Changes in attitude and behaviour by use of The Macho Factory or similar programs

Preventing violence and poor health among children, adolescents, and young adults is a priority issue. Various programs aimed at preventing violence and changing perceptions and attitudes regarding gender, norms, and masculinity are currently offered to children and youth in schools and during sports activities.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut202418 Registration no: SBU 2024/535

Question

What systematic reviews have been published regarding the program The Macho Factory or similar programs regarding their impact on perceptions, knowledge, attitudes, and behaviors related to gender equality, violence, harassment, and abuse among youth?

Method

A systematic literature search was performed using the following databases: Medline (by Ovid), Scopus and SOCIndex, Criminal Justice Abstracts, Psychology and Behavioral Sciences Collection, ERIC, Academic Search Premier, CINAHL and PSYCINFO (by EBSCO).
Two authors independently assessed the abstracts of all identified studies.
Risk of bias in relevant systematic reviews was assessed using an assessment tool based on AMSTAR.

Identified literature

One relevant systematic review with low to moderate risk of bias were identified [1]. The results and conclusions are presented in Table 1. In ten relevant systematic reviews, the risk of bias was considered to be high, therefore the results and conclusions are not reported [2-11].

Table 1 Systematic reviews with low/moderate risk of bias.
Included studies Population, Intervention, Control Outcome and Results
Kettrey et al, 2019 [1]
Effects of Bystander Programs on the Prevention of Sexual Assault among Adolescents and College Students: A Systematic Review
27 studies in 38 reports included in systematic review.
24 studies in 38 reports included in meta-analysis. RCT: 12 studiesCluster-RCT: 9 studies.
Controlled pre-post design: 6 studies.

Setting:USA: 25 studiesCanada: 1 studyIndia: 1 study		 Population:
Adolescents 12 to 25 years of age

Intervention:
Programs in school setting approaching adolescents/ college students as allies in preventing and/or alleviating sexual assault and cultivating willingness to respond when persons are at risk for sexual assaults. All delivery formats and duration.

Control:
No intervention, sham intervention, or attention treatment with no expended effect on bystander outcomes.		 Outcomes:

Rape myth acceptance:
Immediate post-intervention (7 studies): Positive statistically significant effect; Hedges g: 0.43 (95% CI, 0.18 to 0.68)

Gender attitudes:
2–4 months post-intervention (3 studies): No evidence of effect; Hedges g: 0.20 (95% CI, –0.35 to 0.75)

Date rape attitudes:
Immediate post-intervention (3 studies): No evidence of effect; Hedges g: 0.04 (95% CI, –0.29 to 0.38)

Noticing sexual assault/warning signs:
Immediate post-intervention (2 studies): No evidence of effect; Hedges g: 0.19 (95% CI, –0.10 to 0.45)

Identifying situation to intervene:
Immediate post-intervention (5 studies): Positive statistically significant effect; Hedges g: 0.57 (95% CI, 0.08 to 1.05)

Taking responsibility for acting/intervening:
Immediate post-intervention (3 studies): No evidence of effect; Hedges g: 0.29 (95% CI, –0.53 to 1.11)

Knowledge of strategies:
Immediate post-intervention (4 studies): No evidence of effect; Hedges g: 0.54 (95% CI, –0.09 to 1.17)

Bystander efficacy:
Immediate post-intervention (11 studies): Positive statistically significant effect; Hedges g: 0.45 (95% CI, 0.25 to 0.65)

Bystander intention:
Immediate post-intervention
(6 studies): No evidence of effect; Hedges g: 0.17 (95% CI, –0.18 to 0.52)
1–4 months post-intervention (6 studies): Positive statistically significant effect; Hedges g: 0.41 (95% CI, 0.15 to 0.68)

Bystander intervention:
1–4 months post-intervention (11 studies): Positive statistically significant effect; Hedges g: 0.27 (95% CI, 0.19 to 0.36)
6–12 months post-intervention (4 studies): No evidence of effect; Hedges g: 0.12 (95% CI, –0.08 to 0.32

Sexual assault perpetration:
3–4 months post-intervention (2 studies): No evidence of effect; Hedges g: 0.33 (95% CI, –0.70 to 1.36) 

Note: This is a summary. Please see the review [1], p 16–29 for a complete list of results and analyses.
Authors' conclusion:”Bystander programs have an effect on knowledge and attitudes for some outcomes. […] There is no evidence that bystander programs have an effect on participants’ rates of sexual assault perpetration.”

References

  1. Kettrey HH, Marx RA, Tanner-Smith EE. Effects of bystander programs on the prevention of sexual assault among adolescents and college students: A systematic review. Campbell Syst Rev. 2019;15(1-2):e1013. Available from: https://doi.org/10.4073/csr.2019.1.
  2. DeGue S, Valle LA, Holt MK, Massetti GM, Matjasko JL, Tharp AT. A systematic review of primary prevention strategies for sexual violence perpetration. Aggress Violent Behav. 2014;19(4):346-62. Available from: https://doi.org/10.1016/j.avb.2014.05.004.
  3. Finnie RKC, Okasako-Schmucker DL, Buchanan L, Carty D, Wethington H, Mercer SL, et al. Intimate Partner and Sexual Violence Prevention Among Youth: A Community Guide Systematic Review. Am J Prev Med. 2022;62(1):e45-e55. Available from: https://doi.org/10.1016/j.amepre.2021.06.021.
  4. Kettrey HH, Marx RA. Effects of bystander sexual assault prevention programs on promoting intervention skills and combatting the bystander effect: a systematic review and meta-analysis. J Exp Criminol. 2020;17(3):343-67. Available from: https://doi.org/10.1007/s11292-020-09417-y.
  5. Lee C, Wong JS. Examining the effects of teen dating violence prevention programs: a systematic review and meta-analysis. J Exp Criminol. 2020;18(1):1-40. Available from: https://doi.org/10.1007/s11292-020-09442-x.
  6. Malhotra K, Gonzalez-Guarda RM, Mitchell EM. A Review of Teen Dating Violence Prevention Research: What About Hispanic Youth? Trauma Violence Abuse. 2015;16(4):444-65. Available from: https://doi.org/10.1177/1524838014537903.
  7. Melendez-Torres GJ, Orr N, Farmer C, Shaw N, Chollet A, Rizzo AJ, et al. School-based interventions TO Prevent Dating and Relationship Violence and Gender-Based Violence: STOP-DRV-GBV systematic review. Public Health Res (Southampt). 2024;12(3):1-192. Available from: https://doi.org/10.3310/KTWR6997.
  8. Plourde KF, Thomas R, Nanda G. Boys Mentoring, Gender Norms, and Reproductive Health-Potential for Transformation. J Adolesc Health. 2020;67(4):479-94. Available from: https://doi.org/10.1016/j.jadohealth.2020.06.013.
  9. Quinones C, Navarro A. A 10 year (2011-2021) systematic review of teen dating violence prevention programs. J Inj Violence Res. 2022;14(3):209-24. 
  10. Verbeek M, Weeland J, Luijk M, van de Bongardt D. Sexual and Dating Violence Prevention Programs for Male Youth: A Systematic Review of Program Characteristics, Intended Psychosexual Outcomes, and Effectiveness. Arch Sex Behav. 2023;52(7):2899-935. Available from: https://doi.org/10.1007/s10508-023-02596-5.
  11. Villardon-Gallego L, Garcia-Cid A, Estevez A, Garcia-Carrion R. Early Educational Interventions to Prevent Gender-Based Violence: A Systematic Review. Healthcare (Basel). 2023;11(1). Available from: https://doi.org/10.3390/healthcare11010142.

Search strategies

Medline via OvidSP 17 September 2024

Title: Machofactory
/ = Term from the MeSH controlled vocabulary; .sh = Term from the MeSH controlled vocabulary; exp = Term from MeSH including terms found below this term in the MeSH hierarchy; .ti,ab = Title or abstract; .tw = Title or abstract; .kf = Keywords; .kw = Keywords, exact; .bt = Book title. NLM Bookshelf; .pt = Publication type; .ja = Journal abbreviation; .af = All fields; adjn = Adjacent. Proximity operator retrieving adjacent words, adj3 retrieves records with search terms within two terms from each other; * or $ = Truncation; “ “ = Citation Marks; searches for an exact phrase

a. Cochrane Highly Sensitive Search Strategy for identifying randomized trials in MEDLINE: sensitivity- and precision-maximizing version (2008 revision); Ovid format. The Cochrane Collaboration; 2008. Available from: https://training.cochrane.org/handbook/current/chapter-04-technical-supplement-searching-and-selecting-studies#section-3-6-1. with modifications: the following terms are added: clinical trial, phase iii.pt. ; randomised.ab. ; ("Phase 3" or "phase3" or "phase III" or P3 or "PIII").ti,ab,kw.
Search terms Items found
Population:
1. exp schools/ or child/ or adolescent/ or minors/ or (child* or "school child*" or schoolage* or "school age*" or "elementary school*" or "primary school*" or "grade school*" or kid or kids or boy* or girl* or prepube* or "pre-pube*" or preadolescen* or "pre-adolescen*" or "junior school*" or "junior high*" or "middle school*" or tween* or preschool or "pre-school" or young* or youth* or adolescen* or teenage* or teen or teens or underage* or "high school*" or highschool*).ti,ab,kf,bt. 4 676 468
Intervention:
2. (machofabriken or "the macho factory" or "mentors in violence prevention" or (bystander and (intervention* or training or program or education)) or "peer prevention" or "gender* AND violence" or "Interpersonal violence" or "relationship violence" or masculin* or (gender adj3 power) or homophob* or anti-bullying program or bullying prevention or school-based intervention or peer support or violence prevention or program effectiveness).ti,ab,kf,bt 36 884
Outcome:
3. (Behav* OR Attitude* OR (Social and norm*) OR (social AND valu* ) OR (social AND skill*)).ti,ab,kf,bt. 1 987 728
Study types: systematic reviews and meta-analysis / randomized controlled trials a.
4. Systematic Review/ or Meta-Analysis/ or Cochrane Database Syst Rev.ja. or ((systematic adj4 review) or "meta analys*" or metaanalys*).ti,bt,ab. not (editorial/ or letter/ or case reports/) 503 564
Final result
5. 1 and 2 and 3 and 4 233

Scopus via scopus.com 13 September 2024

Title: Machofactory
TITLE-ABS-KEY = Title, abstract or keywords (including indexed keywords and author keywords); ALL = All fields; W/n = Within. Proximity operator retrieving terms within n words from each other; PRE/n = Precedes by. Proximity operator, the first term in the search must precede the second by n words; LIMIT-TO (X) = Includes only results of specified type, e.g., publication type or time range; DOCTYPE = Publication type; “re” = review; “le” = letter; “ed” = editorial; “ch” = book chapter; “cp” = conference proceedings; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. TITLE-ABS-KEY (child* OR Schoolchild* OR ”school child*” OR schoolage* OR ”school age*” OR ”elementary school*” OR "elementary school student*" OR ”primary school*” OR ”grade school*” OR kid OR kids OR boy* OR girl* OR prepube* OR ”pre-pube*” OR preadolescen* OR ”pre-adolescen*” OR ”junior school*” OR ”junior high*” OR ”middle school*” OR tween* OR preschool OR ”pre-school” OR young* OR youth* OR adolescen* OR teenage* OR teen OR teens OR underage* OR ”high school*” OR highschool*) 7 231 996
Intervention:
2. TITLE-ABS-KEY (machofabriken OR {the macho factory} OR {Mentors in Violence Prevention} OR ( bystander AND ( intervention* OR training OR program OR education ) ) OR {peer prevention} OR ( gender* AND violence ) OR {Interpersonal violence} OR {relationship violence} OR masculin* OR {gender w/4 power} OR homophob* ) 112 225
Outcome:
3. TITLE-ABS-KEY (Behav* OR Attitude* OR (Social and norm*) OR (social AND valu* ) OR (social AND skill*)) 8 103 805
Study types: systematic reviews and meta-analysis / randomized controlled trials
4. TITLE-ABS-KEY ( ( systematic W/2 review ) OR "meta analy*" OR metaanaly* ) AND (EXCLUDE (DOCTYPE, “le”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “ch”) OR EXCLUDE (DOCTYPE, “cp”)) 742 468
Final results
5. 1 and 2 and 3 and 4 940

SOCIndex /Criminal Justice Abstracts / Psychology and Behavioral Sciences Collection / ERIC / Academic Search Premier/CINAHL/PSYCINFO via EBSCO 16 September 2024

Title: Machofactory
TI = Title; AB = Abstract; SU = Keyword, exact or part (including all other fields for indexed and author keywords); Nn = Near. Proximity operator retrieving terms within n words from each other; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. AB ( (child* or ”school child*” or schoolage* or ”school age*” or ”elementary school*” or ”primary school*” or ”grade school*” or kid or kids or boy* or girl* or prepube* or ”pre-pube*” or preadolescen* or ”pre-adolescen*” or ”junior school*” or ”junior high*” or ”middle school*” or tween* or young* or youth* or adolescen* or teenage* or teen or teens or underage* or ”high school*” or highschool*) ) OR TI ( (child* or ”school child*” or schoolage* or ”school age*” or ”elementary school*” or ”primary school*” or ”grade school*” or kid or kids or boy* or girl* or prepube* or ”pre-pube*” or preadolescen* or ”pre-adolescen*” or ”junior school*” or ”junior high*” or ”middle school*” or tween* or young* or youth* or adolescen* or teenage* or teen or teens or underage* or ”high school*” or highschool*) ) OR SU ( (child* or ”school child*” or schoolage* or ”school age*” or ”elementary school*” or ”primary school*” or ”grade school*” or kid or kids or boy* or girl* or prepube* or ”pre-pube*” or preadolescen* or ”pre-adolescen*” or ”junior school*” or ”junior high*” or ”middle school*” or tween* or young* or youth* or adolescen* or teenage* or teen or teens or underage* or ”high school*” or highschool*)) 7 906 272
Intervention:
2. TI machofabriken OR "the macho factory" OR "mentors in violence prevention" OR ("bystander AND (intervention* OR training OR program OR education)) OR "peer prevention" OR ("gender* AND violenc") OR "Interpersonal violence" OR "relationship violence" OR masculin*OR AB"mentors in violence prevention" OR ("bystander AND (intervention* OR training OR program OR education)) OR "peer prevention" OR ("gender* AND violenc") OR "Interpersonal violence" OR "relationship violence" OR masculin*OR SU "mentors in violence prevention" OR ("bystander AND (intervention* OR training OR program OR education)) OR "peer prevention" OR ("gender* AND violenc") OR "Interpersonal violence" OR "relationship violence" OR masculin* 181 048
Outcome:
3. TI (Behav* OR Attitude* OR (Social and norm*) OR (social AND valu* ) OR (social AND skill*)) AB (Behav* OR Attitude* OR (Social and norm*) OR (social AND valu* ) OR (social AND skill*)) OR SU; (Behav* OR Attitude* OR (Social and norm*) OR (social AND valu* ) OR (social AND skill*)) 7 269 446
Study types: systematic reviews and meta-analysis
4. TI((systematic N3 review) OR "meta analys*" OR metaanalys*) OR AB((systematic N3 review) OR "meta analys*" OR metaanalys*) OR SU((systematic N3 review) OR "meta analys*" OR metaanalys*) 748 244
Final result
5. 1 and 2 and 3 and 4 685
Page published
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