Carri H. Casteel

Effectiveness of Crime Prevention Through Environmental Design (CPTED) in Reducing Robberies

OBJECTIVE The objective of this study was to determine the effectiveness of the Crime Prevention Through Environmental Design (CPTED) approach in reducing robberies. METHODS CPTED evaluations were obtained through a comprehensive search mechanism. Two sets of inclusion criteria were used: 16 primary studies evaluated a CPTED program with a comparison period; 12 secondary studies presented some evidence of CPTED effects but were not required to have the same level of scientific rigor. The percentage change in pre- and post-intervention events was the outcome examined. Studies were stratified by programs implementing multiple components, a single component, and through ordinances. MAIN RESULTS All primary multiple-component CPTED programs experienced a percentage change in robberies ranging from -84% to -30%. Single-component program effects ranged from -83% to +91%, and ordinances ranged from -65% to +130%. Secondary studies reported robbery changes ranging between -92% and +7.6%. Robbery reductions were larger for interventions comprising basic store design, cash control, and training components compared to those including equipment systems. No associations were found between robbery decreases and either the follow-up period or the number of program components. Studies examining nonfatal injuries found a median pre-post change of -61%; those examining homicides found changes ranging from 0% to +11%. CONCLUSIONS The broad nature of the CPTED approach allows its adaptation to any setting, and results indicate that it is an effective approach to reducing robbery. However, most interventions were not evaluated independently of other factors contributing to robbery risk. More research is needed on individual components and effects in various business settings.

National study of physical and sexual assault among women with disabilities

Objective: To examine the association between the level of disability impairment and physical and sexual assault in a sample of US women at least 18 years of age. Design, setting and participants: Retrospective longitudinal study of 6273 non-institutionalized US women from 8000 women participating in the 1995–1996 National Violence Against Women (NVAW) Survey. Main outcome measure: Women’s experiences of physical and sexual assault in the 12 months before the NVAW interview. Results: Most women reported having no disability (n = 5008, 79.8%) and/or not experiencing an assault in the year before their interview (n = 6018, 95.9%). Less than 5% (n = 280) reported having a disability that severely limited daily activities, and 15.7% (n = 985) reported having a disability that moderately limited activities. Less than 4% (n = 218) of the women reported a physical-only assault, and less than 1% (n = 37) reported being sexually assaulted. Women with severe disability impairments were four times more likely to be sexually assaulted than women with no reported disabilities (RR = 4.0, 95% CI 1.5 to 10.6). Little difference in the risk of sexual assault was found between women with moderate disability impairments and those reporting no disabilities (RR = 1.0, 95% CI 0.3 to 2.8). Women with severe (RR = 1.6, 95% CI 0.9 to 3.0) and moderate (RR = 1.2, 95% CI 0.8 to 1.9) disability impairments were at greater risk, although not quite significantly so, of physical-only assault than were women without a disability. Conclusion: The findings suggest that women with disabilities that severely limit activities of daily living are at increased risk of sexual assault.

Workplace violence prevention programs in hospital emergency departments

Objective: Hospital violence is a growing concern, yet little is known about existing programs. This study compared workplace violence programs in high-risk emergency departments among a representative sample of 116 hospitals in California and 50 hospitals in New Jersey. Methods: Information was collected through interviews, a facility walk-through, and review of written policies, procedures, and training material. Programs were scored on the components of training, policies and procedures, security, and environmental approaches. Results: California had significantly higher scores for training and policies and procedures, but there was no difference for security and environmental approaches. Program component scores were not highly correlated. For example, hospitals with a strong training program were not more likely to have strong policies and procedures. Conclusions: Most hospitals in California and New Jersey had implemented a workplace violence prevention program, but important gaps were found.

Schools and neighborhoods: organizational and environmental factors associated with crime in secondary schools

BACKGROUND While crime and violence in schools are derived primarily from factors external to schools, violent behavior may also be aggravated by factors in the school environment, including the physical environment, its educational and social climate, and its organizational capacity and composition. The objective of this study is to examine the effect of the schools organizational and educational environment on crime rates in secondary schools and to examine how neighborhood factors influence these relationships. METHODS School and neighborhood crime rates for 95 middle (MS) and high (HS) schools were calculated using data from the Los Angeles Unified School District (LAUSD) Police Department and Los Angeles Police Department, respectively. School-level organizational and educational variables, including the academic performance index (API), were obtained from the California Department of Education. A measure of neighborhood dilapidation was created using variables collected on a neighborhood environmental survey. Linear regression was used to examine the relationship between organizational and educational school variables and school crime rates. Community crime and dilapidation were added to the model to examine the influence of the school-community context relationships. RESULTS HS had higher crime rates than MS. As the percentage of certified teachers and student to staff ratios increased, school crime decreased (p < .01). An API of below basic performance was significantly associated with increasing school crime rates (p < .05). Neighborhood crime was not significantly associated with school crime, although dilapidation was positively and significantly associated with school crime even after controlling for community crime (p < .05). CONCLUSIONS Both school- and neighborhood-level factors were associated with increasing crime rates in secondary schools. School violence prevention efforts should include school and community partnerships to address these potentially modifiable factors.

Biomarkers of incident radiographic knee osteoarthritis: Do they vary by chronic knee symptoms?

OBJECTIVE To explore the ability of osteoarthritis (OA)-related biomarkers to predict incident radiographic knee OA in a large sample of African American and Caucasian men and women. METHODS Baseline levels of serum cartilage oligomeric matrix protein (COMP), hyaluronan (HA), high-sensitivity C-reactive protein (hsCRP), and keratan sulfate (KS) and baseline and followup radiographs were available for 353 knees without baseline osteophyte formation and for 446 knees without baseline joint space narrowing (JSN). Cox models estimated the hazard ratio (HR) and 95% confidence interval (95% CI) for incident knee OA for a 1-unit increase in the ln of each biomarker, with adjustment for age, race, sex, body mass index, and knee OA of the contralateral limb. Report of chronic knee symptoms was explored as a modifier of the association. RESULTS The hazard of incident knee osteophytes (HR 2.16 [95% CI 1.39-3.37]) and incident JSN (HR 1.82 [95% CI 1.15-2.89]) increased with higher baseline ln(COMP) levels. The hazard of incident knee JSN increased with higher ln(HA) levels (HR 1.46 [95% CI 1.14-1.87]). Baseline ln(hsCRP) and ln(KS) did not predict incident knee outcomes. HRs per unit increase in ln(COMP), ln(HA), and ln(KS) were higher among knees with chronic symptoms than among those without symptoms. CONCLUSION Higher baseline ln(COMP) and ln(HA) levels were associated with incident knee OA over an average followup period of 6.3 years. These results represent detection of a molecular stage of OA prior to radiographic manifestations. Further exploration is needed to determine how chronic knee symptoms modify the biomarker-incident knee OA association.

A case-site/control-site study of workplace violent injury.

Learning ObjectivesUnderstand the nature of events causing injury to employees of retail and service establishments of which employees are most likely to suffer injury.Identify work-site characteristics related to the risk of injury and any factors that favor homicidal versus nonfatal events.Appraise the influence, if any, of employee training, security guards, alarms, and the like on the risk of violent injury in the workplace. Workers in retail and service industries are at high risk for workplace violence. While studies have examined the association between environmental and community factors on robbery risk, few have examined risk factors for fatal and nonfatal employee violent injury. A matched case-site/control-site study was conducted among various retail and service establishments in seven California counties. An interview and environmental assessment was performed in each participating business. Over half of the injury events occurring in case-sites were robbery-related, and nearly 13% were fatal. Businesses open 24 hours and those having a history of violent events were found to be at increased risk for employee injury.

A Study of the Effectiveness of a Workplace Violence Intervention for Small Retail and Service Establishments

Objective:Examine the effectiveness of a robbery and violence prevention program in small businesses in Los Angeles. Methods:Gas/convenience, liquor and grocery stores, bars/restaurants, and motels were enrolled between 1997 and 2000. Intervention businesses (n = 305) were provided training, program implementation materials, and recommendations for a comprehensive security program. Control businesses (n = 96) received neither training nor program materials. Results:Rate ratios comparing intervention to control businesses were 0.90 for violent crime (95% confidence limits [CL] = 0.53, 1.53) and 0.81 for robbery (95% CL = 0.38, 1.73). The reduction in violent crime was concentrated in high-compliance intervention businesses (risk ratio = 0.74, 95% CL = 0.40, 1.36). Low-compliance intervention businesses had practically the same postintervention crime as the control businesses. Conclusions:Our results suggest that the workplace violence intervention may reduce violent crime among high-risk businesses, especially those with high program compliance.

Effectiveness of crime prevention through environmental design in reducing criminal activity in liquor stores: a pilot study.

Liquor store employees experience disproportionately higher rates of workplace injury death than employees in any other retail setting. However, efforts to introduce workplace violence prevention programs into liquor stores have been minimal. This study examines the effectiveness of a Crime Prevention Through Environmental Design intervention in reducing criminal activity in Santa Monica, California liquor stores. Nine stores enrolling in the study received an individualized intervention safety plan; the remaining 13 served as a comparison group. Mixed-effects Poisson regression was used to examine intervention effectiveness. The largest reductions in criminal activity occurred for robbery and shoplifting outcomes. We conclude that the Crime Prevention Through Environmental Design program reduced crime and injury in liquor stores and educated small businesses about the risks associated with retail violence and the countermeasures that can be taken.

Employee and Customer Injury During Violent Crimes in Retail and Service Businesses

OBJECTIVES We sought to compare the frequency and risk factors for employees and customers injured during crimes in retail (convenience, grocery, and liquor stores) and service businesses (bars, restaurants, motels). METHODS A total of 827 retail and service businesses in Los Angeles were randomly selected. Police crime reports (n=2029) from violent crimes that occurred in these businesses from January 1996 through June 2001 were individually reviewed to determine whether a customer or an employee was injured and to collect study variables. RESULTS A customer injury was 31% more likely (95% confidence interval [CI]=1.11, 1.51) than an employee injury during a violent crime. Customer injury was more frequent than employee injury during violent crimes in bars, restaurants, convenience stores, and motels but less likely in grocery or liquor stores. Injury risk was increased for both employees and customers when resisting the perpetrator and when the perpetrator was suspected of using alcohol. Customers had an increased risk for injury during crimes that occurred outside (relative risk [RR]=2.01; 95% CI=1.57, 2.58) and at night (RR=1.79; 95% CI=1.40, 2.29). CONCLUSIONS Security programs should be designed to protect customers as well as employees.

Hospital Employee Assault Rates Before and After Enactment of the California Hospital Safety and Security Act

PURPOSE This study examines changes in violent event rates to hospital employees before and after enactment of the California Hospital Safety and Security Act in 1995. METHODS We compared pre- and post-initiative employee assault rates in California (n = 116) emergency departments and psychiatric units with those in New Jersey (n = 50), where statewide workplace violence initiatives do not exist. Poisson regression with generalized estimating equations was used to compare assault rates between a 3-year pre-enactment period (1993-1995) and a 6-year post-enactment period (1996-2001) using New Jersey hospitals as a temporal control. RESULTS Assault rates among emergency department employees decreased 48% in California post-enactment, compared with emergency department employee assault rates in New Jersey (rate ratio [RR] = 0.52, 95% confidence interval [CI]: 0.31, 0.90). Emergency department employee assault rates decreased in smaller facilities (RR = 0.46, 95% CI: 0.21, 0.96) and for-profit-controlled hospitals (RR = 0.39, 95% CI: 0.19, 0.79) post-enactment. Among psychiatric units, for-profit-controlled hospitals (RR = 0.41, 95% CI: 0.19, 0.85) and hospitals located in smaller communities (RR = 0.44, 95% CI: 0.21, 0.92) experienced decreased assault rates post-enactment. CONCLUSION Policy may be an effective method to increase safety to health care workers.