opportunity, service acceptance, or completion differs. It can also expose young people when groups are small or identities are sensitive. Establish minimum cell sizes, restrict access, separate improvement data from personnel evaluation, and avoid collecting identity variables that the team cannot protect or use. Invite youth advisors to review not only the dashboard but also the burden and safety of data collection.

Policy research shows the need to examine implementation and outcomes, not only policy presence.¹ Prevention research shows why observed behavior and long-term outcomes should not be inferred from short-term attitude change.^{7, 14, 15} A credible dashboard preserves those distinctions.

90-day plan

Use February as the launch point for a durable safety route

The observance can focus attention, but readiness work should begin before February and continue after it. The sequence below is intentionally practical: map the current route, co-design the future route, correct privacy and partner gaps, train and simulate, pilot in a limited setting, and review the data before spread.

The 2026 theme, “Real Love Respects,” is simple. The executive work behind it is not. Respect must be visible in privacy, language, digital design, documentation, partner capacity, youth choice, and the reliability of the next step. When those conditions are in place, an awareness month can open a route that remains useful long after February ends.