Division Of Violence Prevention Research Articles

Community-Based Participatory Research Approaches to Youth Violence Prevention: Reflections on the Special Issue

Although the rates of violence among adults and youth have declined over the past 15 years, youth violence continues to be a significant public health concern. 1 Given the complexities associated with violence, prevention researchers often form collaborations with community partners to address this intractable public health problem. This special issue of Progress in Community Health Partnerships: Research, Education, & Action is dedicated to the topic of youth violence prevention research. We have collected a series of high-quality papers that highlight research that engages the community in the planning, implementation, and evaluation phases of programs that aim to prevent youth violence. We are pleased to showcase the work of youth violence prevention researchers, practitioners, and community collaborators that is consistent with the principles and practices of community-based participatory research (CBPR). The special issue was supported in part by the U.S. Centers for Disease Control and Prevention (CDC) because preventing youth violence through promoting community–research partnerships is a critical function of the CDC’s Division of Violence Prevention. 1 We received dozens of strong submissions for this special issue. Consistent with the mission of Progress in Community Health Partnerships, we have featured a series of Original Research and Work-in-Progress & Lessons Learned papers that apply principles of CBPR in an effort to develop or implement evidence-based violence prevention strategies. 2 The articles described violence prevention research conducted in different contexts, including schools, after-school programs, community-based programs, and community settings. Several different aspects and forms of youth violence were addressed, such as bullying, aggression, fighting, and gang involvement. All of the empirical articles featured in this special issue were jointly authored by academic researchers and community partners from diverse settings, such as faith-based organizations, community-based programs, community health worker programs, schools, and school districts. Furthermore, all of the articles highlighted the role of partnerships in multiple phases of the research process. Both qualitative and quantitative methods were used by the research teams to document the implementation process and outcomes of the youth violence prevention activities. Several common themes emerged across the diverse set of papers, including issues related to recruitment and retention of qualified staff to implement the programs. As with other types of prevention programs, implementation quality and sustainability were highlighted as common concerns. Some of the authors discussed the critical role of youth voice and the importance of actively engaging youth and community partners in the program development process. Another common challenge was balancing the need for a rigorous research design and meeting priorities of the community. For example, the study by Leff and colleagues 3 described the process by which the Philadelphia Collaborative Violence Prevention Center selected a study design for their after-school prevention program and the decision to forgo additional qualitative data collection. This paper illustrated the importance of shared decision making in all phases of the research process. Also included in this issue is a transcript of the podcast recorded with Leff and co-author Thomas, in which they elaborate on the role of CBPR in their center’s broader program of youth violence prevention research.

Measuring attitudes, behaviours, and influences in inner city victims of interpersonal violence (VIVs) - a Swiss emergency room pilot study

BackgroundSwitzerland is confronted with the problem of interpersonal violence. Violence is in the increase and the potential for aggression seems to be rising. Observations by hospitals discern an appalling increase of the severity of the injuries. The aim of this study is to collect accurate information about the social environment, the motivation and possible reasons for violence. We also intend to investigate whether sociocultural, or ethnic differences among male victims exist.Materials and methodsFor the first time in Switzerland, this survey employed a validated questionnaire from the division of violence prevention, Atlanta, Georgia. The first part of the questionnaire addressed social and demographic factors which could influence the risk of violence: age, gender, duration of stay in Switzerland, nationality and educational level. Beside these social structural factors, the questionnaire included questions on experience of violent offences in the past, information about the most recent violent offence and intra and interpersonal facts. The questionnaire itself consists of 27 questions, translated into German and French. In a pilot study, the questionnaire was checked with adolescents for feasibility and comprehensibility.Results69 male VIVs were interviewed at two hospitals in the Canton of Bern. Most of the adolescents emphasised that weapons were not used during their confrontations. It is astonishing that all of the young men considered themselves to be victims. Most of the brawls were incited after an exchange of verbal abuse and provocations with unfamiliar individuals. The rivals could neither be classified with the help of ethnic categories nor identifiable groups of the youth scenes. The incidents took place in scenes, where violence was more likely to happen. Interestingly and contrary to a general perception the offenders are well integrated into sport and leisure clubs. A further surprising result of our research is that the attitude towards religion differs between young men with experience of violence and non-violent men.DiscussionYouth violence is a health issue, which concerns us globally. The human and economic toll of violence on victims and offenders, their families, and on society in general is high. The economic costs associated with violence-related illness and disability is estimated to be millions of Swiss francs each year. Physicians and psychologists are compelled to identify the factors, which cause young people to be violent, to find out which interventions prove to be successful, and to design effective prevention programs. The identification of effective programs depends on the availability of reliable and valid measures to assess changes in violence-related attitudes. In our efforts to create healthier communities, we need to investigate; document and do research on the causes and circumstances of youth violence.

Prevention is better than cure

started inviting me to spend the nights with him when my mother was at work, recalls Ntombi (name changed), a Swazi now in her mid-twenties who was raped by her father on a routine basis from the age of twelve. said if I said anything to my morn, he would kill me. He said he would protect me from her beatings. The weekly violations went on for a period of seven years until Ntombi finally got help from a teacher. Aberrant as the case may seem, it is by no means unusual in Swaziland as revealed by a 2007 study carried out by the United Nations Children's Fund (UNICEF) in association with the Centers for Disease Control and Prevention (CDC) in the United States of America. The purpose of the study was to describe the epidemiological distribution of sexual violence against young girls in this country of just over one million people. The results were chilling. Approximately one in three females experienced some form of sexual violence as a child, nearly one in four experienced physical violence, while three in 10 experienced emotional says Dr Jama Gulaid, representative of UNICEF in Swaziland. It is important to point out that child sexual abuse is a global problem, says Dr Alexander Butchart, from the Department of Violence and Injury Prevention and Disability at the World Health Organization. Even in high-income countries, it is estimated that more than one in five females experienced some form of sexual abuse as a child, and one in five children have experienced severe parental physical abuse. While not unique in having a high prevalence of child sexual abuse, Swaziland is exceptional in being one of the few low- and middle-income countries in any region to have so fully acknowledged and thoroughly investigated the epidemiology of child sexual abuse as a basis for prevention, Butchart says. The study revealed that boyfriends and husbands were the most frequent perpetrators of sexual assault, while non-sexual physical violence was typically meted out by male relatives (not including victims' fathers). Emotional abuse typically came from female relatives. Sexual violence most frequently occurred in the victim's home or the home of a friend, relative or neighbour. are only a few cases of children who get raped in the bushes or in areas far away from home by complete strangers, says Ncamisile Gwebu, a child protection officer in the Hhohho region in Swaziland. [ILLUSTRATION OMITTED] As is the case with rape all over the world, underreporting was a factor, with less than half of the incidents of child sexual violence being reported to the authorities. Remarkably, however, the primary reasons the victim did not report in this study were: fear of abandonment, a desire to protect the perpetrator or lack of awareness that what she had experienced was in fact abuse. Not that they were unaffected by their experiences. According to Ndo Mdlalose, a clinical psychologist based in the capital Mbabane, the victims typically suffer from depression, panic attacks and anxiety, though the adverse effects are by no means limited to emotional and behavioural problems. Child maltreatment has also been associated with broader health issues such as diabetes, ischaemic heart disease, sexually transmitted diseases and a variety of health risk behaviours including smoking, says James Mercy, from the Division of Violence Prevention at the CDC. Swazi children subject to abuse find themselves isolated at many levels, an isolation which is often self-imposed. Typically, they blame themselves rather than the perpetrators for what has happened, says Mdlalose. There is a tendency to suffer in silence. Those children brave enough to seek professional counselling make do with the two psychologists responsible for the needs of the entire country. Of course, ideally, these children should never be exposed to the abuse in the first place, which is why Mercy believes that prevention is the key to dealing with the issue. …

The public health approach to youth violence and child maltreatment prevention at the Centers for Disease Control and Prevention.

Millions of people in the United States suffer the consequences of violence, including physical injuries, psychological trauma, and death. Solutions to violence have traditionally been reactive. Through the lens of the public health perspective, the Centers for Disease Control and Prevention (CDC) views violence as predictable based on various contributing factors, and thus as preventable. Within CDC, the Division of Violence Prevention (DVP) leads efforts to prevent injury, death, and disability, and to reduce the suffering and medical costs caused by violence. DVP employs a multidisciplinary, public health approach to identify factors associated with violence, and to develop, evaluate, and disseminate preventive interventions. Psychology is one discipline that has contributed to our approach. The authors present a series of violence prevention initiatives funded by the CDC that are framed within a public health perspective, with attention to the contributions of psychology to youth violence and child maltreatment prevention.

Bridging Science and Practice in Violence Prevention: Addressing Ten Key Challenges

This article illustrates ideas for bridging science and practice generated during the Division of Violence Prevention's (DVP) dissemination/implementation planning process. The difficulty of moving what is known about what works into broader use is near universal, and this planning process pushed us to look beyond the common explanations (e.g., providers were resistant/unwilling to change practice) and think about the multiple layers and systems involved. As part of this planning process, the Interactive Systems Framework for Dissemination and Implementation (ISF) was developed and then applied to the fields of child maltreatment and youth violence prevention. Challenges for each of the three systems in the ISF are discussed as well as and action and research ideas to address the challenges. Also described are actions taken by DVP in response to the planning process to illustrate how a funder can use the ISF to bridge science and practice.

Research and Action for Bridging Science and Practice in Prevention

There is a well-known gap between science and practice. To address this gap in the areas of Child Maltreatment (CM) and Youth Violence (Y/V), the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) embarked on a Dissemination/Implementation (D/I) planning project. The project was aimed at identifying better ways to connect research and practice through reviews of the literature as well as through discussions with experts on violence prevention and research utilization. This introductory article sets the stage for the rest of the special issue by defining terms, providing a rationale for the planning project, describing the planning process, and summarizing what is to come in the rest of the issue.

Building an Effective Child Maltreatment Surveillance System in North Carolina

n public health, the first step in assessment of a health or social problem is enumeration of the population affected and the impact of the problem. Estimated rates of child physical abuse in North Carolina range from 0.5 to 36 per 1,000 children, a 70-fold difference. Such disparate estimates of abuse rates challenge policy makers to establish policies and systems for prevention. A child maltreatment surveillance system is needed in North Carolina that will provide for continuous and systematic data to identify the magnitude and the impact of child abuse and neglect. This will inform the allocation of resources and public health action, and it will require leadership and responsibility within state government. In this commentary, we review the current approaches to child maltreatment surveillance, options for surveillance, and promising new practices. A public health-based child maltreatment surveillance system must rely on coordinated efforts and a variety of data sources from multiple sectors: social services, public health, law enforcement, and academic research. One of the challenges of developing a surveillance system lies in the definition of child maltreatment. Currently, this differs widely among agencies and care providers. The Centers for Disease Control and Prevention (CDC) Division of Violence Prevention has made establishing uniform definitions of child abuse and neglect a priority for moving forward with surveillance, research, and prevention. A position statement with uniform definitions of various types of maltreatment will be forthcoming from the CDC. North Carolina’s Division of Public Health needs to begin the work of designing a child maltreatment surveillance system with elements that are aligned with our child maltreatment laws, yet are consistent with national definitions and data elements.

Child Maltreatment Prevention Priorities at the Centers for Disease Control and Prevention

The Division of Violence Prevention at Centers for Disease Control and Prevention's (CDC) National Center for Injury Prevention and Control has had a long-standing interest in the prevention of child maltreatment. The nation's public health agency, CDC, seeks to focus the public health perspective on the problem of child maltreatment and to promote science-based practice in the field. Since 1999, CDC has developed research priorities to address the prevention of child maltreatment. Described here is a brief rationale for applying a public health approach to child maltreatment and a discussion of the priority-setting process, priorities in each of four areas of the public health model, and some of CDC's current child maltreatment prevention activities.

Through a public health lens. Preventing violence against women: an update from the US Centers for Disease Control and Prevention.

Over the past two decades, the Centers for Disease Control and Prevention (CDC) has been a key contributor to the growing public health effort to prevent violence. Although CDC and its partners are proud of their many successes, much work remains to be done. Violence continues to be a leading cause of death worldwide for people aged 15-44. Moreover, although many forms of violence garner national concern and resources, much more violence occurs in private domains and receives less attention. These hidden health hazards silently drain our nation's human, economic, and health resources. In this paper, we highlight the current efforts of the Division of Violence Prevention (DVP), housed within CDC's National Center for Injury Prevention and Control (NCIPC), to use a public health approach to the prevention of one key hidden health hazard: violence against women (VAW). Building from a recently developed strategic plan and a research agenda, we explain how four core public health principles--emphasizing primary prevention, advancing the science of prevention, translating science into effective programs, and building on the efforts of others--drive current programmatic activities in VAW prevention. Several current programs and projects are described. Finally, we conclude with recommendations for future prevention work by deepening our vision of leadership, expanding our partnerships, pursuing comprehensive approaches, and using evidence-based strategies.

Is Domestic Violence Screening Helpful?

FROM 1993 THROUGH 1998, A PEriod when professional medical organizations such as the American Medical Association and the American College of Obstetricians and Gynecologists recommended that physicians screen female patients for intimate partner abuse, violence against women by their intimate partners declined by 21%, according to the US Department of Justice. Experts in the prevention of intimate partner violence would like to know whether medical screening accounted for some of this reported decline. Unfortunately, said Linda Saltzman, PhD, a senior scientist in the Division of Violence Prevention at the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), in a recent interview, “we have no data that would help us answer that.” Department of Justice data do not include data on screening, said Saltzman, and it is not possible to make inferences about the effect of screening without data. However, it is unlikely that screening had a major impact on rates of violence against women because few physicians routinely screen their patients for intimate partner abuse unless they have injuries ( JAMA. 1999; 282:468-474). Practicing physicians say one of the reasons they are reluctant to screen all their patients is the lack of scientific evidence that screening makes a difference for women’s health. Obviously, it makes sense to ask about intimate partner violence if a patient has symptoms or signs of an illness or injury that could have been caused by violence, said Nancy Sugg, MD, associate professor of medicine at the University of Washington School of Medicine. Suppose, she said, that a patient complained of abdominal pain. “I would ask anyone with acute abdominal pain about a history of trauma, and I would also ask if anyone had tried to hit her or hurt her,” said Sugg. Like that of most physicians, her diagnostic evaluation would consider trauma as a direct cause of abdominal injury or an indirect cause of abdominal pain resulting from the stress of an abusive relationship, she said. To address questions about screening and begin to develop a research agenda on the detection and clinical management of intimate partner abuse, the CDC hosted a workshop in April for Saltzman, Sugg, and other experts.