Cultural Context of School Communities in Rural Hawaii to Inform Youth Violence Prevention*

BACKGROUND: Escalation of youth violence within a large geographic school-complex area in southeastern rural Hawaii became a major problem in 2006. How cultural forces impact the problem was an impetus to examine youth violence from perspectives of adults and children in rural communities. Gathering these data was an essential first step toward school-based youth violence prevention program development. METHODS: Eight focus groups involving 86 community stakeholders included 51 adults (parent, teachers, school staff, community leaders) and 35 children aged 8-15 years old (3rd- to 10-th grade). Qualitative narrative analysis elicited major themes. RESULTS: Five themes emerged: (1) School-community violence takes on many forms that become entrenched in local culture. (2) Disintegration of community resources and a sense of learned helplessness underlie the escalation of youth violence. (3) Inadequate role modeling coupled with behavioral ambivalence among adults has sustained a climate of local cultural acceptance with youth violence. (4) Connection to cultural values has diminished, leading to a sense of loss in cultural identity among students. (5) Cultural values and practices are potential strategies for youth violence prevention. CONCLUSIONS: Cultural and community contextual factors contributed to youth violence in rural Hawaiian communities. Study implications include the need to further investigate the impact of vigilant, community involvement of stakeholders in school-based youth violence prevention program development. Cultural revitalization at family, school, and community levels may be critical success factors of such programs.     

Community Violence Exposure and Positive Youth Development in Urban Youth

Youth in urban environments are exposed to community violence, yet some do well and continue on a positive developmental trajectory. This study investigated the relationships between lifetime community violence exposure (including total, hearing about, witnessing, and victimization), family functioning, and positive youth development (PYD) among 110 urban youth ages 10–16 years (54% female) using a paper and pen self-report survey. This cross-sectional study was part of an interdisciplinary community-based participatory research effort in West/Southwest Philadelphia. Almost 97% of the sample reported some type of community violence exposure. Controlling for presence of mother in the home and presence of father in the home, separate linear regression models for PYD by each type of community violence exposure indicated that gender and family functioning were significantly associated with PYD. None of the types of community violence exposure were significant in the models. Significant interactions between gender and presence of mother in the home and gender and family functioning helped better explain these relationships for some of the types of community violence exposure. Presence of mother was associated with higher PYD for girls, but not for boys. Boys with poor family functioning had lower PYD than girls with poor family functioning. This study helps to better delineate relationships between CVE and PYD by adding new knowledge to the literature on the role of family functioning. Points of intervention should focus on families, with attention to parental figures in the home and overall family functioning.     

Considering a Decision-Making Approach to Youth Violence Prevention Programs

ABSTRACT: The unfortunate exception to a general downturn in violent crime involves an upsurge in violence among youth. Violence often results when minor confrontations escalate. As school violence increasingly has become widespread, schools have become the location of many violence prevention efforts, few of which have been evaluated adequately. This paper focuses on enhancing decision-making skills as one approach to increase adolescents' ability to manage interpersonal violence. Adolescents can be considered fairly skilled decision-makers and their unique perspective must be considered in development of effective intervention programs. Data from a pilot study were examined for insights about adolescents' ability to make decisions in situations of interpersonal conflict.     

Attitudes about Violence and Involvement in Peer Violence among Youth: Findings from a High-Risk Community

Peer violence perpetration and victimization are the most common types of violence among youth. This study determined the associations among violent attitudes toward peers, involvement in peer violence perpetration, and experience with peer violence victimization among boys and girls in a high-risk, urban community. Analyses were based on data from the 2004 Youth Violence Survey, which was administered to over 80% of public school students in grades 7, 9, 11, and 12 (N = 4,131) in a disadvantaged, urban, school district in the USA. Logistic regression analyses were conducted to test the associations between attitudes in support of violence and involvement in violent behaviors. Results show that among youth, attitudes supporting boys hitting boys significantly increased the odds of peer violence perpetration after controlling for potential confounders (adjusted odds ratio [AOR], 1.35; 95% confidence interval [CI] = 1.07, 1.72). However, stratified analyses for boys and girls show that attitudes supporting boys hitting boys increased the odds of peer violence perpetration for girls only after controlling for potential confounders (AOR, 1.49; 95% CI = 1.05, 2.13). The findings demonstrate that there are important differences between boys and girls in terms of their associations with violent attitudes and involvement in actual violent behaviors. However, additional research is needed to determine how attitude modifications can be incorporated into youth violence prevention programs.     

Community Monitoring for Youth Violence Surveillance: Testing a Prediction Model

Predictive epidemiology is an embryonic field that involves developing informative signatures for disorder and tracking them using surveillance methods. Through such efforts assistance can be provided to the planning and implementation of preventive interventions. Believing that certain minor crimes indicative of gang activity are informative signatures for the emergence of serious youth violence in communities, in this study we aim to predict outbreaks of violence in neighborhoods from pre-existing levels and changes in reports of minor offenses. We develop a prediction equation that uses publicly available neighborhood-level data on disorderly conduct, vandalism, and weapons violations to predict neighborhoods likely to have increases in serious violent crime. Data for this study were taken from the Chicago Police Department ClearMap reporting system, which provided data on index and non-index crimes for each of the 844 Chicago census tracts. Data were available in three month segments for a single year (fall 2009, winter, spring, and summer 2010). Predicted change in aggravated battery and overall violent crime correlated significantly with actual change. The model was evaluated by comparing alternative models using randomly selected training and test samples, producing favorable results with reference to overfitting, seasonal variation, and spatial autocorrelation. A prediction equation based on winter and spring levels of the predictors had area under the curve ranging from .65 to .71 for aggravated battery, and .58 to .69 for overall violent crime. We discuss future development of such a model and its potential usefulness in violence prevention and community policing.     

Youth Development, Community Engagement, and Reducing Risk Behavior

This article examines behaviors and attitudes associated with the “Youth Development Model,” widely cited as a means of promoting resistance among young people to adverse environmental influences. Focusing on tobacco use as an example of high-risk behavior, the research reported here (1) tests the statistical independence of individual Youth Development Model dimensions, and (2) assesses their relationships to tobacco-related attitudes and behavior. The “engagement” dimension, reflecting strong ties of youths with the broader community, most clearly distinguishes risk reduction interventions based on the Youth Development Model. Two exploratory studies indicate that, among dimensions associated with this model, engagement is the least readily measurable and the least consistent and robust as a predictor of tobacco-related attitudes and behavior. Editors' Strategic Implications: The authors present an important challenge to the increasingly prevalent Youth Development Model. The results of the two studies call for a better conceptual and operational understanding of engagement, which must precede its successful application in reducing risky behavior among young people.     

父母教养方式与社区青少年暴力攻击行为的关系

目的探讨有暴力攻击行为的青少年的父母教养方式,为预防暴力伤害提供理论依据。方法采用病例对照研究的方法,运用父母教养方式评价量表对社区青少年的父母教养方式进行调查。共调查案例组81例,对照组304例。结果案例组的父亲FF1(情感温暖与理解)、FF2(惩罚、严厉)、FF5(拒绝否认)与对照组比较,差异有统计学意义(P0.01或P0.05),案例组的母亲MM2(过度干涉过度保护)、MM3(拒绝、否认)、MM4(惩罚、严厉)与对照组比较,差异有统计学意义(P0.01或P0.05)。父母共有的5个主因素的一致性比较,每一组父母在情感温暖与理解、惩罚严厉、过分干涉、拒绝否认等方面差异均有统计学意义(P值均0.01)。结论社区青少年的暴力攻击行为与父母教养方式存在关联。     

Spatial Analysis of the Impact of a School-Level Youth Violence Prevention Program on Violent Crime Incidents in the Community

Prevention Science - This study investigated the effect of a school-based violence prevention program on community rates of violence for youth aged 10 to 18 in three urban communities with high...     

The SAFER Latinos Project: Addressing a Community Ecology Underlying Latino Youth Violence

This paper describes the intervention model, early implementation experience, and challenges for the Seguridad, Apoyo, Familia, Educacion, y Recursos (SAFER) Latinos project. The SAFER Latinos project is an attempt to build the evidence for a multilevel participatory youth violence prevention model tailored to the specific circumstances of Central American immigrants. Specific circumstances targeted in this intervention are decreased family cohesion as a result of sequential immigration (i.e., parents arriving first and bringing their children years later or youth arriving without parents); multiple school barriers; community disorganization and low community efficacy; limited access to services; and a social context (including gang presence) that is linked to youth norms supporting violence. In its implementation, the initial intervention model was adapted to address barriers and challenges. These are described, along with lessons learned and the ongoing evaluation.     

Needs for Youth Substance Abuse and Violence Prevention in Schools and Communities

Substance abuse and violence among today's youth are at an all time high. Numerous prevention programs have been implemented to address these issues. Not all are successful. Research has found that when schools and communities are involved in the planning of prevention programs, youth are more cognizant of risk factors and of behaviors that strengthen risk factors. The purpose of this study was to assess the emerging needs for prevention and health education among youth, and to identify effective approaches for prevention program development and service delivery in schools and communities. This study surveyed 312 youth prevention specialists, school and community health educators and counselors, and parents in a regional sample of ten states. Results indicated that substance abuse and violence are the two most critical and priority issues in need of comprehensive prevention. Multiple prevention service delivery strategies appropriate to youth, including training, technical assistance, conferencing and networking, needs assessment and evaluation, and information requests are discussed in detail. Implications for prevention programming emphasized reducing risk factors and strengthening protective factors, reaching and motivating youth participation.     

The Impact of Culturally Relevant Violence Prevention Models on School-Age Youth

The Family and Community Violence Prevention (FCVP) Program was established in 1994 to address the escalation of youth violence among ethnic minorities. This federally funded program adapted the public health model and organized Family Life Centers throughout the country to serve youth who were considered to be at risk for violence and other abusive behaviors. The purpose of this three-year study, 1999–2002, was to determine the effectiveness of the FCVP Program's six-component curriculum in reducing violence among participants. Results from posttest scores of 2,315 youth showed girls 12 and over to be most at risk for deviant behaviors; the program was most effective with boys under age 12. Academic performance and bonding to school were protective factors whereas exposure to violence was a risk factor for all four ethnic groups studied—African Americans, Hispanics, Native Americans, and Native Hawaiians. Editors' Strategic Implications: Cultural anthropologists, public health specialists, and school officials should know that prevention programs can be designed to reflect the unique, culturally appropriate norms of specific ethnic minority groups, even as these programs address shared risk factors. The authors discuss the promising strategy of enhancing academic performance and school bonding to serve as protective factors against school violence, but they also describe age, gender, and cultural differences that must be addressed in future research.     

Preventing Youth Violence and Delinquency through a Universal School-Based Prevention Approach

Violence is an important public health problem among adolescents in the United States. Substance use and violence tend to co-occur among adolescents and appear to have similar etiologies. The present study examined the extent to which a comprehensive prevention approach targeting an array of individual-level risk and protective factors and previously found effective in preventing tobacco, alcohol, and illicit drug use is capable of decreasing violence and delinquency. Schools (N=41) were randomly assigned to intervention and control conditions. Participants in the 20 intervention schools received the Life Skills Training prevention program including material focusing on violence and the media, anger management, and conflict resolution skills. Survey data were collected from 4,858 sixth grade students prior to the intervention and three months later after the intervention. Findings showed significant reductions in violence and delinquency for intervention participants relative to controls. Stronger prevention effects were found for students who received at least half of the preventive intervention. These effects include less verbal and physical aggression, fighting, and delinquency. The results of this study indicate that a school-based prevention approach previously found to prevent tobacco, alcohol, and illicit drug use can also prevent violence and delinquency.     

Implementing and Evaluating Comprehensive Evidence-Based Approaches to Prevent Youth Violence: Partnering to Create Communities Where Youth Are Safe From Violence

Violence, including its occurrence among youth, results in considerable physical, emotional, social, and economic consequences in the U.S. Youth violence prevention work at the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) emphasizes preventing youth violence-related behaviors, injuries, and deaths by collaborating with academic and community partners and stakeholders. Since 2000, DVP has funded three rounds of CDC’s National Centers of Excellence in Youth Violence Prevention (YVPCs) in 5-year cycles, with the goal of supporting university-community partnerships so that the best science can be utilized in order to prevent youth violence. The current YVPCs focus on: (a) partnering with communities to identify community needs; (b) selecting and implementing the best comprehensive evidence-based programs to meet those needs; and (c) rigorously evaluating whether those efforts have a community-level impact on youth violence rates. The introduction to this special issue on the current YVPCs provides a brief historical overview on the YVPC Program; outlines the YVPCs’ accomplishments to date; and describes the current YVPCs, their community partners, and their activities. The introduction concludes with an overview of the special issue.     

Methodological Challenges Examining Subgroup Differences: Examples from Universal School-based Youth Violence Prevention Trials

This article reviews the literature on school-based universal violence prevention programs to illustrate key methodological challenges for investigating subgroup differences in prevention effects. The variety of potential moderating factors examined within this literature is discussed within the context of a social-ecological model. Our review of this literature identified the following methodological issues: the need for a clear a priori theoretical basis for selecting potential moderators, inflated Type I error rates that result from large numbers of comparisons, the absence of explicit tests of moderation, interpretive issues arising from a restricted range on moderator variables, the failure to report effect size estimates, the presence of potential confounding factors, and the importance of examining factors that might operate at multiple ecological levels. These points are illustrated using examples of studies, primarily within youth violence prevention research, that have identified factors within the individual, school, and community that moderate the outcomes of preventive interventions. We conclude with general recommendations for future work. These include the benefits of using the social-ecological model to provide a basis for moving from exploratory to more theory-driven confirmatory models of subgroup differences, the potential merits of qualitative research designed to identify factors that may influence the effectiveness of intervention efforts for specific subgroups of individuals, and the provision of effect size estimates and confidence intervals for effect sizes in prevention reports.     

Women's Perspectives on Female-Initiated Barrier Methods for the Prevention of HIV in the Context of Methamphetamine Use and Partner Violence

BackgroundFemale-initiated barrier methods for the prevention of HIV may be an effective alternative for drug-using women who are unable to negotiate safe sex, often as a result of physical and/or sexual partner violence.MethodsUtilizing a SAVA (substance abuse, violence, and AIDS) syndemic framework, we qualitatively examined perspectives on female condoms and vaginal microbicides among 18 women with histories of methamphetamine abuse and partner violence in San Diego, California.FindingsMost women were not interested in female condoms owing to perceived discomfort, difficulty of insertion, time-intensive effort, and unappealing appearance. Alternatively, most women viewed vaginal microbicides as a useful method. Positive aspects included convenience, ability to disguise as a lubricant, and a sense of control and empowerment. Concerns included possible side effects, timing of application, and unfavorable characteristics of the gel. Acceptability of female-initiated barrier methods was context dependent (i.e., partner type, level of drug use and violence that characterized the sexual relationship).ConclusionsFindings indicate that efforts are needed to address barriers identified for vaginal microbicides to increase its uptake in future HIV prevention trials and marketing of future Food and Drug Administration-approved products. Strategies should address gender-based inequalities (e.g., partner violence) experienced by drug-using women and promote female empowerment. Education on female-initiated barrier methods is also needed for women who use drugs, as well as health care providers and other professionals providing sexual health care and contraception to women with histories of drug use and partner violence.     

Evaluating the Impact of a Youth-Led Sexual Violence Prevention Program: Youth Leadership Retreat Outcomes

Prevention Science - Involving youth in developing and implementing prevention programs to reduce sexual violence (SV) has the potential to improve prevention outcomes. However, there has been...     

加强社区疾病预防控制功能的意义与方法探索

目的 分析宝安区社区卫生服务中心疾病预防控制工作存在的问题，探索加强疾病预防控制功能的意义和方法。方法 采用现场调查、文献检索、资料查询、管理者会议和收集意见等方法。结果 宝安区社区疾病预防控制工作存在认识水平低、业务发展不均衡、管理不规范和体系不健全等许多问题，加强社区疾控工作具有重要的现实意义，要从提高认识、健全体系、规范管理、加大力度和培养人才等多方面采取综合性方法加强社区疾控功能。结论 加强社区疾控功能，是完善疾控体系网底基础性建设，健全公共卫生体系的一部分，其有效性和及时性尤其重要。