Violence Prevention Strategies Research Articles

Workplace violence against healthcare workers in the emergency department in Hong Kong

AbstractIntroductionWorkplace violence affects the dignity and well‐being of healthcare workers and poses threats to the efficiency and success of the healthcare system. Healthcare workers in the emergency department (ED) are known to be vulnerable to workplace violence. This study explored the prevalence of workplace violence in the ED in Hong Kong and factors associated with self‐reported workplace violence.MethodsAn anonymous, voluntary, self‐administered and web‐based cross‐sectional survey was carried out from 1 June to 30 June 2022 among doctors and nurses in three regional EDs. Multivariable logistic regression analyses were conducted to examine the factors associated with workplace violence.ResultsA total of 162 healthcare workers including 57 doctors and 105 nurses participated in the study, with an overall response rate of 50.8%. The overall prevalence of workplace violence was 66.7%. Verbal abuse (64.2%) was more common than physical violence (20.4%). Nursing group was significantly correlated with physical violence (aOR 7.27, p = 0.005). Reporting rate of workplace violence remained low (18.2% for physical violence and 12.5% for verbal abuse). More than half of the participants with experience of workplace violence reported that the incident affected their mental well‐being.ConclusionsWorkplace violence was a significant concern in the local ED and under‐reporting was not uncommon. Impact of workplace violence on healthcare workers and the healthcare system should be well recognised. Workplace violence protocol and prevention strategies are crucial.

American Indian and Alaska Native violence prevention efforts: a systematic review, 1980 to 2018

BackgroundViolence is a serious public health concern disproportionately experienced by American Indian and Alaska Native (AIAN) people. While the burden and impact of violence may be explained by the presence of risk factors among this group, AIAN communities benefit from unique protective factors and universal strategies which may be tailored with tribal adaptations. We sought to identify and explore violence prevention strategies specific to AIAN populations.MethodsA review was conducted to systematically identify violence prevention programs, policies, and practices implemented in AIAN communities. We searched nine electronic databases and relevant gray literature released between January 1980 and June 2018. We included intervention-focused records targeting at least one violence topic area (child abuse/neglect, elder abuse, intimate partner violence, sexual violence, youth violence, and suicide) in a majority (> 50%) AIAN population.ResultsA total of 5220 non-duplicate records were screened, yielding 318 full-text records. After applying exclusion criteria, 57 records describing 60 program, policy, or practice implementations of 43 unique interventions were identified. All six violence types were represented, although more than half (58%; n = 25/43) focused on suicide prevention. Among suicide prevention programs, the most common strategies were identifying and supporting people at risk (80%; n = 20), teaching coping and problem-solving skills (56%; n = 14), and promoting connectedness (48%; n = 12). Two-thirds of the implementations (67%; n = 40/60) were in fully (100%) AIAN communities. Programs were implemented across many settings, though schools were the most common (35%, n = 21/60) setting. Of the 60 total implementations, a majority (80%; n = 48) were new approaches developed by and for AIAN communities, while the remainder were AIAN adaptations of programs previously created for non-AIAN populations. Most implementations (60%; n = 36/60) provided some evaluation data although less than half (45%; n = 27/60) reported evaluation results.ConclusionsThis review identified many violence prevention strategies specific to AIAN populations. While programs developed in one tribe may not be completely generalizable to others, shared tribal risk and protective factors suggest programs could be successful across diverse communities. Findings indicate there is a need to develop and evaluate violence prevention programs, policies and practices for AIAN populations.

Gender-based Violence and its Predictors: A Cross-sectional Study Among the Adolescents of Madhya Pradesh, Central India.

Gender-based violence (GBV) is a global public health concern. India's socio-cultural and regional diversity poses challenges for obtaining accurate and comprehensive indicators of gender-based violence. This study aimed to explore the prevalence and predictors of GBV among adolescents. This was a community-based cross-sectional study conducted among adolescents aged 10 to 19 years in six districts of Madhya Pradesh, the central part of India, from December 2017 to 2019. GBV was assessed using a validated questionnaire adapted from a nationwide survey. Data were analyzed using SPSS (version 16.0). Logistic regression analysis was performed to identify factors associated with GBV. The study revealed that 10.4% of adolescents were victims of GBV. The multi-variable logistic regression showed that girls were at higher risk (odds ratio = 5.7) of facing GBV. Other significant factors associated with GBV included older adolescents (15-19 years old), those belonging to scheduled caste/tribal areas, those whose mothers were literate, those who had a boyfriend/girlfriend, and those who justified wife beating. GBV is a serious public health problem among adolescents, with one in every 10 adolescents experiencing GBV. It is essential to instil awareness of gender-equal norms from early childhood and within households. Implementing violence prevention policies and strategies in educational and work institutions, as well as at the community level, is crucial.

Why Violence Cannot be Prevented in Healthcare Settings in Türkiye?: A Retrospective Policy Analysis.

Preventive policies have been devised with the aim of curbing health-related violence, and their efficacy is believed to furnish evidence for their continued implementation, thereby enhancing their effectiveness. This study undertakes a retrospective analysis of these policies in the context of Türkiye. A comprehensive examination involved the review of 26 documents, employing a progressive scanning approach for data collection. This methodology encompassed the utilization of gray literature databases (OECD iLibrary and WHO Iris), extensive Google searches, thorough website scans, and consultations with subject-matter experts. Data analysis was meticulously conducted within the framework of the Health Policy Triangle. The findings reveal active participation from diverse stakeholders, including governmental bodies, political entities, professional organizations, and trade unions, in various preventive initiatives aimed at mitigating health-related violence. Notably, the adoption of legislation for health violence prevention, perceived as a paramount achievement, can be attributed to persistent efforts by both the media and other influential actors and stakeholders. These endeavors have sustained the topic's prominence on the policy agenda, positioning it as a promising source for the development of novel violence prevention and management strategies. This study underscores the necessity for a comprehensive investigation into the working conditions, personal rights, and wage policies of healthcare workers, in light of documented factors that frequently precipitate violence. Concomitantly, it advocates for the development of effective mechanisms to address these issues.

Classifying Studies on Workplace Violence for Visiting Nurses Using the Social-Ecological Model: A Scoping Review

ABSTRACT Purpose To prevent workplace violence (WV) against visiting nurses (VNs), understanding the influencing factors is crucial. To better comprehend potential violence prevention strategies, the U.S. Centers for Disease Control and Prevention has presented the four-level social-ecological model (SEM) at the 1) individual, 2) relationship, 3) community, and 4) societal levels. This study aims to quantify WV studies against VNs, examine the influencing factors, identify gaps based on SEM levels, and propose future research and policy directions. Design A scoping review was conducted following the five-stage protocol proposed by Arksey and O’Malley in 2005. Methods Systematic searches, including manual searches, were performed using English and Korean databases. Published journal articles including editorials on WV against VNs were included, irrespective of the publication date. Findings Sixty journal articles were finally selected. Until the 1990s, most of the literature comprised editorials, with empirical research emerging after the 2000s. Classifying studies by SEM level, many studies have focused on individual (86.7%) and community (66.7%) factors, but fewer have addressed relationship (21.7%) and societal (16.7%) factors. Conclusions The study revealed that much research has focused on individual-centered training, with gaps in risk assessment tool development, training incorporating relational aspects, standardized protocols, and understanding of the impact of legal rights and policies. This article advocates a comprehensive approach that considers all SEM levels to address WV against VNs. Clinical Evidence The findings confirm a research gap, which suggests the direction for future research and policies. Stakeholders should be urged to implement evidence-based strategies that contribute to safer work environments for VNs.

Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use.

Recent data show high school students from racial and ethnic minority (REM) backgrounds in the United States confront a twofold challenge, marked by the highest rates of firearm-related homicides since 1994 and increased youth substance use. The pandemic increased online and telehealth usage opportunities for at-risk REM youth. Therefore, this study investigated (1) the frequency and prevalence of co-occurring youth violence and substance use among REM adolescents, (2) racial/ethnic, age, and natal sex (as gender data was not collected) differences in patterns and trends in co-occurring youth violence and substance use among REM adolescents, and (3) the relationship between these syndemic issues and REM adolescent mental telehealth use during the pandemic. Data was sourced from a nationally representative sample of U.S. 9th-12th students (n = 3241) who completed the CDC's 2021 Adolescent and Behavioral Experiences Survey (ABES). Using univariate (frequency distribution), bivariate (Pearson's chi-squared test), and multivariate logistic regression models, we examined seven violence victimization outcomes, four violence perpetration outcomes, two family violence outcomes, and six substance use outcomes and their associations with telehealth use for mental health (dependent variable) among REM adolescents. This sample was primarily female (50.7%), Black or African American (48.3%), Hispanic or Latinx (20.6%), and identified as straight or heterosexual (69.5%). The study found significant sex-based differences in violence perpetration/victimization, substance use, and telehealth use for mental health. In general, mental telehealth use was significantly associated with substance use among REM adolescents (cigarette smoking, vaping, alcohol, marijuana, prescription meds, and illicit drug use) (p-value = .001). Mental telehealth use was also significantly associated with all peer and family violence outcomes (p < 0.001). Controlling for covariates, gun carrying was associated with 4.8 times higher odds of using mental telehealth. Students in a physical fight or carrying a weapon (gun, knife, or club) on school property had 2.45 times and 8.09 times the odds of utilizing mental telehealth. Bullied students were 2.5 times more likely to use mental telehealth (p-value < 0.05). Illicit drug use (cocaine, heroin, methamphetamines, and ecstasy) was associated with a higher likelihood of mental telehealth use (AOR = 1.3, p-value = .05). Our results suggest crucial insights for shaping violence and substance use prevention strategies, with implications for the future of online and telehealth behavioral services. Mental telehealth help-seeking emerges as a crucial avenue for supporting adolescents affected by violence and substance use, especially when they face obstacles to accessing traditional services. It can work in tandem with in-person services to address these challenges.

Racial/ethnic differences in the bullying victimization-suicidality link among LGBQ high school students in the United States.

Although the relationship between bullying victimization and suicidal behaviors of lesbian, gay, bisexual, transgender, and questioning (i.e., unsure of their sexual orientation) students has been well documented in research, few studies have focused on how bullying victimization might be related to suicidal behaviors among youth with intersectional identities. This study examines associations between bullying victimization and suicidal behaviors across racial/ethnic groups in a sample of lesbian, gay, bisexual, and questioning (LGBQ) students. Data for this cross-sectional study were derived from the Center for Disease Control and Prevention's Youth Risk Behavior Survey combined data set (2003-2019), with a sample of 95,603 students who identified as LGBQ. Analyses included descriptive statistics and logistic regression. We found that homophobic bullying victimization was associated with higher odds of suicidal ideation and plans among the total sample and Black and Hispanic students. School-based bullying victimization was associated with higher odds of suicidal ideation, plans, and attempts among white and Hispanic students and higher suicidal ideation among multiracial-non-Hispanic students. Cyberbullying victimization was not associated with suicidal behavior among Asian students, but it was associated with all forms of suicidal behavior among youth of other racial/ethnic identities. Addressing bullying victimization and suicidality with culturally relevant, evidence-based violence prevention strategies is critical.

Prevalence and factors associated with workplace violence in a tertiary healthcare facility in Nigeria.

Healthcare workers globally are at an increased risk of workplace violence. Adverse effects such as physical injury, reduced quality of care to patients and lower productivity with associated costs to employers occur. Non-reporting hinders the implementation of effective prevention. This study aimed to assess the prevalence, reasons for non-reporting of workplace violence, and knowledge of prevention prior to designing intervention strategies in the study location where there is a paucity of research on this issue. This cross-sectional study was conducted at a Teaching Hospital in Abakaliki, Ebonyi State, for 4 weeks in 2020 among 205 employees. The hospital was stratified into Clinical, Nursing Services, Pharmacy, Laboratory, and administrative divisions; proportionate allocation and random sampling were used to select the allocated samples. A structured questionnaire was used to collect data. Descriptive statistics determined the measures of central tendencies and dispersion, while bivariate analysis of the variables was done using Pearson's Chi-Square test. Statistical significance was set at p ≤ 0.05 with a confidence level of 95%. The mean age of the participants was 39.1 ± 7.8 years. The prevalence of workplace violence was 70%. The most common reason for non-reporting was complexities and time-consuming reporting procedures (26.5%) followed by fear of reprisal on career (22.4%). The proportion of respondents with good knowledge of workplace violence prevention strategies was high (69.8%). Gender (p = 0.03), work setting (p = 0.006), previous workplace violence training (p = 0.005) and knowledge of workplace violence preventive strategies (p = 0.04) had statistically significant associations with experience of workplace violence. The high prevalence of workplace violence suggests a need for a workplace violence prevention program which should include a simple process of reporting and training. The improved awareness from previous training may account for the significant association with workplace violence.

Self-Concept, Family Roles, Knowledge and Information Resource on Dating Violence Prevention Behaviors: A Cross-sectional Study using Smart PLS Software

Background: Gender aspects hold an important role in forming strategies for teenagers to get their acceptance in the neighborhood, especially at the beginning of teenage life development. One of the negative conditions if the development cannot be well developed is violence in dating. Aims: The aim of this study was to determine the direct and indirect effects, as well as the amounts of resources, role of family, knowledge, and self-concept, against the prevention of violence in dating at SMK Wijaya Kusuma in South Jakarta in 2016. Methods: This study used a cross-sectional design. The population consisted of students in the 9th and 10th grades, and 65 students were selected as respondents. This study used a structure equation model as an analysis method using Smart PLS 2.0 and SPSS 18.0. Results: The hypothesis testing produced findings that all independent variables have an effect on dependent variables: resources by 16.14%, role of family by 11.38%, knowledge by 15.95%, and self-concept by 20,38%. The self-concept variable was the dominant factor in influencing the preventive behavior of violence in dating. Model analysis results can explain 95% of the diversity of this research and the ability to assess the phenomenon, while 5% are described by other components that do not exist in this study. Conclusion: In sum, there was an influence-relationship between resources, the role of family, knowledge, and self-concept in preventing violence in dating. We suggest that schools should provide education about violence prevention strategies so that they are well-informed about violence in dating. Received: 07 December 2023, Reviewed: 12 December 2023, Revised: 06 January 2024, Accepted: 14 January 2024.

‘There is a No that means Yes!’ – Coercive and aggressive sexual behaviours in adolescents’ heterosexual relationships in rural KwaZulu-Natal, South Africa

ABSTRACT This qualitative study examined sexual negotiation in heterosexual romantic relationships of rural adolescents in the province of KwaZulu-Natal, South Africa. Participatory visual research methodology alongside focus group discussions were employed with 18 and 19-year-old adolescent boys (n = 10) and girls (n = 12) to understand how sex is negotiated in heterosexual relationships. Findings suggest adolescent boys and girls had little understanding of mutual sexual consent, and lacked the skills for exercising it. Adolescent boys’ coercive and aggressive sexual behaviours in romantic relationships were embedded in hegemonic masculinity characterized by male dominance, hypersexuality and multiple partners; and included boys pleading for sex, buying gifts, threatening to dissolve the relationship if sex is not initiated, screening pornographic films and rape. Sexual violence prevention strategies commencing during early adolescence are needed and should focus on developing adolescents’ understanding of mutual sexual consent, incorporate skills for autonomous sexual negotiation, and emphasize gender transformative and equitable norms.

Say Something, Do Something: Evaluating a Forum Theater Production to Activate Youth Violence Prevention Strategies in Schools.

Youth violence that takes place within school settings exposes youth to serious social, mental and physical consequences that affect education performance, and life opportunities. Previous work shows positive youth development frameworks can promote social-emotional learning by enhancing empathy and building problem-solving and conflict management skills. Theater-based interventions have been shown to enhance social emotional development by privileging youth voices, and building youth capacities and strengths. The current manuscript presents the evaluation of an arts-based and public health framework conducted to assess the development, implementation and impact of a forum theater production, Say Something, Do Something (SSDS) in St. Louis, Missouri. An iterative mixed methods approach was used, starting with observations of productions. Using convenience sampling, we then conducted post interviews of the theater team (n = 8) and school personnel (n = 10). Respondents highlighted that as a result of engagement of school personnel in program development, the language and scenarios presented were relevant to students. Data indicated that SSDS increased student knowledge and changed attitudes, developed student conflict management and problem-solving skills, and improved interpersonal behavior. SSDS also raised awareness of the importance of, and created the foundation for, additional system and policy changes in the schools. Forum theater is an approach that can enhance socio-emotional learning and conflict management among youth. Collaborative initiatives between public health and the arts are poised to uniquely engage community partners, animate interventions, and impact critical public health issues including youth violence prevention.

An exploratory study of prison-based violence from the contemporary prisoner perspective

PurposeUnderstanding and preventing prison-based violence remains a challenge for both prison professionals and academic researchers. Alongside the rising tide of prison violence, the contemporary researcher views prison violence as a social problem and something that needs to be understood from an ecological viewpoint before violence prevention strategies can be implemented. The purpose of this study was to present an exploratory investigation into the causes of violence within a Category B UK prison, its impact and the factors that contribute to violence prevention.Design/methodology/approachAdopting an ethnographic, qualitative methodology, semi-structured interviews were conducted with six prisoners to gather their individual perspectives on prison violence. Interview transcripts were analysed by the researcher using grounded theory analysis.FindingsResults revealed that participants perceived debt as a catalyst for violence and associated a sense of “loss” with emotional violent outbursts. Furthermore, participants placed responsibility on other prisoners and staff to facilitate violence prevention outcomes by making positive changes (prisoners) and being honest, and moral within the workplace (staff). Emphasis was placed on cultural maintenance factors that appeared to promote, reinforce and maintain a violent cultural environment.Practical implicationsIncluding the prisoner voice in prison violence research is fundamental to understanding the complexity of the problem. Understanding the cultural environment within which violence occurs strengthens the ecological perspective. Violence prevention strategies identified in this research requires change from prisoners, staff and ultimately the wider prison system if it is to succeed in preventing violence.Originality/valueResults are discussed considering their implications for future policy and practice in the context of violence prevention.

Impact of Violence against Healthcare Providers on Maternal and Child Health Service Delivery in Karachi

Background There is an increasing global issue with workplace violence against healthcare practitioners. The healthcare system as a whole and individual employee are both hit hard by this. The purpose of this research was to identify the prevalence, nature, and consequences of workplace violence encountered by healthcare workers in maternity and child health service delivery settings in the violent metropolis of Karachi, Pakistan. Methods A quantitative cross-sectional study was conducted among 414 healthcare providers from 14 randomly selected hospitals in Karachi. Participants completed a self-administered questionnaire assessing their experiences of workplace violence, including the type of violence, perpetrators, frequency, and impacts on their health and work performance. Results A shocking 87.9% of healthcare professionals have encountered workplace violence, with verbal/psychological abuse (37.4%) and physical assault (31.6%) being the most prevalent. Violence was most commonly committed by patients' relatives (42.8%) and happened daily (43.2%) or weekly (31.2%). Violence had serious effects, with 87.9% of providers absent 51.9% wanting to resign, and 69.6% feeling PTSD. Violence also lowered paediatric and gynaecology treatment quality. Conclusions Workplace violence is a serious and pervasive problem for healthcare providers in Karachi, with severe consequences for their well-being and the quality of care they provide. Urgent action is needed to address this issue, including stronger enforcement of existing laws, improved hospital security measures, and training for healthcare providers in violence prevention and management strategies. Keywords: workplace violence, healthcare providers, maternal health, child health, healthcare quality

Strategies for Prevention and Management of Student Violence in Kristen Calvin Middle School Central Jakarta

School violence not only affects the physical health and safety of young people, but also their mental health, social relationships and academic performance. In addition to this, student violence in middle school has different degrees of impact on the perpetrators and those affected by the violence. This paper provides an in-depth analysis of the characteristics and manifestations of violent behavior among middle school students, and studies the related factors that influence violent behavior among middle school students. It explores the causes of school violence among middle school students from four perspectives: school, family, society, and the students themselves, and discusses the prevention and management strategies through interviews and literature research with Kristen Calvin Middle School as the research subject.

Understanding Latine perceptions of gun violence prevention strategies across New Mexico: A conceptual paper

Gun violence within Latine communities in New Mexico is on the rise and shows no signs of slowing down. The disparities in gun violence experiences mirror the structural and social position factors which negatively and disproportionately impact Latine people. In response to firearm-related deaths nearly doubling over the last decade, New Mexican legislators have been pressured to implement gun violence prevention policies. However well intended, these strategies often fail to address the structural inequities that underlie the rise in gun violence within Latine communities. There is an urgent need for research to better understand the unique experiences of Latine persons and their experiences in both gun violence and prevention. From a social ecological perspective, examining the structural barriers and facilitators which impede Latine involvement in gun violence prevention is critical to interrupting the cycles which render this group more susceptible. A deeper understanding of the factors associated with both gun violence and prevention is crucial for developing informed and culturally sensitive policies and interventions. This conceptual paper explores theory and research to better understand how gun violence impacts Latine communities and creates a conceptual framework to improve healthcare workers’ ability to encourage empowerment and efficacy regarding Latine engagement in gun violence prevention efforts. The objective of this paper is to analyze research from disciplines in the social and health sciences focusing on the experiences of Latine persons and groups experiencing gun violence and engaging in gun violence prevention.

Nursing Care in Risk of Violent Behavior

&#x0D; &#x0D; &#x0D; &#x0D; The aim of this research is to analyze and design nursing care for two patients, who are at risk of violent behavior. Observations, interviews, and medical record documentation studies are data collection methods. Based on the research results, it is known that both patients have a high risk of violent behavior, especially related to a history of previous violence and underlying mental disorders. Initial assessment includes identification of potential triggers for violence, evaluation of level of coping, and assessment of social support. Risk of violent behavior is the patient's second nursing diagnosis. Treatment plans are implemented with a focus on violence prevention, involving collaboration with a multidisciplinary team, including medical personnel, and psychiatrists. Nursing interventions involve therapeutic approaches to improve coping, interpersonal skills training, and close monitoring for signs of violence. Periodic evaluations are conducted to assess the effectiveness of the treatment plan and identify changes in patient behavior. Discharge planning involves coordination with family and mental health services in the community to ensure continuity of care after discharge. The conclusion of this research is that nursing care for patients at risk of violent behavior requires a careful, proactive and collaborative approach. Implementing integrated violence prevention strategies and close monitoring can help reduce the risk of violent incidents.&#x0D; &#x0D; &#x0D; &#x0D;

Resilience-Informed Community Violence Prevention and Community Organizing Strategies for Implementation: Protocol for a Hybrid Type 1 Implementation-Effectiveness Trial.

Community violence is a persistent and challenging public health problem. Community violence not only physically affects individuals, but also its effects reverberate to the well-being of families and entire communities. Being exposed to and experiencing violence are adverse community experiences that affect the well-being and health trajectories of both children and adults. In the United States, community violence has historically been addressed through a lens of law enforcement and policing; the impact of this approach on communities has been detrimental and often ignores the strengths and experiences of community members. As such, community-centered approaches to address violence are needed, yet the process to design, implement, and evaluate these approaches is complex. Alternatives to policing responses are increasingly being implemented. However, evidence and implementation guidance for community-level public health approaches remain limited. This study protocol seeks to address community violence through a resilience framework-Adverse Community Experiences and Resilience (ACE|R)-being implemented in a major US city and leveraging a strategy of community organizing to advance community violence prevention. The objective of this research is to understand the impact of community-level violence prevention interventions. Furthermore, we aim to describe the strategies of implementation and identify barriers to and facilitators of the approach. This study uses a hybrid type 1 effectiveness-implementation design. Part 1 of the study will assess the effectiveness of the ACE|R framework plus community organizing by measuring impacts on violence- and health-related outcomes. To do so, we plan to collect quantitative data on homicides, fatal and nonfatal shootings, hospital visits due to nonaccidental injuries, calls for service, and other violence-related data. In Part 2 of the study, to assess the implementation of ACE|R plus community organizing, we will collect process data on community engagement events, deliver community trainings on community leadership and organizing, and conduct focus groups with key partners about violence and violence prevention programs in Milwaukee. This project received funding on September 1, 2020. Prospective study data collection began in the fall of 2021 and will continue through the end of 2023. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2024. Community violence is a public health problem in need of community-centered solutions. Interventions that center community and leverage community organizing show promise in decreasing violence and increasing the well-being of community members. Methods to identify the impact of community-level interventions continue to evolve. Analysis of outcomes beyond violence-specific outcomes, including norms and community beliefs, may help better inform the short-term and proximal impacts of these community-driven approaches. Furthermore, hybrid implementation-effectiveness trials allow for the inevitable contextualization required to disseminate community interventions where communities drive the adaptations and decision-making. DERR1-10.2196/50444.

The effectiveness of a workplace violence prevention strategy based on situational prevention theory for nurses in managing violent situations: a quasi-experimental study

BackgroundWorkplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses’ specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects.MethodsUnder the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training.ResultsThe WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05).ConclusionsThe described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses’ WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.

Law Enforcement Officer Knowledge of, Attitudes Toward, and Willingness to Use Extreme Risk Protection Orders

Understanding knowledge of, attitudes toward, and willingness to use extreme risk protection order (ERPO) laws among law enforcement officers (LEOs) can inform efforts to improve implementation of this underused firearm violence prevention strategy. To characterize LEOs' knowledge of, attitudes toward, and willingness to use ERPOs across a range of scenarios. A cross-sectional online survey, fielded from April 5 to August 30, 2021, was conducted in all 19 states and the District of Columbia with an ERPO law in 2021. A nonprobability sample of active-duty LEOs was used. Being a LEO in a state with an ERPO law. Survey participants answered questions about their familiarity with and opinions on ERPO laws, as well as whether they would agree with using an ERPO in a variety of specific case scenarios. The analysis included an exploration of whether within-scenario differences, such as ERPO respondent race or gender, affected agreement by randomly assigning survey participants to 1 of 2 versions of each scenario. A total of 600 eligible individuals started the survey, and 283 survey participants were included in the analysis. The analytic sample consisted mostly of cisgender men (85.2%) and non-Hispanic White (71.4%) LEOs. Participants represented 14 states and the District of Columbia, with 53.7% living in California. Most participants (81.3%) were very or somewhat familiar with ERPO laws and 56.2% had received ERPO training. Opinions about ERPO laws were generally favorable but varied by self-identified political ideology. Across all scenarios, most participants supported using an ERPO; however, support was highest in cases involving intimate partner violence (71.4%-78.6%) and lowest in cases involving suicidality (54.2%-73.3%). Across all scenarios, LEOs with ERPO training or experience were substantially more likely to agree with using ERPOs than those without. None of the randomly assigned within-scenario differences were associated with differences in ERPO support. In this survey study of LEOs in states with ERPO laws, many officers had not received training on their use. Additionally, while conservative political ideology was associated with less favorable views of ERPOs, training and experience with ERPOs was associated with greater support for their use across a range of scenarios. These findings suggest that LEO training on ERPOs may promote their uptake and improve implementation.

Qualitative Analysis of Bystander Intervention Among Young Adult Male Soldiers Who Engage in At-Risk Drinking.

Bystander intervention-when someone intervenes to help in situations that pose a risk for harm-is a promising strategy for sexual violence prevention. In the current study, a sample of U.S. Army male soldiers (N = 10; ages 18-24) who engaged in at-risk drinking completed a 90-min individual semi-structured interview to understand the ways in which soldiers intervene to address risk for sexual violence. Two independent raters coded soldier responses using thematic analysis and identified eight main themes: (a) recognizing risk for sexual violence; (b) labeling situations as problematic and taking responsibility; (c) facilitators of intervention; (d) barriers to intervention; (e) intervention strategies; (f) reactions and consequences to intervention; (g) alcohol's influence on intervention; and (h) using bystander intervention to shift cultural norms. As soldiers reported noticing more extreme risks for violence, prevention interventions may help service members identify situations earlier in the continuum of harm. Soldiers anticipated intervening in a way that was physical and aggressive, which could facilitate physical altercation and result in collateral misconduct. Results from the present study reveal ways that bystander intervention programs for civilians can be tailored to address the unique individual, situational, and contextual factors relevant to the military. These findings also highlight the importance of teaching soldiers indirect and nonaggressive strategies for intervention.