171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
|
 |
December 2007
Evidence-Based Tip
 |
Laura Cousineau, MLS
MUSC Library
Dept. of Pediatrics EBM Faculty |
School Violence: Do intervention programs work?
The tragedy at Virginia Tech last spring is still fresh in our minds. As pediatricians, parents, and members of the community, we worry about our students and the safety of our schools. But events like those at Virginia Tech and Columbine have prompted a response. In 2006, 84% of school districts required schools to teach about violence prevention, up from 73% the previous year. Most middle and high schools now conduct routine locker searches, and up to 46% of high schools require security measures such as surveillance cameras.
The most recent edition of "Indicators of School Crime and Safety," a joint publication of the U.S. Departments of Education and Justice, indicates that both fatal and nonfatal rates of violence have declined in the last few years. Is this a result of the new violence prevention programs? Is there evidence to show about the effectiveness of these programs?
Two systematic review have been published in 2007 that review school-based programs to prevent violence. Dr. Robert Hahn and colleagues report in the American Journal of Preventive Medicine on a study of universal programs; that is, a program given to every student in a given school or grade. Fifty-three studies met their criteria for inclusion based on execution and design suitability. Remarkably, all programs proved effective in reducing violent behavior. And although the effect was higher among high school students, neither program foci, frequency or duration, or student population was associated with a change in effect. There was a slight decrease associated with longer follow-up time.
There were weaknesses to the review. Not all studies included concurrent comparison groups, and some studies had only post measurements. However, studies with strong design were weighted higher in the analysis. The programs varied greatly. Some were for administrators (least effective) and teachers, while others were for students (most effective). Some focused on a specific activity like gang activity (least effective) or bullying, while others focused on violence or antisocial behavior (more effective).
The second systematic review was published in 2006 by Mytton et al in the Cochrane Database of Systematic Reviews. Unlike the first review, it looked at programs for children who displayed aggressive behavior, or who had risk factors for aggressive behavior. The criteria were more rigorous, requiring studies with controls and randomization, concurrently collected data, interventions to prevent specific forms of school violence, and outcomes measuring specific aggressive and violent behaviors. Most trials (43) were conducted in the United States, with five from Canada, two from Argentina, and one from Australia.
In their implications for practice, the authors conclude that school-based interventions are effective in reducing reported and observed aggressive behavior. Further, they suggest that those programs that focus on improving relationships or social skills "may be more effective than interventions designed to teach skills of non-response to provocative situations." They find that these interventions can be successful at any grade level, and "can be beneficial when delivered to either mixed sex or boys alone groups."
Although both systematic reviews indicate that these programs can have a positive effect, there is much more work to be done. Better-designed studies are needed that address the most violent behaviors, and longer follow-ups are needed. Even successful programs do not reach every child; nor can they claim to make a school completely safe. Beyond the effectiveness of school-based programs, we need a better understanding of the causes of violence in our society, as well as better ways to identify those youths who are most at risk for doing violence.
|
|
|
Print Version
