Insights from Developing and Implementing a Novel School Community Collaborative Model to Promote School Safety.

BACKGROUND: School Resource Officer (SRO) programs do not reduce school violence and increase school discipline. We describe the use of a culturally responsive framework to form a school community collaborative among students, parents, staff, administrators, and law enforcement to reform an SRO program, promote school safety, and reduce punitive measures. METHODS: Members of a participating school district, a local county, and a university collaborated. Adapting an identified culturally responsive model, a racially/ethnically diverse school community co-developed and implemented a School Community Collaborative (SCC) to address a school safety priority (SRO program reform). The main outcomes were SCC model development and implementation, policy change, and school community feedback. RESULTS: Sixteen community members participated in the 5-week SCC with students, staff, law enforcement, and parents. The SCC revised the district's SRO memorandum of understanding (MOU) with law enforcement. Participants reported favorable feedback, and 89% reported the inclusion of diverse voices. CONCLUSIONS: Co-development and implementation of an SCC process with schools were feasible. School SCC participated in a community-engaged evaluation and revision of an MOU.

Mental Health Comorbidities, Household Firearm Ownership, and Firearm Access Among Children.

OBJECTIVES: To examine how youth and their caregivers' mental health risk factors for suicide are associated with youth firearm access inside and outside the home. METHODS: This study examines a cross-section of the Adolescent Brain and Cognitive Development Social Development study data collected from 2016 to 2021. The sample included 2277 children aged 10 to 15 years from 5 study sites across the United States. We estimated multilevel generalized linear models of household firearm ownership and the child's reported firearm access (hard access or easy access). The primary exposures were the child's and their caregivers' mental health risk factors for suicide. RESULTS: In the Adolescent Brain and Cognitive Development Social Development study sample, approximately 20% of children lived in a firearm-owning household and 5% of all children reported easy firearm access. In non-firearm-owning households, children with diagnosed lifetime suicidality were 2.48 times more likely (95% confidence interval [CI], 1.50-4.10) than their counterparts to report easy firearm access. In firearm-owning households, children of caregivers who self-reported any mental health history or externalizing problems were 1.67 times (95% CI, 1.10-2.54) and 2.28 times (95% CI, 1.55-3.37) more likely than their counterparts to report easy firearm access. CONCLUSIONS: Youths with mental health risk factors for suicide may be just as likely or more likely to report firearm access as those without such risk factors. Youth suicide prevention efforts should address youths' firearm access outside the home and caregiver mental health.

Exploring Collaborative Care Effects on the Mental and Physical Health of Patients With and Without Violent Victimization Histories.

Collaborative care is a multicomponent intervention delivered by frontline social work, nursing, and physician providers to address patients' physical, emotional, and social needs. We argued that collaborative care may particularly benefit patients with a violent victimization history because it practices three principles of trauma-informed care: patient-provider collaboration, preventing repeat trauma in clinical and community settings, and delivering comprehensive mental and physical healthcare. We conducted an exploratory secondary data analysis of a collaborative care randomized clinical trial involving patients who presented with traumatic physical injury at a Level I trauma center in Washington state between 2006 and 2009. We used random-effect linear regression models to estimate how histories of multiple violent traumas moderated the effects of the collaborative care intervention on Short Form-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) T-scores over time. Collaborative care significantly improved follow-up MCS scores among patients who experienced three to four types of violent victimization in their lifetime. Additionally, intervention effects on MCS scores at the 3- and 6-month follow-up were clinically stronger for patients who reported three to four types of violent victimization (3-month = 7.5, 95% confidence level [CI] = 5.1 to 18.7; 6-month = 11.9, 95% CI = 5.1 to 18.7) than those without a history of violent victimization (3-month = 0.8, 95% CI = -5.1, 6.6; 6-month = 5.6, -2.4 to 13.5). We did not find that intervention effects on PCS scores differed between these groups at any wave. Collaborative care may be a promising approach to delivering trauma-informed mental healthcare to patients with histories of multiple types of violent victimization.

Racial and Ethnic Differences in the Fear-Victimization Gap at School: An Examination of School Context and Trends Over Time.

This study examined racial and ethnic differences in adolescents' fear of attack or harm at school after adjusting for differences in violent victimization prevalence. We analyzed 49,782 surveys from 35,588 adolescents who participated in the NCVS School Crime Supplement (1999-2017). We tested whether differences in fear are attributable to youths' (1) experiences with non-criminal harms, (2) indirect exposure to crime and violence at their school, or (3) school security and disciplinary practices. We then examined trends in fear and victimization by race/ethnicity over a period of crime decline to determine how fear has changed relative to victimization across the racial/ethnic groups. In the pooled sample, Black and Hispanic youth had 93% and 74% higher odds than White youth of expressing fear at school, after adjusting for violent victimization and demographic characteristics. After accounting for non-criminal harms, exposure to crime and violence, and school security/discipline, Black and Hispanic youth had only 39% and 44% higher odds than White youth of expressing fear, respectively. Mediation analyses indicated that the explanatory variables explained half (50.2%) and one third (33.7%) of the difference in the odds of fear between Black and Hispanic youth compared to White youth. Analyses over time indicated that fear declined more for Black and Hispanic youth than White youth, despite similarly-sized declines in victimization across race/ethnicity. Altogether, the results suggest that racial and ethnic differences in fear of criminal victimization partly reflect differential experiences and environments at school. We consider the implications of our findings in terms of understanding how the school context influences fear differently across students' racial and ethnic identities.

Assault-related injuries reported to police and treated by healthcare providers in the United States.

Research suggests that assault-related injuries known by the police significantly differ from those known by healthcare providers, but the magnitude and nature of these differences are poorly understood. To address this gap, our study examined the empirical differences between assault-related injuries reported to police and treated by healthcare providers. In June of 2021, we analyzed the National Crime Victimization Survey (1993-2019) to estimate the prevalence of police reporting and healthcare use among 5093 nonfatal victimizations that caused injury and were either reported to the police or treated by healthcare in the United States. Quasi-Poisson models identified the factors associated with whether people who sustained the injuries used healthcare (v. only reported to police) and reported to police (v. only used healthcare). Among victimizations that caused only minor injuries, 43% involved only a police report, 11% involved only healthcare, and 46% involved both services. Among victimizations that caused serious injuries, 14% involved only a police report, 13% involved only healthcare, and 73% involved both services. Whether people with violent injuries used healthcare (v. only reported to police) and reported to police (v. only used healthcare) was significantly associated with 13 different person- and incident-level factors. The number and nature of assault-related injuries reported to law enforcement significantly differ from those treated by healthcare providers. Therefore, public health efforts to link police and healthcare data are warranted and recommended.

Victim-Offender Relationship and the Emotional, Social, and Physical Consequences of Violent Victimization.

INTRODUCTION: Research is equivocal about how the social relationship between victims and offenders is linked to the emotional, social, and physical consequences of violence. This study examines the association of victim-offender relationship with the adverse outcomes reported by injured and uninjured victims of violence. METHODS: The study analyzed 16,723 violent victimizations recorded by the National Crime Victimization Survey from 2008 to 2018. Multivariable quasi-Poisson models estimated the associations between the victim-offender relationship and victims' emotional distress, social distress, and physical and emotional symptoms. These models also estimated a statistical interaction between victim-offender relationship and violent injury to examine how this association differed for injured and uninjured victims. The analyses occurred during 2020 and 2021. RESULTS: Uninjured victims were more likely to report emotional distress (risk ratio=1.41, 95% CI=1.33, 1.50), social distress (risk ratio=3.12, 95% CI=2.78, 3.51), more physical symptoms (symptom frequency ratio=1.68, 95% CI=1.51, 1.87), and more emotional symptoms (symptom frequency ratio=1.13, 95% CI=1.08, 1.18) in family member/intimate partner violence than in stranger violence. Victims also reported worse outcomes after acquaintance violence than after stranger violence. For injured victims, these differences narrowed-but were still significant-in emotional and social distress models. However, the number of emotional and physical symptoms reported by injured victims did not significantly vary across victim-offender relationships. CONCLUSIONS: Relational closeness between victims and offenders is a risk factor for adverse outcomes after violent victimization, and it is more strongly associated with these outcomes for uninjured victims than for injured victims.

Adversary effects and the tactics of violent offenders.

We examine the implication of adversary effects for target choice, lethal intent, and the use of weapons and allies in violent incidents. Adversary effects refer to the tendency of offenders to make tactical decisions based on the coercive power of victims and potential victims. Using the victim's gender as a proxy for coercive power, we analyzed violent incidents from the National Incident-Based Reporting System (2005-2014). The sample included over six million assaults, robberies, and homicides. Consistent with adversary effects, offenders who attack males (vs. females) are more likely to (a) kill victims; (b) use guns, knives, blunt objects, poison, and automobiles; (c) use male (but not female) allies; and (d) use multiple allies. The evidence for target choice is mixed: unarmed female offenders, but not unarmed male offenders, are more likely to target females than males. The evidence shows how a simple theoretical principle can parsimoniously account for basic patterns of violence in society related to gender, weapons, and group violence.

Gender Interaction Effects on Reporting Assaults to the Police.

This study used two theoretical perspectives-coercive power and gender norms-to examine how gender affects victims' decisions to report physical assaults to the police. The coercive power perspective attributes gender differences in reporting to sex-linked physical coercive power differences that affect the harm of the crime and victims' personal safety. The gender norm perspective attributes gender differences in reporting to specific gender norms that influence crime reporting decisions. Using a sample of 18,627 nonintimate partner physical assaults from the National Crime Victimization Survey (1993-2015), crime reporting models demonstrated significantly better fit when they included the interaction between the victim's gender and the offender's gender than when they included only the main effects. In the sample, (a) female victims were 21.9% more likely to report to the police when the offender was male (vs. female) and (b) male victims were 45.8% more likely to report to the police when the offender was female (vs. male). Victims' tendency to report an opposite-sex offender to the police was strongest in simple assaults and absent in aggravated assaults. We conclude that male and female victims' reporting behaviors were most consistent with gender norms that encourage the use of self-help violence and discourage police reporting in intragender assaults. Consistent with this explanation, self-help violence was negatively related to crime reporting in assaults. Victims were more likely to use self-help violence and avoid reporting to the police against a same-sex offender than an opposite-sex offender. Finally, the offender's gender had a relatively stronger influence on assault victims' decisions to use self-help violence than on victims' decisions to take no action against the offender (i.e., not reporting to the police or using self-help violence).

Understanding the Barriers of Violence Victims' Health Care Use.

Violence is a leading cause of death among U.S. adults under age 45. There are also 3.3 million living violence victims, most of whom forgo formal health care when injured. We developed and tested a framework to understand why. We argue that violence victims must consider their need for care and three situational factors of victimization that may serve as barriers for care seeking: the victim's relationship to the offender, their victimization history, and the offense committed (sexual vs. nonsexual). In analyses of 9,912 violent victimizations from 8,635 participants in the National Crime Victimization Survey from 1993 to 2017, we found that injury severity and situational factors of victimization independently and interactively predict formal health care use. Even when serious injury occurs, victimizations involving known offenders, repeat victimizations, and sexual violence are less likely than their counterparts to result in formal health care use. We discuss the implications of these findings for victims and health care providers.