Bullying bystander behaviors: The role of coping effectiveness and the moderating effect of gender.

Researchers have suggested that bystander behaviors and victim coping play an important role in counteracting the negative effects of bullying. The current study investigated the relationship between students' ratings of coping effectiveness when addressing bullying and their behaviors as bystanders when witnessing bullying. Surveys were administered in a Midwestern, suburban school district. Some associations between perceptions of coping effectiveness and bystander behavior supported our hypotheses (e.g., constructive coping associated with defending bystander behaviors, externalizing associated with pro-bullying behaviors). However, some findings did not support hypothesized relationships. For example, higher ratings of effectiveness for cognitive distancing as a coping strategy were associated with increased defending behaviors as a bystander. Gender moderated some of these relationships. Pro-bullying bystander behavior was associated with increased ratings of cognitive distancing and decreased reports of constructive coping effectiveness for girls. Implications for future research and practice are discussed.

Dark Matter Interactions, Helium, and the Cosmic Microwave Background.

The cosmic microwave background (CMB) places a variety of model-independent constraints on the strength interactions of the dominant component of dark matter with the standard model. Percent-level subcomponents of the dark matter can evade the most stringent CMB bounds by mimicking the behavior of baryons, allowing for larger couplings and novel experimental signatures. However, in this Letter, we will show that such tightly coupled subcomponents leave a measurable imprint on the CMB that is well approximated by a change to the helium fraction, Y_{He}. Using the existing CMB constraint on Y_{He}, we derive a new upper limit on the fraction of tightly coupled dark matter, f_{TCDM}, of f_{TCDM}<0.006 (95% C.I.). We show that future CMB experiments can reach f_{TCDM}<0.001 (95% C.I.) and confirm that the bounds derived in this way agree with the results of a complete analysis. These bounds provide an example of how CMB constraints on Y_{He} have applications beyond studying big bang nucleosynthesis, since tightly coupled dark matter plays no direct role in the formation of light nuclei. We briefly comment on the implications for model building, including millicharged dark matter.

Transverse Velocities with the Moving Lens Effect.

Gravitational potentials that change in time induce fluctuations in the observed cosmic microwave background (CMB) temperature. Cosmological structure moving transverse to our line of sight provides a specific example known as the moving lens effect. Here, we explore how the observed CMB temperature fluctuations, combined with the observed matter overdensity, can be used to infer the transverse velocity of cosmological structures on large scales. We show that near-future CMB surveys and galaxy surveys will have the statistical power to make a first detection of the moving lens effect, and we discuss applications for the reconstructed transverse velocity.

Thankful for the little things: A meta-analysis of gratitude interventions.

A recent qualitative review by Wood, Froh, and Geraghty (2010) cast doubt on the efficacy of gratitude interventions, suggesting the need to carefully attend to the quality of comparison groups. Accordingly, in a series of meta-analyses, we evaluate the efficacy of gratitude interventions (ks = 4-18; Ns = 395-1,755) relative to a measurement-only control or an alternative-activity condition across 3 outcomes (i.e., gratitude, anxiety, psychological well-being). Gratitude interventions outperformed a measurement-only control on measures of psychological well-being (d = .31, 95% confidence interval [CI = .04, .58]; k = 5) but not gratitude (d = .20; 95% CI [-.04, .44]; k = 4). Gratitude interventions outperformed an alternative-activity condition on measures of gratitude (d = .46, 95% CI [.27, .64]; k = 15) and psychological well-being (d = .17, 95% CI [.09, .24]; k = 20) but not anxiety (d = .11, 95% CI [-.08, .31]; k = 5). More-detailed subdivision was possible on studies with outcomes assessing psychological well-being. Among these, gratitude interventions outperformed an activity-matched comparison (d = .14; 95% CI [.01, .27]; k = 18). Gratitude interventions performed as well as, but not better than, a psychologically active comparison (d = -.03, 95% CI [-.13, .07]; k = 9). On the basis of these findings, we summarize the current state of the literature and make suggestions for future applied research on gratitude. (PsycINFO Database Record

Facilitating a School-Based Prevention of Commercial Sexual Exploitation of Children.

The challenges of developing and researching a school-based prevention program using the participatory culture-specific intervention model are described here. We outline the problem of commercial sexual exploitation of children that motivated our project and the characteristics of students most at risk (African American girls in middle school). We provide an analysis of the factors that can facilitate creation and implementation of similar prevention programs in schools. These factors include establishing partnerships with community resources, including school insiders, and establishing trust, especially with students placed at risk.

The Cultural Humility Scale for Students: Development and initial validation among adolescents.

Designed for middle and high school students to rate the cultural humility levels among their teachers, this two-study article reports on the development and initial validation of the Cultural Humility Scale for Students (CHS-S), which was adapted from the original Cultural Humility Scale used in psychotherapy. Having cultural humility may facilitate positive teacher-student relationships by preventing or responding to cultural differences when they occur. Study 1 validated the scale's use with a sample of middle school students (N = 1522). Exploratory and confirmatory factor analyses supported a two-factor structure (positive factor and negative factor) with 11 total items. Scalar measurement invariance was supported for gender comparisons. Partial scalar models were supported for race/ethnicity and grade comparisons. Compared with boys, girls reported that their teachers displayed significantly higher levels of positive cultural humility (estimate = 0.19, Cohen's d = 0.16, p = .005). Study 2 extended this work to examine high school students (N = 1612) and provided evidence that teacher cultural humility was predictive of teacher-student relationship quality (TSRQ). Results indicated that Black students who rated their teachers as having high cultural humility also reported having significantly more trust in their teachers compared to their White peers (p < .001). In terms of gender, boys who rated their teachers as having lower cultural humility had significantly less trust in their teachers and felt more alienated from their teachers compared to girls (p < .001). Results provide initial evidence that the CHS-S may be a reliable and valid instrument for measuring middle and high school students' perceptions regarding their teachers' cultural humility. Additionally, results suggest that perceived teacher cultural humility is significantly associated with TSRQ (p-values ranged from 0.05 to 0.001 in the areas of Trust, Communication, and Alienation) and could be used to complement evaluations of school climate. Limitations and future directions for research and practice are discussed.

Can a school climate survey accurately and equitably measure school quality? Examining the multilevel structure and invariance of the Georgia School Climate Scale.

School climate measures are increasingly utilized as one indicator of school quality within educational accountability systems. However, concerns have been raised about the accuracy of these indicators given that school climate surveys are often not validated using multilevel methods. Further, cross-school comparisons in climate may not be trustworthy because the school-level invariance of climate surveys has not been investigated. There is a need to examine the validity of school-level climate constructs and to determine if surveys measure climate equitably for schools that serve underrepresented populations. The aim of the current study was to examine the multilevel factor structure of a statewide school climate survey to determine whether it measured climate equitably for students of different races/ethnicities and across schools with varying racial/ethnic and socioeconomic compositions. Participants included 259,778 students from 427 middle schools throughout a southeastern U.S. state. Cross-level invariance analyses revealed that the climate constructs were measured differently across levels of analysis, and school-level climate could not be interpreted as merely the aggregate of individual-level climate. Student- and school-level factorial invariance was tested using multilevel modeling procedures. Results revealed item bias with respect to student and school characteristics, and the relationships between school climate and student and school demographics changed after accounting for identified bias. As more educational agencies consider including school climate surveys in their accountability systems, these findings suggest that multilevel validation procedures and school-level invariance analyses are necessary to ensure accurate and equitable measurement.

Multilevel confirmatory factor analysis of the Effective Behavior Support Self-Assessment Survey.

One evaluation measure available through the Positive Behavioral Interventions and Supports framework is the Effective Behavior Support Self-Assessment Survey (SAS). Evaluations of the SAS have supported its factor structure. However, the SAS is designed to be completed by school personnel who are nested within other levels of analysis (e.g., schools, grade level, district). There have been no studies examining the SAS from a multilevel perspective. The current study addressed this gap by evaluating the SAS using data from 1,726 respondents across 36 public schools in 3 school districts. Another purpose of this study was to evaluate whether the SAS can be shortened yet remain psychometrically sound to encourage completion of the survey by busy school staff members. Intraclass correlation coefficients indicated substantial dependence in item responses. Factor correlations were substantial across all models tested. Compared with a 2nd-order, hierarchical model and the basic 4-factor model based on the original hypothesized structure of the SAS, the best combination of fit and parsimony was obtained from a reduced set of 24 of the original 46 items organized within a multilevel bifactor structure (e.g., comparative fit index = .979, root-mean-square error of approximation = .019), suggesting that the SAS may be shortened. The bifactor model partitioned item variances to a general implementation fidelity factor and to 1 of the 4 hypothesized factors. These results suggest that the SAS items aim to describe dimensions for measuring implementation status that may be as relevant at the school level as they are at the individual level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Does a continuous measure of handedness predict reading processes and reading-related skills across the lifespan?

The purpose of this research was to investigate the relationship between handedness, reading skills, and reading-related cognitive processes. Although lateralised differences in brain functioning are well known, research regarding handedness, specific reading skills, and reading-related cognitive processes is ambiguous at best because handedness is often measured as a dichotomous variable rather than a continuous variable. This methodological difference contributes to the diverse research findings, therefore the present investigation addressed these methodological limitations. A large normative sample of up to 1383 participants who ranged in age from 4 to 80 completed the Woodcock Johnson Psycho-Educational Battery-Revised (Woodcock & Johnson, 1989a, 1989b) or the Woodcock Johnson Psycho-Educational Battery-Third Edition (Woodcock, McGrew, & Mather, 2001) in combination with the Dean Woodcock Sensory Motor Battery (Dean & Woodcock, 2003) lateral preference scale, a continuous measure of handedness. Polynomial multiple regression analyses indicated curvilinear relationships between handedness and reading skills, along with handedness and auditory working memory. Individuals towards the extremes of the handedness continuum performed less well on the reading-related tasks. Therefore, just knowing a general classification of right, left, or mixed handed will not provide significant knowledge regarding lateralisation or potential cognitive and academic consequences but rather knowledge of an individual's hand preference on a continuum may well be useful for evaluative purposes.

School personnel social support and nonsupport for bystanders of bullying: Exploring student perspectives.

Defending behaviors by bystanders in bullying situations have been associated with decreases in the frequency and negative effects of bullying incidents. The current study utilized qualitative methodology to investigate the role of perceived school personnel support and nonsupport in students' decisions to display defending behaviors. Forty-six semi-structured interviews were conducted with upper-elementary (n=26) and middle school (n=20) students in the southeastern United States. Qualitative data were analyzed using constant comparison and a recursive inductive-deductive approach. The findings resulted in the conceptualization of a combined social support-nonsupport framework that provides details about the source, description, evaluation, and perceived effects of different types of support and nonsupport bystanders receive from school personnel. Unique contributions to the literature included expanding the sources of support and nonsupport to consider school personnel other than teachers, providing descriptions and evaluations of support and nonsupport specific to bystanders, and demonstrating an overlap between various types of support and nonsupport reiterating the need to consider both supports and nonsupports concurrently. Implications for research and practice are discussed.

"The internet is a mask": High School students' suggestions for preventing cyberbullying.

INTRODUCTION: Interactions through technology have an important impact on today's youth. While some of these interactions are positive, there are concerns regarding students engaging in negative interactions like cyberbullying behaviors and the negative impact these behaviors have on others. The purpose of the current study was to explore participant suggestions for both students and adults for preventing cyberbullying incidents. METHODS: Forty high school students participated in individual, semi-structured interviews. Participant experiences and perceptions were coded using constant comparative methods to illustrate ways in which students and adults may prevent cyberbullying from occurring within their school and community. RESULTS: Students reported that peers would benefit from increasing online security, as well as becoming more aware of their cyber-surroundings. Regarding adult-provided prevention services, participants often discussed that there is little adults can do to reduce cyberbullying. Reasons included the difficulties in restricting online behaviors or providing effective consequences. However, some students did discuss the use of in-school curricula while suggesting that adults blame people rather than technology as potential ways to prevent cyberbullying. CONCLUSION: Findings from the current study indicate some potential ways to improve adult efforts to prevent cyberbullying. These strategies include parent/teacher training in technology and cyberbullying, interventions focused more on student behavior than technology restriction, and helping students increase their online safety and awareness.

A brief measure of adolescent perceptions of school climate.

Student perceptions of school climate represent the ways students feel about the school environment. These include perceptions regarding safety, teaching and learning, and relationships within the school. It has been found that student perceptions of school climate are positively correlated with academic achievement (Brookover et al., 1978), and negatively correlated with risky behaviors (Bandyopadhyay, Cornell, & Konold, 2009; Bayar & Ucanok, 2012; Wang, Berry, & Swearer, 2013). The Georgia Brief School Climate Inventory (GaBSCI) is a measure of student perceptions of school climate. The brevity of the 9-item instrument makes it ideal as a general measure that can be used to monitor student perceptions of school climate. The survey was anonymously administered to 130,968 sixth- and eighth-grade students in the state of Georgia. Cronbach's alpha for the scale was 0.71. Exploratory and confirmatory factor analyses verified the scale's structure. Student perceptions of climate from the GaBSCI varied based on race/ethnicity, gender, and grade. Additional support for the construct validity of the GaBSCI was obtained based on its relationships with several behaviors related to bullying, and the moderating effects of grade and gender on these relationships. Implications for research and practice are discussed.

An examination of bullying in georgia schools: demographic and school climate factors associated with willingness to intervene in bullying situations.

INTRODUCTION: Research dedicated to identification of precursors to cases of aggravated bullying in schools has led to enhanced knowledge of risk factors for both victimization and perpetration. However, characteristics among those who are more likely to intervene in such situations are less understood. The purpose of this study is to examine the associations between demographic characteristics, school climate and psychosocial factors, and willingness to intervene in a bullying situation among middle and high school students in Georgia. METHODS: We computed analyses using cross-sectional data from the Georgia Student Health Survey II (GSHS 2006) administered to public school students in grades 6, 8, 10, and 12 (n=175,311). We used logistic regression analyses to determine the demographic, school climate and psychosocial factors associated with a willingness to intervene in a bullying situation. RESULTS: Students who were white and who were girls were most likely to report willingness to intervene in bullying situations. Several school-climate factors, such as feeling safe at school, liking school, feeling successful at school and perceiving clear rules at school, were associated with willingness to intervene, while youth who reported binge drinking were less willing to intervene. CONCLUSION: These findings, while preliminary, indicate that girls, students who are white, and students who experience a relatively positive school climate and adaptive psychosocial factors are more likely to report that they would intervene in bullying situations. These findings may guide how bullying is addressed in schools and underscore the importance of safe school climates.

Sexualized and dangerous relationships: listening to the voices of low-income african american girls placed at risk for sexual exploitation.

INTRODUCTION: Youth from low-income, urban backgrounds face significant challenges to maintaining a positive developmental trajectory. Dangerous neighborhoods and stressed relationships are common in these settings and threaten adaptation by weakening the natural assets that undergird resilience. African American girls in these contexts face specific, multiple risks, including gender stereotyping, violence, and sexual exploitation. The commercial sexual exploitation of children (CSEC) is a multibillion-dollar industry victimizing over 1 million children around the globe. The typical victim in 1 city in the southeastern United States is an African American girl 12-14 years old. There has been little research investigating the characteristics of girls placed at risk for CSEC and even less research on the personal perspectives of these girls. METHODS: Over 3 school terms we provided preventive intervention groups for 36 African American middle school girls who were placed at risk because they lived in neighborhoods with high rates of interpersonal violence and CSEC. Two group leaders and a process recorder took detailed notes on each group session. Our focus on group conversations over a period of weeks increased the probability of recording spontaneous, open comments by the children and is a promising method with this population. The data were analyzed qualitatively and resulted in an account of the girls' own views of the environmental challenges and personal experiences that may influence their development. RESULTS: The girls' language during the group sessions contained 4 themes: difficulty forming trusting relationships, frequent peer aggression, familiarity with adult prostitution, and sexuality as a commodity. CONCLUSION: Our research shows how girls placed at risk for CSEC view their own lives. These children described violence and sexual exploitation and cited limited supports to protect them from these risks. Understanding the perspectives of these girls should generate future research and intervention strategies to support their coping and resilience.

Bystander motivation in bullying incidents: to intervene or not to intervene?

INTRODUCTION: This research sought to extend knowledge about bystanders in bullying situations with a focus on the motivations that lead them to different responses. The 2 primary goals of this study were to investigate the reasons for children's decisions to help or not to help a victim when witnessing bullying, and to generate a grounded theory (or conceptual framework) of bystander motivation in bullying situations. METHODS: Thirty students ranging in age from 9 to 15 years (M = 11.9; SD = 1.7) from an elementary and middle school in the southeastern United States participated in this study. Open- ended, semi-structured interviews were used, and sessions ranged from 30 to 45 minutes. We conducted qualitative methodology and analyses to gain an in-depth understanding of children's perspectives and concerns when witnessing bullying. RESULTS: A key finding was a conceptual framework of bystander motivation to intervene in bullying situations suggesting that deciding whether to help or not help the victim in a bullying situation depends on how bystanders define and evaluate the situation, the social context, and their own agency. Qualitative analysis revealed 5 themes related to bystander motives and included: interpretation of harm in the bullying situation, emotional reactions, social evaluating, moral evaluating, and intervention self-efficacy. CONCLUSION: Given the themes that emerged surrounding bystanders' motives to intervene or abstain from intervening, respondents reported 3 key elements that need to be confirmed in future research and that may have implications for future work on bullying prevention. These included: first, the potential importance of clear communication to children that adults expect bystanders to intervene when witnessing bullying; second, the potential of direct education about how bystanders can intervene to increase children's self-efficacy as defenders of those who are victims of bullying; and third, the assumption that it may be effective to encourage children's belief that bullying is morally wrong.

A case study with an identified bully: policy and practice implications.

OBJECTIVE: Bullying is a serious public health problem that may include verbal or physical injury as well as social isolation or exclusion. As a result, research is needed to establish a database for policies and interventions designed to prevent bullying and its negative effects. This paper presents a case study that contributes to the literature by describing an intervention for bullies that has implications for practice and related policies regarding bullying. METHODS: An individualized intervention for an identified bully was implemented using the Participatory Culture-Specific Intervention Model (PCSIM; Nastasi, Moore, & Varjas, 2004) with a seventh-grade middle school student. Ecological and culture-specific perspectives were used to develop and implement the intervention that included psychoeducational sessions with the student and consultation with the parent and school personnel. A mixed methods intervention design was used with the following informants: the target student, the mother of the student, a teacher and the school counselor. Qualitative data included semi-structured interviews with the parent, teacher and student, narrative classroom observations and evaluation/feedback forms filled out by the student and interventionist. Quantitative data included the following quantitative surveys (i.e., Child Self Report Post Traumatic Stress Reaction Index and the Behavior Assessment Scale for Children). Both qualitative and quantitative data were used to evaluate the acceptability, integrity and efficacy of this intervention. RESULTS: The process of intervention design, implementation and evaluation are described through an illustrative case study. Qualitative and quantitative findings indicated a decrease in internalizing, externalizing and bullying behaviors as reported by the teacher and the mother, and a high degree of acceptability and treatment integrity as reported by multiple stakeholders. CONCLUSION: This case study makes important contributions by describing an intervention that is targeted to specific needs of the bully by designing culture specific interventions and working with the student's unique environmental contexts. Contributions also are made by illustrating the use of mixed methods to document acceptability, integrity and efficacy of an intervention with documented positive effects in these areas. In addition, implications for policy and practice related to the treatment of students identified as bullies and future research needs are discussed.

Pre-Teen Alcohol Use as a Risk Factor for Victimization and Perpetration of Bullying among Middle and High School Students in Georgia.

OBJECTIVE: We examined the association between pre-teen alcohol use initiation and the victimization and perpetration of bullying among middle and high school students in Georgia. METHODS: We computed analyses using data from the 2006 Georgia Student Health Survey (N=175,311) of students in grades 6, 8, 10 and 12. The current analyses were limited to students in grades 8, 10 and 12 (n=122,434). We used multilogistic regression analyses to determine the associations between early alcohol use and reports of both victimization and perpetration of bullying, perpetration only, victimization only, and neither victimization or perpetration, while controlling for demographic characteristics, other substance use, peer drinking and weapon carrying. RESULTS: Pre-teen alcohol use initiation was significantly associated with both bullying perpetration and victimization relative to non drinkers in bivariate analyses (OR=3.20 95%CI:3.03-3.39). The association was also significant between pre-teen alcohol use initiation and perpetration and victimization of bullying in analyses adjusted for confounders (Adj.OR=1.74; 95%CI:1.61-1.89). Overall, findings were similar for boys and girls. CONCLUSION: Pre-teen alcohol use initiation is an important risk factor for both the perpetration and victimization of bullying among boys and girls in Georgia. Increased efforts to delay and reduce early alcohol use through clinical interventions, education and policies may also positively impact other health risk behaviors, including bullying.

High school students' perceptions of motivations for cyberbullying: an exploratory study.

OBJECTIVES: Internet usage has increased in recent years resulting in a growing number of documented reports of cyberbullying. Despite the rise in cyberbullying incidents, there is a dearth of research regarding high school students' motivations for cyberbullying. The purpose of this study was to investigate high school students' perceptions of the motivations for cyberbullying. METHOD: We undertook an exploratory qualitative study with 20 high school students, conducting individual interviews using a semi-structured interview protocol. Data were analyzed using Grounded Theory. RESULTS: The developed coding hierarchy provides a framework to conceptualize motivations, which can be used to facilitate future research about motivations and to develop preventive interventions designed to thwart the negative effects of cyberbullying. The findings revealed that high school students more often identified internally motivated reasons for cyberbullying (e.g., redirect feelings) than externally motivated (no consequences, non-confrontational, target was different). CONCLUSION: Uncovering the motivations for cyberbullying should promote greater understanding of this phenomenon and potentially reduce the interpersonal violence that can result from it. By providing a framework that begins to clarify the internal and external factors motivating the behavior, there is enhanced potential to develop effective preventive interventions to prevent cyberbullying and its negative effects.

Pre-teen alcohol use initiation and suicide attempts among middle and high school students: findings from the 2006 Georgia Student Health Survey.

Early alcohol use initiation has been linked to suicide attempts among youth. However, very little is known about the potential impact of alcohol-related norms and beliefs and how these may impact the association between alcohol use and suicide attempt. This study examines the associations between early alcohol use and suicide attempts while controlling for demographic characteristics, and alcohol-related beliefs and norms (e.g., believing alcohol causes harm to health or that adults or friends disapprove of alcohol use) and potential confounders. Analyses were based on the 2006 Georgia Student Health Survey (N=175,311) of students in grades 6, 8, 10 and 12. The current analyses were limited to students in grades 8, 10 and 12, who either began drinking prior to age 13 or who were non drinkers (n=87,349). Pre-teen alcohol use initiation was associated with suicide attempts (Adj.OR=1.51; 95%CI:1.38-1.66) relative to not drinking with similar associations for boys (Adj.OR=1.72; 95%CI:1.52-1.94) and girls (Adj.OR=1.26; 95%CI:1.08-1.45). Students who believed that alcohol was harmful to their health, or that friends or adults disapproved of their alcohol use, or who had been taught about substance use in school were less likely to make a suicide attempt, although findings differed for boys and girls. Pre-teen alcohol use initiation is an important risk factor for suicide attempts among boys and girls in Georgia. Increased efforts to delay and reduce early alcohol use through clinical interventions, education, and policies that impact norms and knowledge related to alcohol use are needed and may in turn reduce suicide attempts.

Long-term acyclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation--a randomized double-blind placebo-controlled study.

Varicella-zoster virus (VZV) disease occurs in 30% of allogeneic hematopoietic cell transplant recipients who had a history of VZV infection. A safe and effective prevention strategy has not been established. In a double-blind controlled trial, 77 hematopoietic cell transplant recipients at risk for VZV reactivation were randomized to acyclovir 800 mg twice daily or placebo given from 1 to 2 months until 1 year after transplantation. VZV disease at 1 year was the primary end point; VZV disease after discontinuation of prophylaxis, VZV-specific T-cell immunity, herpes simplex virus (HSV) infection, cytomegalovirus (CMV) disease, survival, and safety were secondary end points. Acyclovir significantly reduced VZV infections at 1 year after transplantation (HR, 0.16; 95% CI, 0.035-0.74; P = .006). In the post-intervention observation period, this difference was not statistically significant (2 years: HR, 0.52; 95% CI, 0.21-1.3; 5 years: HR, 0.76; 95% CI, 0.36-1.6). There was no statistically significant difference in reconstitution of VZV-specific T-helper cell responses, HSV infections, CMV disease, chronic graft-versus-host disease, and overall survival between the groups. Acyclovir was well tolerated. Post-study VZV disease predominantly occurred in patients with continued need for systemic immunosuppression. In conclusion, acyclovir effectively and safely prevents VZV disease during the first year after hematopoietic cell transplantation. Periods of prophylaxis longer than 12 months may be beneficial for those hematopoietic cell transplant recipients on continued immune suppression.