Violence reduction efforts should be modeled on noncontagious diseases, which have as their root cause environmental determinants, not contagious diseases.

To date, two fundamental approaches to understanding and responding to violence have been articulated: a criminal/juvenile justice approach and a public health approach. In this presentation, we will present a third approach based upon human rights. A human rights framework for understanding and responding to youth and school violence is comprised of four fundamental components. First, it provides principles and norms, as well as a positive vision, for understanding and contextualizing the rights of children and their caretakers. Second, this framework makes visible multiple forms of violence, humiliation, and abuse—whether reflected in behavior, educational climate, curricula, neighborhood norms (e.g., retaliatory violence), discipline practices, or in regulations or policies—as infractions of fundamental human rights. Instead of focusing on incidents of violence, a human rights framework monitors and assesses whether human rights are appropriately accorded within the educational and neighborhood setting. Third, a human rights framework recognizes that human rights are not passively given but rather require participatory engagement, critical reflection, and meaningful dialogue among all stakeholders. As such, human rights framework establishes guidelines not only for the content and purpose of what is taught in educational settings, particularly as it impinges upon the rights of children, but, as importantly, for the form of the pedagogical process itself. And fourth, a human rights framework dictates responsibilities monitor and adhere to established rights and requires all individuals, groups, and institutions to remedy human rights violations in whatever guise they appear. Particular attention must be paid to the examination of human rights’ adherence in one’s own community. In addition, a human rights framework requires the adoption of preventive, corrective, and therapeutic programs and strategies. Such strategies will be illustrated through reference to human rights education practices and programs, as well as through a case study of youth community organizing.

The emergence of evidence-supported interventions allows hospitals the opportunity to reduce future reinjury among patients who are violently injured. However, hospital knowledge of these interventions and their perceived role in violence prevention is unknown. The Patient Protection and Affordable Care Act created new legal requirements for non-profit hospitals to conduct community health needs assessments (CHNA) every three years to maintain not-for-profit status. In turn, this allows an empiric evaluation of hospital recognition and response to community violence. To do so, this study performed a content analysis of hospital CHNAs from the 20 U.S. cities with the highest violent crime rates. A total of 77 CHNAs were examined for specific violence-related keywords as well as whether violence prevention was listed as a priority community need. Overall, 74% of CHNAs mentioned violence-related terms and only 32% designated violence prevention as a priority need. When discussed, 88% of CHNAs referenced community violence, 42% intimate partner or sexual violence, and 22% child abuse. This study suggests that hospitals may lack awareness of violence as an actionable, preventable public health issue. Further, evidence-based program models are available to hospitals that can reduce the recurrence of assaultive injuries.

This article synthesizes the current research on bullying prevention and intervention in order to provide guidance to schools seeking to select and implement antibullying strategies. Evidence-based best practices that are shared across generally effective antibullying approaches are elucidated, and these strategies are grounded in examples garnered from model antibullying programs as implemented in contemporary schools. Future directions for practice, research, and policy are also explicated.

[ILLUSTRATION OMITTED] Harassment, intimidation, and bullying pose a serious public and mental health concern that can poison climate of schools and affect students' ability to focus on learning. We know that many children have experienced harassment, intimidation, and bullying at school: Nearly 28% of all students ages 12-18 reported being bullied physically, verbally, or online at least once during survey year, according to one U.S. Department of Education report (2013). Another study found that 20% of high school students were bullied on school property and 15% through electronic means over course of 12 months (Centers for Disease Control, 2014). Even White House has taken notice by hosting its first-ever Conference on Bullying Prevention in 2011, raising awareness about topic by addressing in-school approaches, community-based strategies, and effects of bullying on achievement. All 50 states have antibullying laws, many of which include model antibullying policies. Nonetheless, educational settings are struggling to determine and implement suitable antibullying approaches. A myriad of antibullying programs are available--many claiming significant reductions in bullying--and schools are unsure which ones would work best for them. Further, there is a fundamental misunderstanding of potency of individual programs related to bullying. Comprehensive antibullying approaches require schools to mobilize substantial resources, forcing administrators to balance this need against ever-increasing budget constraints. Without a deep understanding of pervasive effect of harassment, intimidation, and bullying and its connection to overall school culture and climate, schools can find it tempting to opt for contained and less costly approaches (Greene, 2008). Clear guidance is needed regarding parameters of truly effective intervention. Are programs effective? Most antibullying programs have demonstrated only mild to moderate reductions in bullying behavior. A review of whole-school approaches in U.S. and Europe found that success rates were modest (Pepler, Smith, & Rigby, 2004). Likewise, a meta-analysis of 16 bullying interventions in Europe and U.S. revealed that bullying interventions were only weakly effective. A review of 48 evaluated interventions by W.M. Craig and colleagues (2010) revealed that almost half reported reductions in victimization, one-quarter reported some positive and negative effects, 15% reported no change, and 4% reported only negative results (Merrell et al., 2008). But there are examples of successes. As promising programs are tested in more challenging and diverse environments, we have learned about their strong points, both conceptually and pragmatically. While we generally agree with Pepler, Smith, & Rigby (2004) that the research is not at point where we can reliably point to specific elements of interventions that are known to be active and essential elements associated with change (p. 313), we also recognize that schools and policy makers can't wait for ultimate studies to be conducted, reviewed, and published. Schools require guidance now for initial and ongoing selection and review of programs and their coordination with related prevention efforts. We believe that successful implementation ultimately hinges on a hybrid of best practices and evidence-based approaches that are embedded in a comprehensive, coordinated, and sustained school-wide approach. Common features Successful antibullying programs generally share three common features: #1. The program's central values and philosophy emphasize a positive school climate and strategies founded on social-emotional and character development; #2. A long-term commitment to effective program implementation, assessment of program effectiveness, and sustainability; and #3. Clear and consistent strategies outlining what to do when bullying occurs. …

The authors quantify and unpack the prevalence and effects of bullying on children and adolescents before prescribing provisos for schools to consider when planning preventive and responsive approaches to bullying.

Emergency medicine practitioners often see young patients who are treated for injuries sustained during a violent encounter, most often with a peer from the same neighborhood. In addition, many more of the children and adolescents that we see are affected by the violence that surrounds them in their homes, neighborhood, and schools. This article reviews the prevalence and impact of interpersonal violence on our young patients, offers a suggested management approach to assault-injured children and adolescents who visit the emergency department, and reviews multidisciplinary outpatient programs for which the emergency department practitioners can advocate within their medical and social services systems.

I prevention activities are a defining characteristic of the modern trauma center. Violent injuryVwith a 5-year reinjury rate as high as 45%Vrepresents a priority area for preventive intervention. Advances in trauma care increase the likelihood that a patient will survive violent injury but do nothing to reduce the chances that they will be reinjured after leaving the hospital. The recurrent nature of violent injury strains trauma systems financially, and the absence of preventive intervention is inconsistent with trauma centers’ commitment to providing optimal care. Hospital-based violence intervention programs (HVIPs) offer a strategy to address these issues. HVIPs combine brief in-hospital intervention with intensive community-based case management and provide targeted services to high-risk populations to reduce risk factors for reinjury and retaliation while cultivating protective factors. Rigorous evaluations of HVIPs have demonstrated promising results in preventing violent reinjury, violent crime, and substance misuse. Violent injury, as a focus of HVIPs, is generally defined as any injury intentionally inflicted by another person by any mechanism, excluding family, intimate partner, and sexual violence. The latter are excluded because they generally involve different dynamics and intervention strategies.