A Multi-State Examination of School District Policies to Address Teen Dating Violence.

In 2021, 13.6% of United States (U.S.) high school students reported experiencing teen dating violence (TDV). Most states have at least one law for addressing TDV in high schools through policies and/or educational programs. Limited research has been done to analyze the content and variability of school district TDV policies across the U.S., and its association with TDV victimization. Twenty-three large urban school districts across the U.S. were included in the analysis. School district TDV policies were obtained through an online search and were coded for the presence or absence of information pertaining to the scope, prevention education, response to TDV, and implementation of the policy. Self-reported TDV victimization was also obtained for each school district from the 2021 Youth Risk Behavior Survey. Overall, 18 school districts had a written TDV policy available online, with 15 school districts defining TDV in the policy. In terms of prevention education, only two school districts used culturally responsive language for diverse populations in the policy. Although 17 school districts included disciplinary consequences for TDV perpetration in the policy, only 6 school districts specified the consequences. All school districts with a TDV policy designated a liaison for TDV coordination. Overall, the prevalence and odds of self-reported TDV victimization was higher in school districts without a TDV policy compared to school districts with a TDV policy. Although most of the school districts had a TDV policy, there was substantial variation in the content of these TDV policies. Identifying and addressing gaps in school district TDV policies can potentially lead schools to preventing and responding to TDV more comprehensively, ultimately creating safer school environments.

Mapping Multilevel Contributions to the Sexual Victimization of Trans Women and Trans Feminine People: A Qualitative Intersectional Stigma Analysis.

We aimed to characterize and conceptually organize multilevel factors associated with the sexual victimization experiences of trans women and trans feminine people to advance violence prevention interventions for health-equity. Between October 2020 and July 2021, we conducted in-depth interviews with 17 expert informants in New York City, which we transcribed, coded, and analyzed. Qualitative insights were derived through an intensive, team-based iterative coding strategy resulting in the development of an exhaustive set of consensus codes which were organized and interpreted in a multi-level structure. Findings revealed a complex constellation of intersecting macro- and micro-structural mechanisms reinforcing sexual violence. Unique characteristics of this violence were characterized hierarchically in terms of: 1) violence forms (e.g. murder, fetishization), 2) perpetrators (e. g. safety-staff; group assault), 3) contexts (e.g. public accommodations), 4) functions (e.g. gender policing), 5) ideological reinforcers (e.g. transphobia, racism), and 6) structural reinforcers (e.g. legislation; linking access to material means of survival to poverty/illness). Results indicate that acute incidents of sexual victimization are "the tip of the iceberg" of the violence impacting trans communities. The community experts we interviewed (e.g. trans women, violence prevention practitioners, social workers) understand chronic functional, ideological, and structural oppression as inextricable from sexual violence. Multi-level determinants of violence therefore constitute essential targets of sexual violence prevention intervention for this population.

Development and Preliminary Validation of the Dating Violence Prevention Self-Efficacy Scale for School Staff.

This article describes the development of an instrument used to evaluate the perceived self-efficacy of school staff in addressing dating violence (DV) among youth. The study employed a mixed exploratory sequential design. First, a series of items was elaborated upon based on the scientific literature on self-efficacy and material from 15 semi-structured interviews conducted with school staff. Then, a sample of 110 school staff members answered an online survey. An exploratory factor analysis revealed a two-factor structure reflecting dimensions of self-efficacy in addressing DV: communicating DV content to youth (α = .93) and the ability to intervene with youth who experience DV (α = .91). The scale could offer a means to assess the effectiveness of training offered to school counselors and teachers regarding DV prevention.

Association between social vulnerability factors and homicide and suicide rates - United States, 2016 - 2020.

BACKGROUND: Differences in social and environmental factors contribute to disparities in fatal injury rates. This study assessed the relationship between social vulnerability and homicide and suicide rates across United States counties. METHODS: County-level age-adjusted homicide and suicide rates for 2016-2020 were linked with data from the Centers for Disease Control and Prevention's 2020 Social Vulnerability Index (SVI), a dataset identifying socially vulnerable communities. We conducted negative binomial regressions to examine the association between SVI and homicide and suicide rates, overall and by Census region/division. We mapped county-level data for SVI and homicide and suicide rates in bivariate choropleth maps. RESULTS: Overall SVI was associated with homicide rates across U.S. counties. While no association was found for overall SVI and suicide rates, Socioeconomic Status and Racial & Ethnic Minority Status domains were associated. The geographic distribution of SVI and homicide and suicide rates varied spatially; notably, counties in the South had the greatest levels of social vulnerability and greatest homicide rates. CONCLUSIONS: Our findings demonstrate county-level social vulnerability is associated with homicide rates but may be more nuanced for suicide rates. A modified SVI for injury should include additional social and structural determinants and exclude variables not applicable to injuries. PRACTICAL APPLICATIONS: This study combines the SVI with homicide and suicide data, enabling researchers to examine related social and environmental factors. Modifying the SVI to include relevant predictors could improve injury prevention strategies by prioritizing efforts in areas with high social vulnerability.

Replacement thinking, status threat, and the endorsement of political violence among non-Hispanic white individuals in the US: A cross-sectional study.

Objective: This study investigates the association between replacement thinking, status threat perceptions, and the endorsement of political violence among non-Hispanic white adults in the United States. It explores how perceived threats to social status can drive support for extreme measures aimed at preserving white hegemony, addressing a gap in research on factors contributing to political violence, a public health concern. Methods: The 2022 Life in America Survey provided data for this cross-sectional study, focusing on status threat and replacement thinking among non-Hispanic white respondents. Status threat was inferred from relative income, education level, and racial segregation in residential census tracts, while replacement thinking was derived through agreement with the statement "in America, native-born white people are being replaced by immigrants." The outcome was the endorsement of political violence. Analysis utilized a survey-weighted robust modified Poisson model. Results: Among 5,976 non-Hispanic white respondents, 18.7 % supported political violence in at least one scenario. A U-shaped relationship was observed between racial segregation and political violence endorsement: respondents from more diverse communities were less likely to support political violence. Those endorsing replacement thinking were 233 %-229 % more likely to endorse political violence than those who did not, dependent on income levels. White respondents without a high school degree were 29 % more likely to endorse political violence. Conclusion: The study found a positive association between replacement thinking, markers of status threat, and political violence endorsements among non-Hispanic white Americans. These findings emphasize the need for research and interventions to mitigate these perceptions and prevent political violence.

Institutional, humane, therapeutic: Towards an understanding of caregiver violence through third sector violence prevention discourse in Finland.

Violence in family caregiving, once a social taboo, is now emerging as a topic of scientific inquiry. Engaging with a non-normative approach to care and critical reflection on research of abusive caregiver behaviour and elder abuse, this study argues that as caregiver violence is increasingly addressed in research, it is crucial to understand it as a complex issue within its social context. The study adds to this understanding by conducting a discourse analysis of violence prevention programmes in Finland, where third sector organisations have taken the initiative in addressing caregiver violence. Based on analysis of project materials, media texts and expert interviews related to two such violence prevention programmes, the study illuminates how caregiver violence is made intelligible through a combination of three kinds of understanding: institutional, humane and therapeutic. It is suggested that these understandings offer a way forward in thinking about the complex, sensitive topic of caregiver violence in sociological research on care.

A stakeholder perspective on the necessary conditions for successfully implementing parenting interventions in Botswana.

Background: Encouraging positive parenting practices through evidence-based interventions is vital for the achievement of SDG target 16.2, which aims to eradicate all forms of violence against children while promoting their safety and mental wellbeing. As low- and middle- income countries increasingly adopt parenting programs, policymakers and implementers face the challenge of efficiently transporting, adapting, and implementing them across multiple settings. Purpose: This study seeks to evaluate the real-world experiences, challenges, and best practices in implementing parent support programs in Botswana. Method: A series of interviews with program implementers and stakeholders from governmental and non-governmental organizations were conducted. Key informants from governmental and non-governmental institutions were recruited through purposive and snowball sampling and 17 practitioners participated in the study. Data collection was carried out through online Zoom video conferencing at a convenient time and location for participants. Findings: The findings indicate several factors that contribute to the successful implementation of parenting programs in Botswana, including (a) enabling factors such as supportive policies, regulations and guidelines, (b) innovative factors such as capacity building, program adaptation and mixed method program delivery, (c) bridging factors through collaborations with skilled organizations, and (d) intra-organizational factors such as organizational resources, program sustainability, and support for program staff. Conclusion: No single organization or strategy can sustainably foster positive parenting support in Botswana. Instead, a collective and collaborative learning approach is necessary to develop lasting and scalable solutions.

Suicide Prevention Effects of Extreme Risk Protection Order Laws in Four States.

More than half of suicide deaths in the United States result from self-inflicted firearm injuries. Extreme risk protection order (ERPO) laws in 21 states and the District of Columbia temporarily limit access to firearms for individuals found in a civil court process to pose an imminent risk of harm to themselves or others. Research with large multistate study populations has been lacking to determine effectiveness of these laws. This study assembled records pertaining to 4,583 ERPO respondents in California, Connecticut, Maryland, and Washington. Matched records identified suicide decedents and self-injury method. Researchers applied case fatality rates for each suicide method to estimate nonfatal suicide attempts corresponding to observed deaths. Comparison of counterfactual to observed data patterns yielded estimates of the number of lives saved and number of ERPOs needed to avert one suicide. Estimates varied depending on the assumed probability that a gun owner who attempts suicide will use a gun. Two evidence-based approaches yielded estimates of 17 and 23 ERPOs needed to prevent one suicide. For the subset of 2,850 ERPO respondents with documented suicide concern, comparable estimates were 13 and 18, respectively. This study's findings add to growing evidence that ERPOs can be an effective and important suicide prevention tool.

Prevention of Violence Against Children: A Qualitative Exploration of Colombian Policymakers', Programme Facilitators' and Caregivers' Perceptions.

OBJECTIVE: Violence against children (VAC) is a global public health and human rights issue that can lead to long-lasting negative consequences for individual and societal outcomes. While extensive evidence indicates that parenting programmes might be effective in preventing VAC, there are several unsolved questions on how to ensure interventions are acceptable, feasible, effective and sustainable, particularly in low- and- middle-income countries (LMICs). METHOD: In this study, we report findings from a qualitative examination of policymakers' (N = 10), early childhood and parenting programme facilitators' (N = 20) and parents' and other caregivers' (N = 38) perspectives on VAC prevention to examine the implementation ecosystem of parenting programmes in Colombia, including contextual risk and protection factors, features of existing programmes, and stakeholders' needs. We conducted interviews and focus groups using a semistructured format, along with a thematic approach, to analyse the data from each group of participants (i.e., policymakers, facilitators and caregivers) independently. RESULTS: Overall, the data revealed the critical role of intersecting and interacting factors at the micro (e.g., caregivers' capabilities and beliefs), meso (e.g., programme content and delivery approaches) and macro (e.g., policymakers' vision and existing infrastructure) levels in exacerbating risks/imposing barriers versus protecting/promoting VAC prevention. CONCLUSIONS: These findings provide evidence on the implementation ecosystem of prevention programmes to inform the design of novel strategies and programmes aimed at preventing violence and promoting families' well-being and young children's development.

The Relationship between Adolescent Dating Violence and Risky Health Behavioral Outcomes.

Dating violence is a serious public health issue among adolescents due to the detrimental short- and long-term consequences. The purpose of this study is to examine the relationship between adolescent dating violence (ADV) and adverse health behavioral outcomes related to substance abuse, mental health, and select risky health behaviors such as feeling unsafe, school performance, and inadequate sleep within the state of Florida. This study used data from the 2015 Youth Risk Behavior Survey (YRBS). The high school students represented a weighted total of 542,818 (n = 4301). Logistic regression analyses, stratified by gender, examined the relationship between ADV and health risk behaviors after adjusting for race and grade. Proportions of ADV were as follows: 3.1% of students reported being abused both physically and sexually; 3.4% reported being abused only physically; 3.9% reported being abused only sexually; and 89.6% were uninvolved. ADV was associated with almost all the health risk behavior outcomes studied, with a few exceptions. Experiencing both kinds of abuse held the highest odds ratio among the four mutually exclusive categories of ADV. The findings from this study could be helpful in identifying youths who demonstrate warning signs of ADV abuse and thus could provide opportunities for targeted preventive interventions.

Assessing workplace well-being in healthcare: The violence-prevention climate and its relationship with workplace happiness.

AIM: To identify the relationship between the violence-prevention climate and workplace happiness in hospitals. The secondary objective is to adapt a valid and reliable scale to a different culture in healthcare settings. BACKGROUND: Healthcare settings are not immune to the harmful effects of violence, which can exacerbate existing challenges such as staff shortages. In the midst of these challenges, organizational efforts to ensure the safety of health workers are critical. These efforts can contribute positively to workers' happiness or well-being. METHOD: Using a cross-sectional design with 400 healthcare professionals from five hospitals in Trabzon, Turkey, data collection involved the Violence-Prevention Climate Scale and Workplace Happiness Scale. Confirmatory factor analysis was conducted to test the Turkish validity and reliability of the scale, and the consistency coefficient was calculated. RESULTS: The findings revealed that, on average, employees exhibited high levels of violence-prevention climate ( x ¯ ${{\bar{\rm x}}}$  = 4.22) and moderate levels of workplace happiness ( x ¯ ${{\bar{\rm x}}}$  = 3.70). Subsequently, correlation analysis unveiled a statistically significant association between the dimensions of violence-prevention climate and workplace happiness (p < 0.05, r = 0.392). It was observed that those who experienced violence and did not feel safe in the workplace had lower levels of happiness. DISCUSSION: The instances of healthcare workers being exposed to violence identified in the study largely align with previous theories related to both individual and organizational effects. CONCLUSION: Violence-prevention climate affects the safety and workplace happiness of workers. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: Employees expect their managers to seriously consider all reports of violence. In this context, creating a violence-prevention climate would be a good start. According to WHO 2030 targets, in an environment where there is a significant shortage of healthcare personnel, especially nurses, ensuring that existing employees work in a safer and happier environment will make a positive contribution to healthcare systems.

The Impact of the Communities that Care Approach in Reducing Violence and Crime Within an Urban, High-Burden Community.

Community violence and crime are significant public health problems with serious and lasting effects on young people, families, and communities. This violence and crime have significant ripple effects, affecting not just those who are directly physically injured, but also those who witness violent episodes, those who have friends or loved ones killed or injured, and those who must everyday navigate streets that they know have been frequent sites of serious violence and crime. The current study presents evidence of the impact that a data-driven, collective impact approach - the Communities that Care prevention system - can have on violence and crime outcomes within a large urban, high-burden community. Established as one of the national Youth Violence Prevention Centers (YVPC) funded by the Centers for Disease Control and Prevention, the Chicago Center for Youth Violence Prevention is among the first to implement the CTC approach in a large, urban community. The current study's findings show reductions in violence (i.e., aggravated assaults and robberies) in the Bronzeville community, compared to similar communities in Chicago.

"You Have to Humanize Your feelings:" Black fathers' Reflections on How Youth Violence Prevention and Perpetration Influence Their Overall Health and Fathering Practices.

In Baton Rouge, LA, and nationally, youth violence is a serious public health problem affecting the lives of community members. Fortunately, Black fathers have responded to the urgent call to prevent youth violence in Louisiana. In 2021, the SUPPORT project was launched to unearth stories of Black fathers' prevention practices and interventions. Since relationships are embedded within and across various systems, the Social-Ecological Model for Violence Prevention was applied to a semi-structured interview approach to investigate two aims with 12 Black fathers from Baton Rouge: (1) how their experiences with youth violence influence their mental and social health, and their children's violence exposure, and (2) the benefits of addressing youth violence. Using Braun and Clarke's (2021) thematic analysis, the three major themes that emerged related to Black fathers' history with violence were: (1) self-reflexive moments on lessons learned, (2) the impacts of victimization and bullying, and (3) socioemotional responses to youth violence. Related to the second aim, the salutary impact on the neighborhood and improvement of the school community were the major themes that emerged regarding the perceived benefits of addressing youth violence. These findings demonstrate that interviewees are cognizant of how their history of violence led to maladaptive coping mechanisms in response to youth violence and influenced their fathering ideologies; moreover, they were concerned with familial betterment. Further research is needed to deepen understanding of how Black fathers' socioemotional responses to youth violence impact their wellness and fathering practices as their children mature.

A workplace violence prevention program targeting high-risk patients in emergency departments.

Objective: Patient violence in emergency departments (EDs) may be prevented with proactive mitigation measures targeting potentially violent patients. We aimed to evaluate the effects of two interventions guided by a validated risk-assessment tool. Methods: A prospective interventional study was conducted among patients ≥10 years who visited two EDs in Michigan, USA, from October 2022 to August 2023. During triage, the ED nurses completed the Aggressive Behavior Risk Assessment Tool for EDs (ABRAT-ED) to identify high-risk patients. Following the baseline observational period, interventions were implemented stepwise for the high-risk patients: phase 1 period with signage posting and phase 2 period with a proactive Behavioral Emergency Response Team (BERT) huddle added to the signage posting. Before ED disposition, any violent events and their severities were documented. The data were retrieved retrospectively after the study was completed. Results: Of 77,424 evaluable patients, 546 had ≥1 violent event. The violent event rates were 0.93%, 0.68%, and 0.62% for baseline, phase 1, and phase 2, respectively. The relative risk of violent events for phase 1 compared to the baseline was 0.73 (95% confidence interval [CI]: 0.59‒0.90; p = 0.003). The relative risk for phase 2 compared to phase 1 was 0.92 (95% CI: 0.76‒1.12; p = 0.418). Conclusion: The use of signage posting as a persistent visual cue for high-risk patients identified by ABRAT-ED appears to be effective in reducing the overall violent event rates. However, adding proactive BERT huddle to signage posting showed no significant reduction in the violent event rates compared to signage posting alone.

Challenging Pennsylvania's Firearm Preemption Law as a Public Health Danger: The Case of Philadelphia.

Firearm violence has soared in American cities, but most states statutorily preempt municipal firearm regulation. This article describes a unique collaboration in Philadelphia among elected officials, public health researchers, and attorneys that has led to litigation based on original quantitative analyses and grounded in innovative constitutional theories and statutory interpretation.

Feasibility and acceptability of a digital parent group chat intervention to prevent child and adolescent maltreatment in the Philippines.

This study examined the feasibility, acceptability, and preliminary outcomes of MaPaChat, a parent support intervention delivered using Viber group chat to caregivers in the Philippines during the COVID-19 pandemic. Forty caregivers of children aged 4-17 from predominantly low-income households participated in a culturally adapted version of the Parenting for Lifelong Health ParentChat programme. Feasibility was assessed by enrolment, attendance, and dropout rates. Semi-structured interviews with caregivers and programme facilitators explored programme acceptability. A single-group pre-post design was used to explore changes in child maltreatment, positive parenting, parenting stress, and other secondary outcomes. The mean attendance rate was 82% and the dropout rate was 10%. Caregivers and facilitators found the programme helpful in enhancing parenting knowledge and skills and were satisfied with the programme delivery using Viber group chat but also reported experiencing technological challenges. Pre-post comparisons suggested that the intervention has potential in reducing physical and emotional abuse and associated risk factors. The findings suggest that a parenting intervention delivered over digital group chat by trained community service providers may be a feasible and acceptable way to support caregivers in low-resource settings.

Extreme Risk Protection Orders in Connecticut, 2013-2020.

Twenty-one states and the District of Columbia have enacted Extreme Risk Protection Order (ERPO) statutes, which allow temporary removal of firearms from individuals who pose an imminent risk of harm to themselves or others. Connecticut was the first state to enact such a law in 1999. The law's implementation and use between 1999 and 2013 were previously described, finding that ERPOs were pursued rarely for the first decade and that most orders were issued in response to concerns about suicide or self-harm rather than about interpersonal violence. The current study analyzes over 1,400 ERPOs in Connecticut between 2013 and 2020 in several domains: respondent demographics, circumstances leading to ERPO filing, type of threat (suicide, violence to others, or both), number and type of firearms removed, prevalence of mental illness and drug and alcohol use, and legal outcomes. Results are similar to the earlier study, indicating that ERPO respondents in Connecticut are primarily White, male, middle-aged residents of small towns and suburbs who pose a risk of harm to themselves (67.9%) more often than to others (42.8%). Significant gender differences between ERPO respondents are discussed, as are state-specific trends over time and differences between Connecticut and other states with published ERPO data.

Examining Parental Abilities to Recognize Sexual Grooming Behaviors of Child Sexual Abusers.

PURPOSE: Identifying sexual grooming behaviors holds potential to reduce the occurrence of child sexual abuse (CSA) and increase disclosure rates. Given the influential role parents play in CSA prevention and the lack of previous research examining parent-specific sexual grooming recognition abilities, this study examined both generalized adult (i.e., parent and nonparent) and parent special abilities to recognize sexual grooming behaviors as identified in the Sexual Grooming Model (SGM), as well as the relationship between reported confidence in recognition abilities and measured abilities. METHODS: The current study used an experimental vignette design among a sample of 420 parents and 445 nonparents to measure abilities to associate sexual grooming behaviors with CSA. Participants also rated how confident they felt in their abilities to recognize signs of sexual grooming. RESULTS: Parental status did not have a significant impact on sexual grooming recognition abilities. However, the sample as a whole (i.e., parents and nonparents combined) were more likely to recognize sexual grooming when presented with behaviors from all of the SGM's stages or behaviors related to desensitization to touch and sexual content. Participant confidence in their recognition abilities did not predict measured abilities. CONCLUSION: Regardless of parental status, the sample did not strongly associate sexual grooming behaviors with CSA perpetration except when behaviors related to sexual content and physical touch were presented. This suggests heightened associations of more overt sexual grooming behaviors with CSA. The discrepancy found between confidence and recognition abilities calls for targeted educational efforts to increase awareness in types of behaviors that may be indicative of abuse.

Co-creating a global shared research agenda on violence against women in low- and middle-income countries.

BACKGROUND: Despite a large growth in evidence on violence against women (VAW) over the last 25 years, VAW persists, as do gaps in the field's knowledge of how to prevent and respond to it. To ensure that research on VAW in low- and middle-income countries (LIMCs) is addressing the most significant gaps in knowledge, and to prioritise evidence needs to reduce VAW and better support victims/survivors, the Sexual Violence Research Initiative (SVRI) and Equality Institute (EQI) led a process of developing a global shared research agenda (GSRA) on VAW in LMICs. METHODS: The GSRA was developed through a six-stage adaptation of the Child Health and Nutrition Research Initiative (CHNRI) method, which draws on the principle of the 'wisdom of the crowd'. These steps included: a review of the literature on VAW in LMICs and development of domains; the generation of research questions within four domains by an Advisory Group; the consolidation of research questions; scoring of research questions by a Global Expert Group and the Advisory Group according to three criteria (applicability, effectiveness and equity); consultation and validation of the findings with the Advisory Group; and wide dissemination of the findings. RESULTS: The highest ranked research questions in the GSRA pertain to the domain of Intervention research, with some highly ranked questions also pertaining to the domain of Understanding VAW in its multiple forms. Questions under the other two domains, Improving existing interventions, and Methodological and measurement gaps, were not prioritised as highly by experts. There was strong consistency in top ranked research questions according to experts' characteristics, albeit with some important differences according to experts' gender, occupation and geographical location. CONCLUSIONS: The GSRA findings suggest that currently the VAW field is shifting towards intervention research after several decades of building evidence on understanding VAW, including prevalence, drivers and impacts of violence. The findings also suggest a strong emphasis on under-served populations, and under-researched forms of VAW. Future priority setting exercises in LMICs that seek to decolonise knowledge should ensure that methodologies, and modalities of engagement, put diverse voices at the centre of engagement. Trial registration Not applicable.