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Interpersonal Violence Victimization Among High School Students — Youth Risk Behavior Survey, United States, 2019 | #schoolsaftey


Discussion

This report describes the 2019 prevalence and frequency of different forms of interpersonal violence victimization experienced by U.S. high school students. Similar to findings from previous YRBSs (https://www.cdc.gov/violenceprevention/pdf/2012FindingsonSVinYouth-508.pdf), physical dating violence, sexual dating violence, sexual violence by anyone, bullying on school property, and electronic bullying victimization are adverse childhood experiences (ACEs) that are occurring at high rates. Examining their prevalence individually and in combination by key demographic characteristics provides an overall observation and contextual understanding of interpersonal violence experienced by U.S. high school students and helps identify disparities in health and safety among U.S. youths, which can guide prevention efforts.

All five types of victimization, including any or both forms of dating violence and any form of bullying, were more common among female and sexual minority students, highlighting their more frequent victimization. These findings are consistent with previous studies that reported disparities in interpersonal violence victimization, particularly dating violence and sexual violence, by sex and sexual identity (6,7). Although findings did not reveal substantially greater prevalence for racial/ethnic minority youths for the forms of violence examined, research has consistently shown that racial/ethnic minority youths are at greater risk for homicides and other community violence victimization (https://www.cdc.gov/violenceprevention/pub/technical-packages.html). Disparities in health and risk for violence have been linked to sexism, homophobia, and structural disadvantage (10).

Half of students who reported sexual violence victimization by anyone did not report sexual violence by a dating partner, indicating that students who experience sexual violence are often victimized by someone other than a dating partner. This finding is consistent with previous research (3) documenting that sexual violence happening in school during adolescence is frequently perpetrated by peers and not necessarily by dating partners. Indeed, perpetrators of sexual violence during youth can be acquaintances, family members, persons in a position of authority, and strangers, in addition to dating partners (https://www.cdc.gov/violenceprevention/pdf/2012FindingsonSVinYouth-508.pdf). This indicates that efforts might need to be focused on preventing sexual violence both inside and outside the context of dating relationships to be most helpful.

Males who experienced dating violence or sexual violence reported high frequencies of victimization (≥4 times during the previous year) substantially more often than did females. That is, although male students do not report higher prevalence of victimization than do female students, when they do report it, they report experiencing it at a higher frequency. Previous research has documented that, among youths at high risk (i.e., previously exposed to violence in the home or community), adolescent males reported higher frequency of victimization than did females for sexual dating violence (11). However, male adolescents might also be more likely to disclose dating violence and sexual violence when the victimization has happened more than once.

In this study, bullying victimization was the only type of violence victimization examined for which racial/ethnic differences existed, with substantially higher prevalence occurring among white students compared with black or Hispanic students. This result for bullying is supported in part by previous research (12). In addition, Hispanic students reported substantially higher prevalence of electronic bullying victimization compared with black students. Other research has indicated that black students might underreport bullying victimization when presented with a definition-based measure of bullying that includes a form of the word “bully,” as is used in YRBS, as opposed to behaviorally specific measures that describe the victimization behaviors but do not use the word “bully” (13). The measurement of bullying in this study might have differentially affected reporting across racial/ethnic groups.

Overall, these findings highlight the importance of early engagement in effective, evidence-based efforts for preventing violence victimization and perpetration before they begin or stopping them from continuing. Findings from this study also demonstrate substantial differences in exposure to these types of violence by sex, race/ethnicity, and sexual identity, highlighting the need for prevention efforts that address the unique needs of these groups. To help communities focus their prevention efforts on what works and to address risk and protective factors for violence and other ACEs across the social ecology, CDC developed a series of technical packages that identify key violence prevention strategies and approaches on the basis of the best available research evidence. (CDC’s technical packages for violence prevention are available at https://www.cdc.gov/violenceprevention/pub/technical-packages.html.) This series includes packages focused on sexual violence, intimate partner violence (including dating violence), and youth violence (including bullying). Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence compiles evidence focused on ACEs from across the technical packages (https://www.cdc.gov/violenceprevention/pdf/preventingACES.pdf).

Multiple evidence-based interpersonal violence prevention approaches are directly related to the findings in this study. For example, social-emotional learning programs that support development of skills for communication, emotion regulation, empathy, and respect and that target risk factors for interpersonal violence (e.g., impulsivity or drug use) have been reported to decrease adolescent sexual violence perpetration and homophobic name-calling, with indirect effects on peer bullying, cyberbullying, and sexual harassment perpetration when mediated by delinquency (14,15). By addressing shared risk and protective factors across types of violence, social-emotional learning programs can build the skills youths need for engaging in healthy relationships with family, peers, dating partners, and others, thus preventing multiple forms of adolescent interpersonal violence and long-term consequences into adulthood. In addition, bystander programs teach youths how to safely act when they see behaviors that increase risk for violence and change social norms within their peer groups. Although originally conceptualized as a means of challenging heterosexist attitudes to prevent sexual and dating violence (16), such programs might also prevent other forms of adolescent violence, including bullying and violence targeting sexual, gender, and racial minorities by focusing the training on recognizing and challenging these specific harmful attitudes and behaviors (17,18).

Modifying the social and physical environment in schools and neighborhoods might improve safety and reduce risk for violence for more of the population than individual- or relationship-level approaches alone. For example, one school-based prevention approach that includes a building-level intervention (e.g., addressing physical areas in the school identified by students as less safe) has been reported to reduce sexual violence victimization and perpetration by peers and dating partners (19). In addition, the development of safe and supportive environments in schools that promote protective factors (e.g., school connectedness and professional development regarding lesbian, gay, bisexual, and transgender [LGBT] youths) can help create accepting school environments for LGBT youths and reduce the risk for bullying and other violence (20). Results from this report indicate that LGB youths, specifically, are at a disproportionately higher risk for interpersonal violence victimization compared with heterosexual youths. As of 2019, gender identity has not been assessed by the YRBS nationwide. However, during 2017, gender identity was assessed in YRBSs conducted in 10 states and nine large urban school districts; these data show that transgender students consistently report greater prevalence of violence victimization than their cisgender peers (21). Promotion of gay-straight alliances and support of LGBT students can help provide these youths with an accepting school environment, which might also reduce the risk for school-based violence against these youths (22). (Information about CDC’s current school health programs is available at https://www.cdc.gov/healthyyouth/fundedprograms/1807/resources.htm.)

CDC is engaged in ongoing research and programmatic activities for expanding the research evidence and adding to the knowledge base of effective primary prevention programs, policies, and practices available to communities for preventing interpersonal violence among youths. For example, CDC’s Dating Matters: Strategies to Promote Healthy Teen Relationships is a comprehensive adolescent dating violence prevention model. Dating Matters includes multiple integrated prevention strategies that address risk factors for youths and their families, schools, and neighborhoods with demonstrated effects on adolescent dating violence, bullying, and peer violence in middle school. (Additional information about Dating Matters is available at https://www.cdc.gov/violenceprevention/intimatepartnerviolence/datingmatters/index.html.)

In addition, since 2001, CDC has provided funding for primary prevention of sexual violence through the Rape Prevention and Education Program to state health departments in all 50 states, the District of Columbia, and four U.S. territories. Funded organizations implement initiatives that address youths in their communities, including community- and societal-level approaches (e.g., improving education and leadership opportunities for girls). (Additional information about the Rape Prevention and Education Program is available at https://www.cdc.gov/violenceprevention/sexualviolence/rpe/index.html.) CDC also sponsors youth violence prevention research through its National Centers of Excellence in Youth Violence Prevention. Their goal is to build the scientific infrastructure and community partnerships necessary for stimulating new youth violence prevention research and practice across the country, including a focus on the impact of structural factors (e.g., housing, education, or systemic discrimination) that limit access to positive social determinants of health.

Prevention of interpersonal violence among adolescents might be most successful when a comprehensive strategy is used that addresses these ACEs at multiple levels of the social ecology simultaneously and recognizes that these different forms of victimization can be co-occurring (1). The findings reported here also highlight the importance of acknowledging the disproportionate prevalence of these forms of victimization on certain youths (i.e., females and sexual minorities) and addressing these disparities in prevention efforts.



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