Examining the influence of adversity, family contexts, and a family-based intervention on parent and child telomere length.

Background: Exposure to adversity, trauma, and negative family environments can prematurely shorten telomeres, the protective caps at the ends of chromosomes. Conversely, some evidence indicates that positive environments and psychosocial interventions can buffer the shortening of telomere length (TL). However, most work has examined individual aspects of the family environment as predictive of TL with little work investigating multiple risk and protective factors. Further, most research has not examined parent TL relative to child TL despite its heritability. Objective: In the current study, we examined interparental conflict, positive parenting, alcohol use, adverse childhood experiences (ACEs), and a family-based intervention as predictive of parent TL. We also examined interparental conflict, positive parenting, ACEs, and a family-based intervention as predictive of child TL. Method: Parents and adolescents from a sample of divorced families participated in either a 10-session family-based intervention, the New Beginnings Programme (NBP), or a 2-week active control condition. Approximately six years after the intervention, a subsample of parents (n = 45) and adolescents (n = 41) were assessed for TL. Parents reported on interparental conflict, ACEs, and alcohol use. Children reported on interparental conflict, positive parenting, and ACEs. In separate models, these constructs and the NBP intervention condition were examined as predictors of parent TL and child TL. Results: Findings indicated that the family-based intervention was associated with longer TL in parents. Also, positive parenting was associated with longer TL in children. Conclusions: These findings have important implications for the role of the family and family-based preventive interventions in buffering parent and child biological stress. HIGHLIGHTS: Across multiple indices of psychosocial functioning, we found a family-based intervention associated with longer telomere length in parents and positive parenting associated with longer telomere length in children.

Antecedentes: La exposición a la adversidad, el trauma y los entornos familiares negativos pueden acortar prematuramente los telómeros, las tapas protectoras en los extremos de los cromosomas. Por el contrario, algunas pruebas indican que los entornos positivos y las intervenciones psicosociales pueden amortiguar el acortamiento de la longitud de los telómeros (LT). Sin embargo, la mayor parte del trabajo ha examinado aspectos individuales del entorno familiar como predictivo de LT con pocos trabajos que investiguen múltiples factores de riesgo y protección. Además, la mayoría de las investigaciones no han examinado la LT de los padres en relación con la LT del niño a pesar de su heredabilidad.Objetivo: En el estudio actual, examinamos el conflicto interparental, la crianza positiva, el consumo de alcohol, las experiencias infantiles adversas (ACE, por sus siglas en inglés) y una intervención basada en la familia como predictores de LT de los padres. También examinamos el conflicto interparental, la crianza positiva, las ACE y una intervención basada en la familia como predictores de LT infantil.Método: Los padres y los adolescentes de una muestra de familias divorciadas participaron en una intervención familiar de 10 sesiones, el nombre de la intervención está oculto para su revisión, o en una condición de control activo de 2 semanas. Aproximadamente seis años después de la intervención, se evaluó la longitud de los telómeros en una submuestra de padres (n = 45) y adolescentes (n = 41). Los padres informaron sobre conflictos entre padres, ACE y consumo de alcohol. Los niños informaron sobre conflictos entre padres, crianza positiva y ACE. En modelos separados, estos constructos y la condición de intervención nombre oculto para su revisión se examinaron como predictores de LT de padres y LT de niños.Resultados: Los hallazgos indicaron que la intervención basada en la familia se asoció con una LT más prolongada en los padres. Además, la crianza positiva se asoció con una LT más prolongada en los niños.Conclusiones: Estos hallazgos tienen implicaciones importantes para el papel de la familia y las intervenciones preventivas basadas en la familia para amortiguar el estrés biológico de padres e hijos.

A Person-centered Approach to Violence Exposure in Postwar Colombian Youth: Demographic Covariates and Positive Youth Development Outcomes.

While the negative impact of extensive exposure to community violence and armed conflict is known, less emphasis has been focused on outcomes supportive of resilience. It is critical to begin exploring these constructs to both promote healing from decades-long conflict and to inform targeted interventions that focus on positive youth development in contexts of adversity. This study thus utilized a person-centered approach to estimate violence exposure profiles among 3,443 Colombian youth to explore what demographic covariates and positive youth development outcomes, such as school engagement, hope, goals, social competence, future expectations, and barriers to education were associated with each violence exposure profile. Four profiles emerged: a low exposure profile, a high community violence profile, a some combined exposure profile, and a high combined exposure profile, each with various levels of community violence witnessing and victimization as well as armed conflict exposure. Demographic covariance results showed older, urban, male youth were more likely to be in the high violence exposure profiles compared to the low exposure group. Youth in the high combined exposure profile were more likely to have lower hope, educational expectations, and social competence compared to the low exposure group. Findings highlight that a person-centered approach provides a more multidimensional view of adolescent violence exposure. Demographic differences suggested the importance of tailoring violence prevention initiatives to the local context. Finally, results concerning positive youth development outcomes suggest that resiliency-oriented constructs, which can be instrumental toward youth's postwar healing and growth, should be emphasized among populations who experience high levels of co-occurring exposure.

School racial-ethnic discrimination, rule-breaking behaviors and the mediating role of trauma among Latinx adolescents: Considerations for school mental health practice.

Much of the literature linking adversity to trauma fails to account for racialized experiences, including racial-ethnic discrimination, which is a highly prevalent form of adversity for youth of color in the U.S. Adversity and trauma often result in students experiencing elevated rule-breaking behaviors, exacerbating existing racial-ethnic disparities in disproportionate school discipline. Drawing from race-based trauma theory, the present study explored trauma as a mediator of the longitudinal association between racial-ethnic discrimination from teachers, other adults, and students in schools and rule-breaking behaviors among Latinx youth. Data were from a longitudinal study of 547 Latinx students in a southeastern U.S. state. Across gender and nativity groups, school racial-ethnic discrimination and trauma positively predicted later rule-breaking behaviors. Additionally, for girls only, increased levels of trauma partially explained the association between school racial-ethnic discrimination and rule-breaking behaviors. The study highlights the importance of addressing school racial-ethnic discrimination and trauma in equitable school metal health systems. Indeed, efforts aimed at reducing disproportionate school discipline among Latinx students should focus on reducing their exposure to school racial-ethnic discrimination and increasing access to trauma-informed and restorative justice approaches.

Factors Associated With Urban Youth and Parent Perceptions of the Preventability of Assault Injury: An Emergency Department Sample.

OBJECTIVES: This study aimed to identify factors associated with urban youth and parent's perception of the preventability of medically attended youth assault injuries to guide future violence prevention strategies. METHODS: Assault-injured youth (n = 188; ages, 10-15 years; 60% male; 96% black) and their parents were recruited from 2 pediatric emergency departments in 2 cities. Mental health, injury severity, circumstances of injury, and family composition were some of the factors explored as cross-sectional predictors of the perception of the preventability of youth assault injury. Separate models were developed using stepwise regression for youth and parents. RESULTS: Sixty-eight (38%) youth and 123 parents (68%) reported that the injury was definitely preventable (χ2 = 9.6250, P < 0.05). For youth, identifying themselves as the aggressor (odds ratio [OR], 0.23, 95% confidence interval [CI], 0.07-0.70) or having been hospitalized for psychiatric illness (OR, 0.21; 95% CI, 0.05-0.85) was associated with lower odds of perceiving their injury as preventable, while being under the care of a mental health professional (OR, 3.87; 95% CI, 1.21-12.39) was associated with higher odds. For parents, being in a household with grandparents (OR, 0.21; 95% CI, 0.04-0.99) or having a child with a learning disability (OR, 0.16; 95% CI, 0.05-0.57) was associated with lower odds of perceiving the injury as preventable. CONCLUSIONS: Several factors in youth and parents were identified as being associated with perception of preventability of injuries in this high-risk population of youth. Youth and parents identified different factors. In addition, although most parents reported that the assault injury sustained by their child was preventable, the opposite was true for youth perceptions. Future violence prevention programs should consider youth and parent perspectives and develop unique strategies to address both their needs.

Triangulating School Climate: Areas of Convergence and Divergence Across Multiple Levels and Perspectives.

Students often have differing perceptions of their school's climate. Although these subjective perceptions can be meaningful outcome predictors, discrepancies create challenges for those seeking to globally characterize or intervene to improve the climate of a school. Trained, independent  observers can provide insights on perceptible and ostensibly malleable aspects of the school; however, the extent to which these observations help us to understand differences in students' report of school climate has not been examined. To study this, we assessed convergence and divergence between independent observers' assessments and students' perceptions of school climate at the classroom and school levels. Data come from the Maryland Safe and Supportive Schools Initiative (MDS3), which included 20,647 students and observations of 303 teachers in 50 high schools. Students responded to survey items regarding safety, engagement, and environment; independent observers assessed teachers' classroom practices and the school physical environment. A three-level model partitioned variance to the individual, classroom, and school levels. The variance in students' climate perceptions was primarily between students, with most classroom and school intraclass correlation coefficients (ICCs) ranging from 0.01 to 0.08, though one was as high as 0.20; however, observations explained large percentages of between-school variation in climate (58%-91%). Findings suggest the potential utility of outside observations for explaining school-level variation in school climate to inform decision-making and future research.

A MARGINAL COST ANALYSIS OF A BIG BROTHERS BIG SISTERS OF AMERICA YOUTH MENTORING PROGRAM: NEW EVIDENCE USING STATISTICAL ANALYSIS.

The objective of this study was to evaluate the cost of serving one additional youth in the Big Brothers Big Sisters of America (BBBS) program. We used a marginal cost approach which offers a significant improvement over previous methods based on average total cost estimates. The data consisted of eight years of monthly records from January 2008 to August 2015 obtained from program administrators at one BBBS site in the Mid-Atlantic. Results show that the BBBS marginal cost to serve one additional youth was $80 per mentor-month of BBBS mentoring (irrespective of program type). The cost to offer services for the average match duration of 19 months per marginal added youth was $1,503. The marginal costs per treated program participant in school-based versus community-based programs were $1,199 and $3,301, respectively. Marginal cost estimates are in the range of youth mentoring programs with significant returns on investment but are substantially higher than prior BBBS unit cost estimates reported using less robust estimation methods. This cost analysis can better inform policy makers and donors on the cost of expanding the scale of local BBBS programs as well as suggest opportunities for cost savings.

Beyond blunts: Reasons for cigarette and cigar use among African American young adult dual users.

BACKGROUND: African American young adults are at high risk for dual use of cigarettes and cigars. Limited work has explored and characterized the reasons for use in this population and their relative importance for initiation and current smoking of these products. METHOD: Reasons for cigarette and cigar use were systematically explored and categorized using a mixed methods participatory approach called concept mapping. A series of in-person group sessions were held with 30 African American young adult (ages 18-29) current smokers of both cigarettes and cigars in Prince George's County, MD and Washington, DC. Participants brainstormed, sorted, rated, and interpreted their reasons for initiation and past 30-day use of cigarettes and cigars. A cluster map was generated using multi-dimensional scaling, and t-tests were used to explore differences in ratings by background characteristics. RESULTS: Participants generated 64 reasons for smoking cigarettes and cigars, and categorized these reasons into six groups: emotions, urges, access, product characteristics, lifestyle, and outside pressure. Emotions and urges were the most important motivations for initiation and current smoking of both products. Product characteristics were significantly more important for cigar initiation and smoking than for cigarettes, and outside pressure was more important for current smoking of cigars than cigarettes. Ratings differed by gender, socioeconomic status, and smoking characteristics. CONCLUSIONS: Cigarette and cigar smoking have several overlapping motivations, but key differences were also found, most notably for product characteristics. The FDA's regulation of cigars and cigarettes should focus on addressing key characteristics appealing to young adults to curb dual use.

Meeting Quality Measures for Adolescent Preventive Care: Assessing the Perspectives of Key Stakeholders.

BACKGROUND: Health plans are increasingly implementing quality improvement strategies aimed at meeting adolescent clinical quality measures, yet clinics often struggle to meet these measures. This qualitative study was conducted to explore how efforts to meet the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) performance measure for adolescent well-care visits were perceived by a multidisciplinary group of stakeholders. METHODS: The research team conducted 26 in-depth, semistructured interviews with participants from three stakeholder groups: clinic staff with direct patient contact, health care institutional leaders, and representatives of a payer organization. Interviews were about 45 minutes in duration, audio-recorded, and professionally transcribed. Framework analysis was used to identify and organize emergent themes, and Atlas.ti was used to facilitate data management and analysis. RESULTS: Stakeholder groups diverged in their opinions regarding strategies for achieving adolescent quality measures. Stakeholders with no direct patient interaction touted transactional quality improvement strategies that directly incentivized patients and families. In contrast, clinic staff with direct patient contact believed that incentive-based efforts undermined patient-provider relationships and the clinics' focus on wellness. CONCLUSION: A considerable disconnect exists between stakeholders with and without patient contact with regard to approaches to the delivery of well care and quality improvement strategies for meeting the adolescent well-care visit performance measure. Efforts to reconcile discordant perspectives and promote a mutual understanding between payers, institutional leaders, and clinic staff could inform the development of creative initiatives that are sustainable and effective at achieving adolescent and family engagement, as well as clinical performance benchmarks.

"I Used to Be Wild": Adolescent Perspectives on the Influence of Family, Peers, School, and Neighborhood on Positive Behavioral Transition.

Public health practice involving adolescents is largely focused on preventing or delaying the initiation of risk behavior. However, given the experimental and exploratory nature of this developmental period, this is often impractical. This paper focuses on behavioral transitions and the ways in which youth involved in risk behaviors shift to more promotive behaviors. Based on a positive youth development perspective, in-depth interviews with urban youth were conducted and analyzed to gain an understanding of the influences on behavior change. Specific family support, ability to detach from harmful peer relationships, and school connectedness and vocational support emerged as important to those youths who made a positive behavioral transition. These findings suggest the importance of understanding ways to support the cessation of involvement in risk behaviors and reinforce the significance of contextual influences on youth development.

The Impact of Adolescent Dating Violence Training for Primary Care Providers.

OBJECTIVE: This study presents results from an educational training to increase adolescent dating violence (ADV) screening among primary care clinicians and provides adolescents' perceptions regarding discussing ADV with their clinicians. METHODS: A national dating violence advocacy group provided a training in ADV to 16 clinicians serving an urban health clinic. Knowledge, self-efficacy, and expectations were examined before training, after training, and at a 6-month follow-up. Forty-five adolescent patients of the clinicians were also surveyed. RESULTS: Analysis shows significant increases in clinician knowledge, self-efficacy, outcome expectancies, and outcome expectations after training and at the 6-month follow-up. About half of adolescents reported that they would disclose if they were in an abusive relationship and believed that their providers could help them. DISCUSSION: This training successfully improved clinician self-efficacy, outcome expectancies, knowledge, and behavioral capability regarding ADV. Additional research is needed to determine whether the training leads to improved ADV screening and intervention.

Associations Between Adolescents' Perceptions of Alcohol Norms and Alcohol Behaviors: Incorporating Within-School Variability.

BACKGROUND: Social norm interventions have been implemented in schools to address concerns of alcohol use among high school students; however, research in this area has not incorporated measures of variability that may better reflect the complexity of social influences. PURPOSE: To examine the association between perceived alcohol norms, the student and school-level variability of those norms, and alcohol use behaviors among high school students. METHODS: A sample of 25,824 students from 58 high schools completed an online self-report survey. Hierarchical linear regression models were fit to examine the relationships between student- and school-level alcohol norm predictors, within school variability, and current alcohol use and binge drinking. RESULTS: Individual- and school-level norms were predictive of both current alcohol use and binge drinking. Whereas measures of norm diversity at the school-level were not predictive of alcohol use behaviors, individual norm proximity was predictive of both current alcohol use and binge drinking. DISCUSSION: The study findings were both consistent with prior research and support assertions that variability measures should be incorporated into social norms research approaches. TRANSLATION TO HEALTH EDUCATION PRACTICE: The findings support the incorporation of student-level variability measures, which could assist in identifying students who are susceptible to peer influence.

Teen Dating Violence Victimization Among High School Students: A Multilevel Analysis of School-Level Risk Factors.

BACKGROUND: Much etiologic research has focused on individual-level risk factors for teen dating violence (TDV); therefore, less is known about school-level and neighborhood-level risk factors. We examined the association between alcohol outlet density around high schools and TDV victimization and the association between markers of physical disorder around schools and TDV victimization among adolescents. METHODS: Data come from high school students participating in the Maryland Safe and Supportive Schools Initiative. Alcohol outlet density was calculated using walking distance buffers around schools. An observational tool was used to assess indicators of physical disorder on school property (eg, alcohol and drug paraphernalia). Hierarchical linear modeling was used to identify student- and school-level predictors associated with TDV victimization. RESULTS: Overall, 11% of students reported experiencing physical TDV and 11% reported experiencing psychological TDV over the past year. Recent alcohol use was a risk factor for TDV victimization for both sexes, whereas feeling safe at school was protective against TDV victimization for both sexes. Greater alcohol outlet density was associated with decreased TDV victimization for males, however, it was nonsignificant for females. Physical disorder around schools was not associated with TDV victimization for either sex. CONCLUSION: Although the school-level predictors were not associated with TDV victimization, alcohol use and perceptions of safety at school were significantly associated with TDV victimization. Prevention efforts to address alcohol use may affect TDV victimization.

How school climate relates to chronic absence: A multi-level latent profile analysis.

Chronic absence is a significant problem in schools. School climate may play an important role in influencing chronic absence rates among schools, yet little research has evaluated how school climate constructs relate to chronic absence. Using multilevel latent profile analysis, we evaluated how profiles of student perceptions of school climate at both the student and school level differentiated school-level rates of chronic absence. Participants included 25,776 middle and high school students from 106 schools who completed a district administered school climate survey. Students attended schools in a large urban school district where 89% of 6th through 12th grade students were African-American and 61% were eligible for the federally subsidized school meals program. Three student-level profiles of perceptions of school climate emerged that corresponded to "positive," "moderate," and "negative" climate. Two predominant patterns regarding the distribution of these profiles within schools emerged that corresponded to the two school-level profiles of "marginal climate" and "climate challenged" schools. Students reporting "moderate" and "negative" climate in their schools were more likely to attend schools with higher chronic absence rates than students reporting that their school had "positive" climate. Likewise, "climate challenged" schools had significantly higher chronic absence rates than "marginal climate" schools. These results suggest that school climate shares an important relation with chronic absence among adolescent students attending urban schools. Implications for prevention and intervention programs are discussed.

Alcohol Outlets and Substance Use among High Schoolers.

Few studies have considered the potential role of the built environment in increasing adolescent substance use. The current study explored the relationship between alcohol outlets, a potential malleable component of the neighborhood environment, and adolescent behavioral outcomes. Specifically, we investigated the relationship between alcohol outlet density, perceived alcohol, tobacco, and marijuana availability (ATOD), perception of substance use as a problem at the school, and self-reported ATOD use. Data come from Maryland Safe and Supportive Schools (MDS3) Initiative, a statewide project focused on measuring and improving school climate. The sample includes 25,308 adolescents from 58 high schools (9th-12th grade) across 12 counties. Multi-level path models indicated a positive relationship between the count of alcohol outlets and perceived availability of ATOD among girls but not boys. Perceived availability was associated with increased ATOD use at both the individual- and school-level, as well as other students' ATOD use. Findings provide support for the potential role of the built environment in adolescent risk for substance use, particularly among girls.

The School Assessment for Environmental Typology (SAfETy): An Observational Measure of the School Environment.

School safety is of great concern for prevention researchers, school officials, parents, and students, yet there are a dearth of assessments that have operationalized school safety from an organizational framework using objective tools and measures. Such a tool would be important for deriving unbiased assessments of the school environment, which in turn could be used as an evaluative tool for school violence prevention efforts. The current paper presents a framework for conceptualizing school safety consistent with Crime Prevention through Environmental Design (CPTED) model and social disorganization theory, both of which highlight the importance of context as a driver for adolescents' risk for involvement in substance use and violence. This paper describes the development of a novel observational measure, called the School Assessment for Environmental Typology (SAfETy), which applies CPTED and social disorganizational frameworks to schools to measure eight indicators of school physical and social environment (i.e., disorder, trash, graffiti/vandalism, appearance, illumination, surveillance, ownership, and positive behavioral expectations). Drawing upon data from 58 high schools, we provide preliminary data regarding the validity and reliability of the SAfETy and describe patterns of the school safety indicators. Findings demonstrate the reliability and validity of the SAfETy and are discussed with regard to the prevention of violence in schools.

Career Readiness: A Potential Pathway through which Urban Youth Exposure to Stress Influences Adult Health.

A growing body of research provides support for the detrimental effects of stress during childhood on future adult health, however, less is known about how stress disrupts normal developmental processes. This pathway may be particularly relevant for urban adolescents who are exposed to additional contextual stressors. This study will longitudinally explore how psychological stress from multiple domains influences urban adolescents' career readiness. Two hundred youth (ages 14-21) completed surveys assessing their school, family, neighborhood and health stress. Path analysis using a parallel process model found that school and neighborhood stress at 6 months were significantly associated with decreased career readiness at 15 months. Health stress at baseline was related to an increased report of career readiness at 15 months, which was moderated by parental closeness. These findings suggest that experiences of stress for urban youth negatively impact their planning for the future, particularly in the absence of supportive parental relationships.

Overlapping verbal, relational, physical, and electronic forms of bullying in adolescence: influence of school context.

Interest in youths' experience of the various forms of bullying has grown due to the numerous social-emotional correlates associated with bullying. Only recently has there been consideration of the school context in light of these associations. The current study examined the overlap in four different forms of bullying that youth commonly experience (i.e., verbal, relational, physical, electronic), with the aim of understanding their association with social-emotional correlates (i.e., internalizing symptoms, externalizing symptoms, retaliatory attitudes) and exploring associations with school contextual factors such as supervision, school physical disorder, and behavioral expectations. Self-report data on the forms of peer bullying were collected from 24,620 adolescents (Grades 9-12; M age = 15.98, SD age = 1.32) enrolled in 52 high schools. Latent class analyses indicated significant overlap in the different forms of bullying victimization, with youth experiencing multiple forms of bullying reporting the greatest risk for social-emotional problems. A series of two-level hierarchical linear models revealed that indicators of school physical disorder and a lack of positive behavioral expectations were associated with increased risk for multiple forms of bullying. Several gender and age differences were also observed in relation to the patterns of bullying experienced. These findings extend prior research by emphasizing a potential link between the overlap in different forms of bullying and school contextual factors, even after controlling for individual-level risk factors.

Measuring school climate in high schools: a focus on safety, engagement, and the environment.

BACKGROUND: School climate has been linked to multiple student behavioral, academic, health, and social-emotional outcomes. The US Department of Education (USDOE) developed a 3-factor model of school climate comprised of safety, engagement, and environment. This article examines the factor structure and measurement invariance of the USDOE model. METHODS: Drawing upon 2 consecutive waves of data from over 25,000 high school students (46% minority), a series of exploratory and confirmatory factor analyses examined the fit of the Maryland Safe and Supportive Schools Climate Survey with the USDOE model. RESULTS: The results indicated adequate model fit with the theorized 3-factor model of school climate, which included 13 subdomains: safety (perceived safety, bullying and aggression, and drug use); engagement (connection to teachers, student connectedness, academic engagement, school connectedness, equity, and parent engagement); environment (rules and consequences, physical comfort, and support, disorder). We also found consistent measurement invariance with regard to student sex, grade level, and ethnicity. School-level interclass correlation coefficients ranged from 0.04 to .10 for the scales. CONCLUSIONS: Findings supported the USDOE 3-factor model of school climate and suggest measurement invariance and high internal consistency of the 3 scales and 13 subdomains. These results suggest the 56-item measure may be a potentially efficient, yet comprehensive measure of school climate.

Bullies, gangs, drugs, and school: understanding the overlap and the role of ethnicity and urbanicity.

Recent media attention has increased interest in behavioral, mental health, and academic correlates of involvement in bullying. Yet, there has not been much interest in investigating the co-occurrence of other health-risk behaviors, such as gang membership, weapon carrying, and substance use. The potential influence of contextual factors, such as youth ethnicity, urbanicity, and school characteristics, also has been overlooked in previous research. The current study examined different subtypes of involvement in bullying-as primarily a victim, as primarily a bully, as both a victim and bully, and no involvement-and the association with significant health-risk behaviors, including engaging in violence and substance use, as well as academic problems. The analyses use self-report data from 16,302 adolescents (50.3 % female, 62.2 % Caucasian, 37.8 % African American) enrolled in 52 high schools. A series of three-level HLM analyses revealed that bullies and bully/victims were generally at greatest of risk of being involved in violence, engaging in multiple types of substance use, and having academic problems. These findings extend prior research by emphasizing a potential link between involvement in bullying and multiple health-risk behaviors, particularly among urban and African American high school youth.

Prioritizing the school environment in school violence prevention efforts.

BACKGROUND: Numerous studies have demonstrated an association between characteristics of the school environment and the likelihood of school violence. However, little is known about the relative importance of various characteristics of the school environment or their differential impact on multiple violence outcomes. METHODS: Primarily African-American students (n = 27) from Baltimore City high schools participated in concept mapping sessions, which produced interpretable maps of the school environment's contribution to school violence. Participants generated statements about their school environment's influence on school violence and, with the assistance of quantitative methods, grouped these statements according to their similarity. Participants provided information about the importance of each of these statements for the initiation, cessation, and severity of the violence that occurs at school. RESULTS: More than half of the 132 statements generated by students were rated as school environment characteristics highly important for the initiation, cessation, and/or severity of school violence. Participants identified students' own actions, expectations for disruptive behavior, and the environment outside the school as the characteristics most important for the initiation and increased severity of violence that occurs in school. Participants had a more difficult time identifying school environment characteristics important for the cessation of school violence. CONCLUSION: This study provides support from students for the role of the school environment in school violence prevention, particularly in preventing the initiation and reducing the severity of school violence. Schools can utilize the information presented in this article to begin discussions with students and staff about prioritizing school environment changes to reduce school violence.