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1.
J Interpers Violence ; 37(17-18): NP15020-NP15036, 2022 09.
Article in English | MEDLINE | ID: mdl-36073620

ABSTRACT

This article presents strategies to promote researcher-practitioner collaborations in the development and evaluation of bystander intervention programs that address sexual and dating violence (SDV) at Institutions of Higher Education (IHEs). The benefits of practitioner partnerships with researchers are reviewed. We then review examples of researcher-practitioner collaborations to develop, implement, and evaluate bystander programs. Suggestions are also offered for researcher-practitioner collaborators to engage survivors of SDV and overlooked populations, such as racial, ethnic, gender, and sexual minorities, as ways to promote diversity. Lastly, we provide guidelines for researcher-practitioner collaborations to engage bystanders based on the lessons learned from these collaborations within and around the IHE community.


Subject(s)
Intimate Partner Violence , Sex Offenses , Humans , Intimate Partner Violence/prevention & control , Sex Offenses/prevention & control , Sexual Behavior , Students , Universities
2.
J Prev (2022) ; 43(2): 277-295, 2022 04.
Article in English | MEDLINE | ID: mdl-35088198

ABSTRACT

Sexual violence (SV) is a public health problem on college campuses. Research suggests that bystanders can effectively prevent and respond in situations of SV. There is no research to date concerning correlates of bystander behavior (e.g., gender, perceptions of SV) on community college campuses. However, there are notable differences between students enrolled in two- and four-year colleges. We conducted two exploratory studies across seven community colleges in one northeastern state to examine correlates of bystander intentions and behavior. In Studies 1 and 2, the majority of respondents identified as women, heterosexual, and White. We administered online surveys that inquired about demographics, peer attitudes, knowledge of sexual consent, history of victimization, and intent to help (Study 1) or self-reported bystander behavior (Study 2). The first study (n = 1,067) demonstrated that gender (i.e., identifying as woman), less accepting peer attitudes toward SV, and greater knowledge of sexual consent and awareness of campus SV were significantly associated with bystander intentions. The second study (n = 1,506) indicated that age (i.e., younger than 25 years old), greater knowledge of sexual consent, and victimization history were associated with bystander behavior. Implications for research and practice are discussed.


Subject(s)
Crime Victims , Sex Offenses , Adult , Female , Humans , Intention , Sex Offenses/prevention & control , Students , Universities
3.
J Interpers Violence ; 36(7-8): 3855-3879, 2021 04.
Article in English | MEDLINE | ID: mdl-29862886

ABSTRACT

The prevalence of sexual violence crimes on U.S. college campuses is prompting institutions of higher education to increasingly invest in centers to support survivors and programs to prevent the violence before it happens. Understanding bystanders to sexual violence and what may motivate them to step in and help is a promising prevention strategy. The purpose of this study was to understand how potential active bystanders' (first-year college students) perceptions of community (including a sense of one's influence in the community and positive peer norms for helping) and individual beliefs about self (including sense of responsibility and self-efficacy) affect their self-reports of performing bystander behavior to address sexual violence risks. Participants were 948 students at two different universities (one a rural, primarily residential campus and the other an urban, mostly commuter campus) in the northeastern United States. Regression and path analysis quantitative results suggest that individual-level characteristics may mediate some of the impact that community-level norms and perceptions have on bystander outcomes, explaining some of the mixed findings in previous research. Prevention strategies should work to change community norms and perceptions of mattering and perceptions of community influence in addition to the more traditional focus on individual-level violence specific attitudes.


Subject(s)
Sex Offenses , Humans , New England , Perception , Sex Offenses/prevention & control , Students , Universities
4.
Violence Against Women ; 27(14): 2815-2834, 2021 11.
Article in English | MEDLINE | ID: mdl-33211624

ABSTRACT

Although 2-year institutions report higher rates of sexual violence (SV) than 4-year institutions, few resources exist to address SV on these campuses. The present study describes and assesses the impact of a 3-year initiative to engage personnel and students at seven 2-year colleges and community professionals to increase the effectiveness of SV prevention and response strategies. We administered a climate survey during the first and third year of this initiative. Compared with 2017 participants, 2019 participants reported increases in awareness of campus resources and perceptions of SV. Implications and suggestions for prevention and response efforts at 2-year institutions are discussed.


Subject(s)
Sex Offenses , Universities , Humans , Sex Offenses/prevention & control , Sexual Behavior , Students , Violence/prevention & control
5.
Health Educ Behav ; 47(1_suppl): 7S-16S, 2020 06.
Article in English | MEDLINE | ID: mdl-32250186

ABSTRACT

Recently, much research has been dedicated to understanding how to prevent and address the aftermath of sexual assault (SA) on traditional 4-year college and university campuses in the United States. However, less scholarly attention has been paid to 2-year institutions, commonly known as community colleges. This review illuminates the different situational contexts faced by community college students, compared with students at 4-year colleges. These differences are shaped by community college characteristics, student demographics, and geographic location of their students. Community colleges enroll a higher percentage of women, first-generation students, and low-income students than 4-year colleges. Furthermore, community colleges are academic homes to the most racially and ethnically diverse student population, with higher numbers of African Americans, Latinos, immigrants, and nonnative English speakers. These populations (e.g., women, racial minorities, first-generation, low-income) are at a greater risk for SA; yet, 2-year institutions have less funding and resources available to address SA on their campuses. Thus, this article reviews the problem of campus SA on community colleges and highlights the challenges that 2-year institutions face in comparison with those that 4-year institutions face when implementing SA prevention and response strategies. Then, a case study of a 3-year project on one nonresidential and seven community colleges is presented, which illustrates how 2-year institutions can forge relationships with community professionals to address SA on their campuses.


Subject(s)
Emigrants and Immigrants , Sex Offenses , Female , Humans , Prevalence , Students , United States , Universities
6.
J Interpers Violence ; 35(21-22): 4375-4392, 2020 11.
Article in English | MEDLINE | ID: mdl-29294800

ABSTRACT

Sexual assault, partner abuse, and stalking are major problems on college campuses. Past research has demonstrated a host of physiological and psychological outcomes associated with victimization; however, there has been little research conducted on the potential academic outcomes associated with victimization. The purpose of this study was to measure the relation between academic outcomes and experiences of sexual violence, intimate partner violence, and stalking victimization among college students. A sample of 6,482 undergraduate students currently enrolled at one of eight universities in New England was surveyed using items from the subscales of the College Persistence Questionnaire (Academic Efficacy, Collegiate Stress, Institutional Commitment, and Scholastic Conscientiousness). All four types of victimization were associated with significant differences on academic outcomes after controlling for sex and year in school, with victimized students reporting lower academic efficacy, higher college-related stress, lower institutional commitment, and lower scholastic conscientiousness. Polyvictimization was also significantly correlated with outcomes, with the greater number of types of victimization experienced by students being associated with more negative academic outcomes. Implications for future research and campus response were discussed.


Subject(s)
Crime Victims , Intimate Partner Violence , Stalking , Humans , New England , Students , Universities
7.
J Am Coll Health ; 67(7): 674-687, 2019 Oct.
Article in English | MEDLINE | ID: mdl-30257142

ABSTRACT

Objective: To assess the prevalence of sexual violence victimization among a community college student population. Participants: In March 2017, students (800) from seven community colleges in a northeastern state participated in an online campus climate survey using the ARC3 Survey Instrument. Methods: We analyze demographic differences between participants who were victimized and those who were not, and we examine the relationship between participant victimization and well-being. Results: Participants who identified as female, younger than 26, not heterosexual, or a race other than Caucasian were significantly more likely to report victimization. Participants who reported victimization were significantly more likely to score negatively on well-being scales than those who did not. Conclusions: Sexual violence prevalence rates among community college students are similar to reported prevalence rates among traditional 4-year undergraduate students. Results suggest a need for increased research on sexual violence among the understudied community college student population.


Subject(s)
Bullying/statistics & numerical data , Crime Victims/statistics & numerical data , Sex Offenses/statistics & numerical data , Sexual Behavior/statistics & numerical data , Students/statistics & numerical data , Universities/statistics & numerical data , Adolescent , Adult , Female , Humans , Male , New England/epidemiology , Prevalence , Sex Factors , Surveys and Questionnaires , Young Adult
8.
J Am Coll Health ; 66(6): 496-507, 2018.
Article in English | MEDLINE | ID: mdl-29447618

ABSTRACT

OBJECTIVE: To examine the well-documented mental and physical health problems suffered by undergraduate women sexually assaulted while on campus with an exploration of how the trauma impacts a survivor's lifetime education trajectory and career attainment. PARTICIPANTS: In November and December 2015, researchers recruited US participants using an online crowdsourcing tool and a Listserv for sexual violence prevention and response professionals. METHODS: Of 316 women who completed initial screening, 89 qualified to complete a Qualtrics survey. Eighty-one participants completed the online survey, and 32 participated in phone interviews. RESULTS: Ninety-one percent of the participants reported health problems related to the assault that they attributed to difficulties they faced in their attainment of their education and career goals. CONCLUSIONS: The findings suggest the importance of simultaneously examining the effects of human capital losses and mental and physical health problems attributed to the costly public health problem of campus sexual assault.


Subject(s)
Crime Victims/education , Crime Victims/psychology , Educational Status , Health Status , Sex Offenses/psychology , Students/psychology , Survivors/psychology , Adolescent , Adult , Crime Victims/statistics & numerical data , Female , Humans , Sex Offenses/statistics & numerical data , Students/statistics & numerical data , Surveys and Questionnaires , Survivors/statistics & numerical data , Time Factors , United States , Universities/statistics & numerical data , Young Adult
9.
Violence Against Women ; 21(2): 165-87, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25540255

ABSTRACT

Bystander approaches to reducing sexual violence train community members in prosocial roles to interrupt situations with risk of sexual violence and be supportive community allies after an assault. This study employs a true experimental design to evaluate the effectiveness of Bringing in the Bystander™ through 1-year post-implementation with first-year students from two universities (one rural, primarily residential; one urban, heavily commuter). We found significant change in bystander attitudes for male and female student program participants compared with the control group on both campuses, although the pattern of change depended on the combination of gender and campus.


Subject(s)
Attitude , Helping Behavior , Residence Characteristics , Sex Offenses/prevention & control , Students , Universities , Violence/prevention & control , Adolescent , Adult , Female , Humans , Male , Rape/prevention & control , Social Marketing , Young Adult
10.
Violence Against Women ; 21(2): 269-88, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25540257

ABSTRACT

Research on covictims, family members, and close friends who have lost loved ones to intimate partner homicide (IPH) is a neglected area of study. We conducted phenomenological interviews with covictims to gain insights into risk and lethality, examined affidavits from criminal case files, and reviewed news releases. The data uncovered acute risk factors prior to the homicide, identified changes in the perpetrators' behavior and the perpetrators' perceived loss of control over the victim, and described barriers that victims faced when attempting to gain safety. Findings suggest that recognizing acute risk factors is an important area for future IPH research.


Subject(s)
Homicide , Spouse Abuse/mortality , Adult , Aged , Comprehension , Crime Victims , Criminals , Female , Humans , Intimate Partner Violence , Male , Middle Aged , Risk Factors , Sexual Partners , Surveys and Questionnaires
11.
J Interpers Violence ; 30(1): 110-32, 2015 Jan.
Article in English | MEDLINE | ID: mdl-24850763

ABSTRACT

Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene.


Subject(s)
Helping Behavior , Interpersonal Relations , Sex Offenses/prevention & control , Violence/prevention & control , Adolescent , Adult , Female , Humans , Male , Program Evaluation , Sexual Partners , Universities , Young Adult
12.
J Interpers Violence ; 30(4): 580-600, 2015 Feb.
Article in English | MEDLINE | ID: mdl-24923891

ABSTRACT

The purpose of this study was to estimate the 6-month incidence rates of sexual assault, physical dating violence (DV), and unwanted pursuit (e.g., stalking) victimization among sexual-minority (i.e., individuals with any same-sex sexual experiences) college students with comparison data from non-sexual-minority (i.e., individuals with only heterosexual sexual experiences) college students. Participants (N = 6,030) were primarily Caucasian (92.7%) and non-sexual-minority (82.3%). Compared with non-sexual-minority students (N-SMS; n = 4,961), sexual-minority students (SMS; n = 1,069) reported significantly higher 6-month incidence rates of physical DV (SMS: 30.3%; N-SMS: 18.5%), sexual assault (SMS: 24.3%; N-SMS: 11.0%), and unwanted pursuit (SMS: 53.1%; N-SMS: 36.0%) victimization. We also explored the moderating role of gender and found that female SMS reported significantly higher rates of physical DV than female N-SMS, whereas male SMS and male N-SMS reported similar rates of physical DV. Gender did not moderate the relationship between sexual-minority status and victimization experiences for either unwanted pursuit or sexual victimization. These findings underscore the alarmingly high rates of interpersonal victimization among SMS and the critical need for research to better understand the explanatory factors that place SMS at increased risk for interpersonal victimization.


Subject(s)
Courtship/psychology , Crime Victims/statistics & numerical data , Heterosexuality/psychology , Homosexuality/psychology , Sex Offenses/statistics & numerical data , Violence/statistics & numerical data , Adolescent , Adult , Female , Humans , Incidence , Male , Young Adult
13.
Mil Med ; 176(8): 870-5, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21882775

ABSTRACT

OBJECTIVES: This pilot study describes an evaluation of the Bringing in the Bystander (BITB) in-person program conducted with United States Army Europe personnel. METHODS: The sample was comprised of 394 soldiers (29% participated in and 71% had not participated in the BITB program). Data were analyzed 4V2 months after the program was presented. RESULTS: Compared to the soldiers who did not participate in the program, soldiers who participated in the program were significantly more likely to report that they had engaged in one or more of the 117 behaviors, that they had helped an acquaintance or a stranger, and that they had taken action when they saw sexual assault or stalking occurring, about to occur or after it had occurred. CONCLUSIONS: The results indicate that with thoughtful and appropriate modifications, the BITB in-person prevention program, initially developed for a college audience, can be transferred to a military audience.


Subject(s)
Military Medicine/organization & administration , Military Personnel , Sex Offenses/prevention & control , Stalking/prevention & control , Crime Victims , Humans , Interpersonal Relations , Pilot Projects , Program Development , United States
14.
Violence Against Women ; 17(6): 703-19, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21628337

ABSTRACT

Sorority members may be at greater risk than other college women for sexual violence and intimate partner violence (IPV). We evaluated the Bringing in the Bystander in-person program with sorority members who participated in the program (n = 30) compared with those who did not (n = 18). Results indicate that program participants showed increased bystander efficacy, likelihood to help, and responsibility for ending violence without unintended "backlash" effects. Implications include a call for future programming with more diverse sorority members over longer time. In addition, we discuss what the findings might mean for formal campus policies and practices for preventing sexual violence and IPV.


Subject(s)
Helping Behavior , Rape/prevention & control , Social Responsibility , Spouse Abuse/prevention & control , Student Health Services , Adult , Female , Humans , Male , Sexual Partners , Students , Young Adult
15.
J Interpers Violence ; 26(5): 971-90, 2011 Mar.
Article in English | MEDLINE | ID: mdl-20522887

ABSTRACT

Bystander-focused in person sexual violence prevention programs provide an opportunity for skill development among bystanders and for widening the safety net for survivors. A social marketing campaign was designed modeling prosocial bystander behavior and using content familiar to target audience members by staging and casting scenes to look similar to the people and situations that the target audience regularly encounters. We refer to this sense of familiarity as social self-identification. In this exploratory study, we attempt to understand how seeing oneself and one's peer group (e.g., social self-identification) in poster images affects target audience members' (e.g., college students) willingness to intervene as a prosocial bystander. The posters in the social marketing campaign were displayed throughout a midsize northeastern public university campus and neighboring local businesses frequented by students. During the last week of the 4-week poster display, the university's homepage portal featured an advertisement displaying a current model of an iPod offering undergraduate students an opportunity to win the device if they completed a community survey. We found that among students who had seen the posters, those who indicated that the scenes portrayed in the posters looked like situations that were familiar to them were significantly more likely to contemplate taking action in preventing a situation where sexual violence had the potential to occur. Furthermore, students who indicated familiarity with the poster content were more likely to indicate that they had acted in a manner similar to those portrayed in the poster. Future directions based on findings from this exploratory study are discussed.


Subject(s)
Advertising/methods , Health Knowledge, Attitudes, Practice , Helping Behavior , Interpersonal Relations , Social Identification , Spouse Abuse/prevention & control , Adult , Aggression , Crime Victims/psychology , Female , Humans , Male , Peer Group , Self Efficacy , Social Environment , Surveys and Questionnaires , Young Adult
16.
J Am Coll Health ; 59(3): 197-204, 2010.
Article in English | MEDLINE | ID: mdl-21186450

ABSTRACT

OBJECTIVE: the object of this exploratory evaluation was to evaluate the "Bringing in the Bystander" sexual and intimate partner violence prevention program with a new sample of intercollegiate athletes. PARTICIPANTS AND METHODS: fifty-three male and female athletes participated in the program (experimental group), and 86 were in the control group. All completed pretest, posttest, and 2-month follow-up surveys, including assessment of rape myth acceptance, intent to engage in bystander behaviors, bystander confidence, and bystander behaviors. RESULTS: the program worked overall and for both women and men, improved bystander confidence and intent to engage in bystander behaviors, and did not create significant backlash effects (ie, worsening of attitudes as a result of program). CONCLUSIONS: the program fits with the intent of the National Collegiate Athletic Association CHAMPS/Life Skills program regarding its focus on the overall development of student-athletes and demonstrates the promising bystander approach compatible with the 2007 American College Health Association toolkit, Shifting the Paradigm: Primary Prevention of Sexual Violence.


Subject(s)
Domestic Violence/prevention & control , Rape/prevention & control , Spouse Abuse/prevention & control , Spouses/psychology , Students/psychology , Community Psychiatry , Domestic Violence/psychology , Domestic Violence/statistics & numerical data , Female , Humans , Male , Organizational Policy , Program Development , Program Evaluation , Psychometrics , Rape/psychology , Rape/statistics & numerical data , Risk Assessment , Sex Factors , Social Marketing , Sports/statistics & numerical data , Spouse Abuse/psychology , Spouse Abuse/statistics & numerical data , Spouses/statistics & numerical data , Students/statistics & numerical data , United States , Universities , Young Adult
17.
J Trauma Dissociation ; 11(2): 134-51, 2010.
Article in English | MEDLINE | ID: mdl-20373203

ABSTRACT

In order to continue to facilitate the disclosure of sexual assault to professional support services, the current study examined the extent to which survivors report using campus services and whether friends who had disclosed to participants used the services. We also compared knowledge of a campus sexual assault center and likelihood of using the center among college men and women. Surveys were completed by 1,230 students, including victims of unwanted contact (n = 127), victims of unwanted intercourse (n = 26), and friends of victims (n = 253). Students who reported being victims of unwanted sexual experiences were reluctant to use services, expressing concerns that they would not be believed and that they would be blamed for what had happened to them. College men were significantly less likely to know where the sexual assault center was located, to report that they would use the center, and to report that unwanted sexual experiences were a problem on campus. Results indicate that much needs to be done to educate the campus community about the value of using professional support services after a sexual assault.


Subject(s)
Patient Acceptance of Health Care/statistics & numerical data , Self Disclosure , Sex Offenses/psychology , Student Health Services/statistics & numerical data , Students/psychology , Universities , Chi-Square Distribution , Crime Victims/psychology , Crime Victims/statistics & numerical data , Female , Humans , Interpersonal Relations , Male , Models, Theoretical , Rape/psychology , Rape/statistics & numerical data , Sex Offenses/statistics & numerical data , Social Support , Students/statistics & numerical data , Surveys and Questionnaires , Survivors/psychology , Survivors/statistics & numerical data , Young Adult
18.
J Interpers Violence ; 25(2): 242-56, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19506165

ABSTRACT

Since sexual assault survivors are most likely to disclose their experiences to a friend; prevention efforts increasingly focus on friends as informal helpers. The current study examined friends' perceptions of the disclosure experience. Undergraduates (N=1,241) at the University of New Hampshire completed a shortened version of the Ahrens and Campbell (2000) Impact on Friends measure. Results found that about 1 in 3 female undergraduates and 1 in 5 male students were told by a friend that they were a victim of an unwanted sexual experience. Gender differences were found in friends' responses to disclosure. Women reported greater emotional distress in response to a friend's disclosure, greater positive responses and lesser-perceived confusion/ineffectiveness as compared to men. Implications include the need to develop specific and clear educational material to help the community cope with and effectively respond to unwanted sexual experiences on college campuses.


Subject(s)
Friends/psychology , Residence Characteristics , Sex Offenses/psychology , Students/psychology , Survivors/psychology , Adaptation, Psychological , Analysis of Variance , Confusion/epidemiology , Confusion/psychology , Crime Victims/psychology , Crime Victims/statistics & numerical data , Emotions , Female , Humans , Male , New Hampshire/epidemiology , Peer Group , Sex Distribution , Sex Offenses/statistics & numerical data , Social Perception , Social Support , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Students/statistics & numerical data , Survivors/statistics & numerical data
19.
J Interpers Violence ; 25(1): 111-35, 2010 Jan.
Article in English | MEDLINE | ID: mdl-19252067

ABSTRACT

Increasing numbers of empirical studies and theoretical frameworks for preventing sexual violence are appearing in the research- and practice-based literatures. The consensus of this work is that although important lessons have been learned, the field is still in the early stages of developing and fully researching effective models, particularly for the primary prevention of this problem in communities. The purpose of this article is to discuss the utility of applying the transtheoretical model of readiness for change to sexual violence prevention and evaluation. A review of this model and its application in one promising new primary prevention program is provided, along with exploratory data about what is learned about program design and effectiveness when the model is used. The study also represents one of the first attempts to operationalize and create specific measures to quantify readiness for change in the context of sexual violence prevention and evaluation. Implications for program development and evaluation research are discussed.


Subject(s)
Helping Behavior , Primary Prevention/methods , Rape/prevention & control , Social Perception , Spouse Abuse/prevention & control , Students/statistics & numerical data , Adult , Female , Health Promotion , Humans , Interpersonal Relations , Male , Models, Psychological , Prejudice , Rape/statistics & numerical data , Sex Offenses/prevention & control , Social Behavior , Social Environment , Spouse Abuse/statistics & numerical data , Stereotyping , Students/psychology , Surveys and Questionnaires , Young Adult
20.
Violence Against Women ; 15(1): 106-21, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19052283

ABSTRACT

Researchers at a midsized public northeastern university evaluated the efficacy of a poster campaign to determine if students increase their knowledge of prosocial bystander behaviors and willingness to intervene in instances of sexual violence after viewing a series of campaign posters where student actors model appropriate bystander behaviors. During the last week of the campaign, undergraduates were invited to participate in a Web survey. The results of this preliminary evaluation indicate promising variation in the awareness of students who reported seeing the campaign compared to those who did not.


Subject(s)
Advertising , Health Knowledge, Attitudes, Practice , Helping Behavior , Interpersonal Relations , Spouse Abuse/prevention & control , Adult , Aggression , Crime Victims , Female , Humans , Male , New Hampshire , Peer Group , Social Environment , Violence/prevention & control
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