Dionne Barnes-Proby

How Much Does “How Much” Matter? Assessing the Relationship Between Children’s Lifetime Exposure to Violence and Trauma Symptoms, Behavior Problems, and Parenting Stress

The study explores whether and how lifetime violence exposure is related to a set of negative symptoms: child internalizing and externalizing behavior problems, child trauma symptoms, and parenting stress. Using a large sample of violence-exposed children recruited to participate in intervention research, the study employs different methods of measuring that exposure. These include total frequency of all lifetime exposure, total frequency of lifetime exposure by broad category (i.e., assault, maltreatment, sexual abuse, and witnessing violence), and polyvictimization defined as exposure to multiple violence categories. The results indicate that only polyvictimization, constructed as a dichotomous variable indicating two or more categories of lifetime exposure, emerged as a consistent predictor of negative symptoms. The total lifetime frequency of all violence exposure was not associated with negative symptoms, after controlling for the influence of polyvictimization. Likewise, in the presence of a dichotomous polyvictimization indicator the total lifetime frequency of exposure to a particular violence category was unrelated to symptoms overall, with the exception of trauma symptoms and experiences of sexual abuse. Taken together, these findings suggest that total lifetime exposure is not particularly important to negative symptoms, nor is any particular category of exposure after controlling for polyvictimization, with the single exception of sexual abuse and trauma symptoms. Instead, it is the mix of exposure experiences that predict negative impacts on children in this sample. Further research is needed to continue to explore and test these issues.

An examination of measures related to children's exposure to violence for use by both practitioners and researchers

Millions of children each year are exposed to violence in their homes, schools, and communities as both witnesses and victims. As a result, evidence-based programs for children and adolescents who have been exposed to traumatic events (CEV-EBPs) have been widely disseminated but rarely evaluated in their real-world applications. One crucial aspect of conducting such evaluations is finding appropriate measures that can be of use both to the practitioner and to the researcher. This review aims to provide guidance to the field by first identifying any gaps in the availability of psychometrically tested measures for certain outcome domains and age ranges and then recommending the measures that are most appropriate for use by both researchers and practitioners. Interviews with content experts in the measurement of trauma symptoms and parent–child relationships were conducted to identify the key outcome domains for measurement that are critical to the evaluation of CEV-EBPs and the criteria for dual-use measures, defined as measures that are useful to both researchers and practitioners. A database of 46 relevant measures was created by compiling measures from existing repositories and conducting a focused literature review. Our review of these measures found that existing repositories had few measures of depression, a major gap that should be addressed. Further, there were few measures for young children ages 0–3 years (n = 15) and only a handful of measures (n = 9) had both a child and parent version of the measure. Overall, although the different repositories that currently exist are helpful, researchers and practitioners would benefit from having a single reputable source (e.g., a centralized repository or item bank) to access when searching for measures to use in evaluating CEV-EBPs. Such a tool would hold promising to narrow the current gap between research and practice in the field of children’s exposure to violence.

RAND's Fidelity Monitoring Protocol for Suicide Prevention Workshops in California

elements and to improve their presentation styles to be more consistent with other ASIST trainers. In addition, feedback can be prioritized and tailored to what content may be most important to convey and to enhance how the content is delivered; future research could systematically identify which of these items may be associated with outcomes for training participants. In the remainder of this document, we describe our methods for developing and testing the protocol. Then, we describe our rationale for each of the items included in the protocol. The protocol itself can be found at the end of this document.

Improving Outcomes for Children Exposed to Violence: Safe Start Promising Approaches

Childrens exposure to violence is common and can lead to mental health problems and delinquent behaviors. Because many interventions have focused on specific violence types or symptoms and been difficult to implement in real-world settings, the evidence base is still emerging. The Office of Juvenile Justice and Delinquency Preventions Safe Start Promising Approaches (SSPA) initiative focused on preventing and reducing the impact of childrens exposure to violence through interventions in ten diverse communities. The evaluation examined the effectiveness of the SSPA interventions to address issues for children and families exposed to violence. The ten sites were diverse in their intervention approaches, types of violence exposure targeted, and implementation settings. To evaluate each approachs effectiveness in reducing violences harmful effects, RAND researchers partnered with the community-based sites to develop a rigorous controlled evaluation design for each intervention, with either a randomized control group or a comparison group selected on similar characteristics. The longitudinal analyses found that families in both the intervention and comparison groups had positive gains on many outcomes, but there was no evidence that the intervention groups improved more. Among those who received Safe Start services, one site produced large, significant improvements in posttraumatic stress disorder symptoms, and another site produced medium, significant effects on several outcomes (child self-control, posttraumatic stress disorder, and behavior; caregiver depression; and family conflict). Although the initiative added to knowledge about how to address the problem, there was no clear case for using a particular intervention to help these children and their families.

Helping Kids and Families Cope with Violence: Safe Start Promising Approaches

Although rates of children’s exposure to violence have been declining in the United States, the problem remains extensive. The most recent study found that more than half of children in a national sample had been exposed to violence in the past year.1 Children who have been abused or witnessed violence are more likely than other children to develop mental health problems and engage in risky behaviors. Some of these problems can persist into adulthood. The need is clear for interventions to help children deal with these harmful effects. Yet the evidence base for understanding which interventions work best under different circumstances is still developing. Some interventions have proven effective for specific kinds of violence or specific symptoms; others, although they show signs of promise, have been difficult to implement in real-world settings. Safe Start Promising Approaches is a large-scale initiative intended to test how effectively interventions in community settings can help children deal with the effects of exposure to violence. The initiative was developed by the federal Office of Juvenile Justice and Delinquency Prevention (OJJDP). At first, OJJDP selected 15 sites to implement promising interventions, and RAND evaluated both implementation processes2 and outcomes.3 Extending this effort to test more interventions, OJJDP selected an additional ten sites in 2010 and asked RAND to evaluate outcomes. The sites varied by size, location, age range served, and types of violence exposure, with each proposing an intervention to fit the needs of its target population (see Table 1). Each site identified a primary outcome that best matched the expected impact of the intervention. The evaluation used experimental or quasi-experimental designs to examine whether Safe Start interventions led to child and caregiver improvements in a range of outcomes, with each site selecting one outcome as primary, depending on the goal of its intervention.

Characteristics and proximal outcomes of calls made to suicide crisis hotlines in California

Background: Suicide hotlines are commonly used to prevent suicides, although centers vary with respect to their management and operations. Aims: To describe variability across suicide prevention hotlines. Method: Live monitoring of 241 calls was conducted at 10 suicide prevention hotlines in California. Results: Call centers are similar with respect to caller characteristics and the concerns callers raise during their calls. The proportion of callers at risk for suicide varied from 3 to 57%. Compliance with asking about current suicide risk, past ideation, and past attempts also ranged considerably. Callers to centers that were part of the National Suicide Prevention Lifeline (NSPL) were more likely to experience reduced distress than callers to centers that were not part of the NSPL. Conclusion: Because callers do not generally choose the center or responder that will take their call, it is critical to promote quality across call centers and minimize the variability that currently exists. Accrediting bodies, funders, and crisis centers should require that centers continuously monitor calls to ensure and improve call quality.

Can Technology Make Schools Safer

A project of the RAND Corporation, the Police Executive Research Forum, RTI International, and the University of Denver Th is brief describes work done in RAND Justice, Infrastructure, and Environment and documented in e Role of Technology in Improving K–12 School Safety, by Heather L. Schwartz, Rajeev Ramchand, Dionne Barnes-Proby, Sean Grant, Brian A. Jackson, Kristin J. Leuschner, Mauri Matsuda, and Jessica Saunders, RR-1488-NIJ (available at www.rand.org/t/RR1488), 2016. To view this brief online, visit www.rand.org/t/RB9922. Th e RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofi t, nonpartisan, and committed to the public interest. RAND’s publications do not necessarily refl ect the opinions of its research clients and sponsors. R® is a registered trademark.