Jennifer L. Matjasko

A systematic review of primary prevention strategies for sexual violence perpetration

This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates (Foshee et al., 2004); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003).

A Systematic Qualitative Review of Risk and Protective Factors for Sexual Violence Perpetration

The current review summarized results of 191 published empirical studies that examined the risk and protective factors for sexual violence perpetration. Studies in the review examined factors for perpetration by and against adolescents and adults, by male and female perpetrators, and by those who offended against individuals of the same sex or opposite sex. Factors associated with child sexual abuse (CSA) perpetration were not included. In all, 2 societal and community factors, 23 relationship factors, and 42 individual-level factors were identified. Of these 67 factors, consistent significant support for their association with SV was found for 35, nonsignificant effects were found for 10, 7 factors had limited or sample-specific evidence that they were associated with SV but were in need of further study, and 15 demonstrated mixed results. The factors identified in the review underscore the need for comprehensive prevention programs that target multiple risk and protective factors as well as factors that occur across the social ecology. Moreover, we identified two domains of factors—the presence and acceptance of violence and unhealthy sexual behaviors, experiences, or attitudes—that had consistent significant associations with SV but are not typically addressed in prevention programs. Therefore, SV prevention may also benefit from learning from effective strategies in other areas of public health, namely sexual health and youth violence prevention.

Bullying and suicidal ideation and behaviors: a meta-analysis

BACKGROUND AND OBJECTIVES: Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS: We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS: Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67–2.69] to 4.02 [95% CI, 2.39–6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study’s country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS: Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior.

A systematic meta-review of evaluations of youth violence prevention programs: Common and divergent findings from 25 years of meta-analyses and systematic reviews☆

Violence among youth is a pervasive public health problem. In order to make progress in reducing the burden of injury and mortality that result from youth violence, it is imperative to identify evidence-based programs and strategies that have a significant impact on violence. There have been many rigorous evaluations of youth violence prevention programs. However, the literature is large, and it is difficult to draw conclusions about what works across evaluations from different disciplines, contexts, and types of programs. The current study reviews the meta-analyses and systematic reviews published prior to 2009 that synthesize evaluations of youth violence prevention programs. This meta-review reports the findings from 37 meta-analyses and 15 systematic reviews; the included reviews were coded on measures of the social ecology, prevention approach, program type, and study design. A majority of the meta-analyses and systematic reviews were found to demonstrate moderate program effects. Meta-analyses yielded marginally smaller effect sizes compared to systematic reviews, and those that included programs targeting family factors showed marginally larger effects than those that did not. In addition, there are a wide range of individual/family, program, and study moderators of program effect sizes. Implications of these findings and suggestions for future research are discussed.

Looking Ahead Toward Community-Level Strategies to Prevent Sexual Violence

The Division of Violence Prevention within CDCs National Center for Injury Prevention and Control recently undertook a systematic review of primary prevention strategies for sexual violence (SV) perpetration. This review identified the lack of community-level strategies to prevent SV as a critical gap in the literature. Community-level strategies function by modifying the characteristics of settings (e.g., schools, workplaces, neighborhoods) that increase the risk for violence victimization and perpetration. Identification of evidence-based strategies at the community level would allow implementation of ecologic approaches to SV prevention with a greater potential for reducing the prevalence of SV perpetration. The field will face several challenges in identifying and evaluating the effectiveness of promising community-level strategies to prevent SV. These challenges include limited knowledge of community-level and societal-level risk factors for SV, a lack of theoretical or empirical guidance in the SV literature for identification of promising community-level approaches, and challenges in evaluating SV outcomes at the community level. Recognition of these challenges should guide future research and foster dialogue within the SV prevention field. The development and evaluation of community-level approaches to SV prevention represent a vital and logical next step toward the implementation of effective, multilevel prevention efforts and a population-level reduction in the prevalence of SV.

Commentary on Foubert, Godin, & Tatum (2010): The Evolution of Sexual Violence Prevention and the Urgency for Effectiveness

Foubert, Godin, and Tatum describe qualitative effects among college men of The Men’s Program, a one-session sexual violence prevention program. This article and the program it describes are representative of many sexual violence prevention programs that are in practice and provide an opportunity for a brief discussion of the development and evaluation of sexual violence prevention approaches. In this commentary, we will focus on two considerations for an evolving field: the adherence to the principles of prevention and the use of rigorous evaluation methods to demonstrate effectiveness. We argue that the problem of sexual violence has created urgency for effective prevention programs and that scientific and prevention standards provide the best foundation to meet this need.

Sexual Risk Taking and Bullying Among Adolescents

BACKGROUND: Psychological and educational correlates of bullying have been explored extensively. However, little information is available about the link between bullying and sexual risk-taking behaviors among adolescents, though for some youth it may be that sexual risk taking emerges in response to bullying involvement. Associations for both heterosexual youth and those who identify as gay, lesbian, bisexual, transgender, or questioning (GLBTQ) should be considered, as should the influence of victimization exposures in other domains. Accordingly, associations among bullying, other victimization forms, and sexual risk-taking behaviors were examined among adolescents with particular consideration to sexual orientation. METHODS: A sample of 8687 high school students completed the Dane County Youth Survey, a countywide survey administered high school students from 24 schools. Participants were asked questions about their bullying involvement and sexual risk-taking behaviors (ie, engaging in casual sex and having sex while under the influence of alcohol or drugs). RESULTS: Results indicated that bullies and bully-victims were more likely to engage in casual sex and sex under the influence. In multivariate analyses, these findings held even after controlling for demographic characteristics and victimization exposures in other domains, but primarily for heterosexual youth. CONCLUSIONS: Bullies and bully-victims engaged in more sexual risk-taking behaviors, although patterns of association varied by sexual orientation. Bullying prevention programs and programs aimed at reducing unhealthy sexual practices should consider a broader stress and coping perspective and address the possible link between the stress of bullying involvement and maladaptive coping responses.

Identifying Links Between Sexual Violence and Youth Violence Perpetration: New Opportunities for Sexual Violence Prevention

Objective One promising opportunity for advancing sexual violence (SV) research and identifying new avenues for prevention involves examining other forms of violence that may share risk factors with SV. Youth violence (YV) is ideal for consideration given evidence of overlap in SV and YV risk factors, a large set of established YV risk factors across the social ecology, and the number of evidence-based YV prevention strategies available. The current paper identifies shared and unique risk factors for SV and YV and highlights evidence-based YV prevention strategies that impact these shared risk factors. Conclusions Researchers and program developers should consider adapting and evaluating evidence-based YV prevention strategies to prevent SV. Modifying these programs to address SVs unique risk factors may maximize their potential effectiveness. In addition, expanding SV research at the outer levels of the social ecology is critical to developing community-level prevention strategies. The YV literature suggests several potential risk factors at these levels in need of research for SV, including school connectedness, social disorganization, and availability of alcohol and drugs. Using the YV literature as a starting point for expanding SV research leverages prior investments in YV research, may help identify new SV prevention strategies at a limited cost, and moves the field more quickly toward implementation of cost-effective, multidomain violence prevention strategies in communities.

Mobilizing communities and building capacity for youth violence prevention: the National Academic Centers of Excellence for Youth Violence Prevention.

Violence, including its occurrence among youth, results in considerable physical, emotional, social, and economic consequences in the US. Youth violence prevention work at the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) emphasizes preventing youth violence-related behaviors, injuries, and deaths by collaborating with academic and community partners and stakeholders. In 2000 and 2005, DVP funded the National Academic Centers of Excellence (ACE) for Youth Violence Prevention. Most ACE Centers focus on building community capacity and competence so that evidence-based programs for youth violence prevention can be successfully implemented through effective and supportive research-community partnerships. This commentary provides historical information about the ACE Program, including the development, goals, accomplishments of the Centers, and the utilization of a community-based participatory research approach to prevent youth violence.

Prevalence and Correlates of Youth Homelessness in the United States

Purpose Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Methods Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13–17 and young adults aged 18–25, as well as self-reports from young adults aged 18–25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Results Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. Conclusions The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations.