CDC-Public Health Research Awards (OPHR)
Elimination of Health Disparities through Translation Research Award (R18)
RFA-CD-08-001

Lutzker, John
Georgia State University Research Foundation, Inc.
Post Office Box 3999
Atlanta, GA 30302
Phone: (770) 841-0522
Email: jlutzker@gsu.edu

Grant Number: CE001479A
Project Title: Implementing SafeCare to Prevent Child Maltreatment in Underserved Populations: A Study of Training Models
Project Period: 09/30/2008 – 09/29/2011

Abstract:

This study will examine the impact of enhanced versus standard training for trainers and coaches in the implementation of a train-the-trainer (TTT) approach of the SafeCare parenting program. The research study will be layered on a training contract being developed between NSTRC and the Georgia Department of Human Resources to provide SafeCare training to DHR staff. With funds provided by the research grant, we will increase the number of DHR trainers and coaches trained by NSTRC as DHR begins statewide implementation of SafeCare. We will randomly assign half of trainees to the standard training model of training, and half to an enhanced model of training. The standard training model includes workshop training, practice, and in-vivo skill demonstration. The enhanced training model will consist of the standard training plus coaching or consultation from NSTRC trainers for up to six months. NSTRC trainers will work with trainers and coaches assigned to the enhanced model by observing them and providing feedback on their performance to ensure training and coaching is delivered with fidelity and competence. The primary outcomes of the study are fidelity- and competence- related measures for trainers and coaches and the home visitors they train/coach, and engagement measures for the families served. The primary analyses will focus on understanding whether the enhanced training model results in (1) greater fidelity and more competent provision of services for trainers, coaches, and home visitors, and (2) greater engagement and retention of families. We will also examine how a variety of individual and organizational characteristics influence fidelity and competence, alone or in combination with training. Finally, because of the increased cost of the enhanced training model, we will conduct an economic analysis to calculate the incremental benefits in fidelity, competence, and engagement/retention afforded by the more costly enhanced training.

PUBLIC HEALTH RELEVANCE:
Successful prevention and intervention of child maltreatment requires the implementation of evidence-based practices in child welfare systems and prevention programs. Reducing disparities requires a focus on implementation of evidence-based programs for problems that disproportionately affect vulnerable populations, and attention to how those populations receive those programs. As the state of Georgia begins a statewide rollout of the SafeCare parent training program, this study will compare two training models for SafeCare(R) with regard to how they influence trainer and coach fidelity and competence, and provider fidelity and competence and client engagement.
 

Past Awards

Extramural Violence-Related Injury Prevention Research 

Grantee Abstracts

Vangie A. Foshee, PhD
University of North Carolina at Chapel Hill
Injury Prevention Research Center
204 Chase Hall, CB#7505
Chapel Hill, NC 27599-7505
Phone: 919-966-6616
Fax: 919-966-2921
E-mail: foshee@email.unc.edu

Project Title: Violence Towards Peers, Dates, and Self: A Developmental Focus
Project Period: 09/01/03–08/31/06

Description: Using a developmental perspective, this study will examine the interrelationships among violence directed at peers, towards dates (psychological, physical, and sexual), and towards self (suicide attempts) and identify unique and shared risk factors across those types of violence from four levels of influence: individual, peer, family, and neighborhood. The study will involve collaboration with a currently funded panel study (the Context Study) that is assessing three cohorts of adolescents in the 6th, 7th, and 8th grades in three North Carolina counties, using self-administered questionnaires every 6 months until the adolescents are in the 8th, 9th, and 10th grades, for a total of five data collection waves. Waves 1 (N=5,220) and 2 (N=5,304) are complete and Wave 3 is ongoing. The questionnaires used in those waves measured risk factors, dating violence, and physical and verbal aggression.

This project will collect two additional waves of data from adolescents in grades 9 through 11, and it will add questionnaire items to Waves 4 and 5 to measure all proposed violence outcomes. Peer relationships will be measured using social network methods, which provide an innovative but underused means of advancing understanding of how peer context shapes and is shaped by adolescent violence. Hierarchical linear models and latent curve analysis will be used to address various aims of the project. Specifically, the project will 1) model and compare trajectories of each type of violence across multiple grades, providing information about the timing of onset and patterns of escalation and deceleration for each type of violence; 2) determine the developmental trajectories for each type of violence; 3) model trajectories of each type of violence as a function of baseline risk factors and changes in risk factors over time; and 4) identify the prevalence of perpetration profiles, based on combinations of different types of violence used and risk factors for the different profiles.


Project Title: Piloting a Family-based Program for Preventing Adolescent Dating Violence
Project Period: 09/01/03–08/31/06

Description: This project will develop and pilot test Families for Safe Dates, a family-based program designed to address multiple types of youth violence, including dating violence (psychological, physical, and sexual), victimization and perpetration, and violence directed at peers. The content of Families for Safe Dates will draw heavily from Safe Dates, an effective school-based, dating violence prevention program. The premise and structure will model the Family Matters program, developed and evaluated by the investigators in a national randomized trial and found to be successful in reducing the prevalence of adolescent substance use. Family Matters consisted of successive mailings of four booklets to families throughout the United States identified by Random Digit Dialing (RDD) with each mailing followed two weeks later by a telephone call from a health educator.

This research will include five pilot studies that will support the conduct, if indicated, of a subsequent national randomized efficacy trial that will use the same methods as the efficacy trial of Family Matters. Two pilot tests will develop and refine the Families for Safe Dates program. Two pilot tests will develop and refine the RDD screening protocols and the telephone interview protocols for adolescents and parents. The final pilot test, the prototype study, will replicate the procedures to be used in the future efficacy trial.

For the prototype study, 500 households with adolescents ages 13 to 15 will be identified through RDD. Baseline telephone interviews will be administered with the adolescent and parent, and half of the families will be chosen randomly to receive the Families for Safe Dates program. Follow-up telephone interviews will be conducted with parents and adolescents 3 months after program completion. In addition to being a pilot test of the full set of procedures to be used in the future efficacy trial, the prototype study will have sufficient power for examining the effects of the program on the proposed theory-based mediating variables and on several violence outcomes. The pilot tests are essential to adequately prepare for and justify the subsequent national randomized trial with sufficient sample size, study duration, and funding to fully examine the impact of the family program on the prevention of multiple forms of violence.

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Debra E. Houry, MD, MPH
Emory University
1518 Clifton Road, NE
Suite 230
Atlanta, GA 30322
Phone: 404-727-9978
Fax: 404-727-8744
E-mail: dhoury@emory.edu

Project Title: Safety and Effectiveness of Computer Screening for IPV
Project Period: 09/01/03–08/31/06

Description: The study will address the lack of knowledge about the effectiveness of routine screening and intervention for IPV in the health care setting and the possible harm derived from such actions. The overall goal is to assess the potential benefit or harm resulting from routine computer-based screening for emotional, physical, and sexual abuse in both women and men in an acute care setting. The researchers will test computer screening for IPV to examine a screening method that will minimize provider time spent on information gathering and maximize provider time for responding to the patient's needs. This study, a randomized clinical trial with longitudinal follow-up, has four specific aims:

1. To assess the safety of screening, identifying, and referring IPV victims as part of an overall computer-based health risk assessment in an ED setting;
2. To assess the effect of computer screening with automatic advocate notification, compared with physician notification alone, on rates of patient contact with community-based IPV resources;
3. To assess the effect of screening in a health care setting on incidents of violence and on IPV victim-defined desirable outcomes;
4. To assess the safety of screening and identifying IPV perpetrators as part of an overall computer-based health risk assessment in an ED setting.

The researchers hypothesize that a) the computer screening will not result in violence related to the screening; b) automatic advocate notification in addition to physician notification in IPV-positive cases will result in higher IPV resource contacts, improved patient knowledge of resources, and greater likelihood of having a safety plan; c) advocate counseling in addition to the physician contact will lead to small improvements in victim-desired outcomes and victim mental health and quality of life; d) the computer screening will not result in adverse incidents during the ED visit, nor increase the rates of 911 calls from the address of patients disclosing victimization and/or perpetration; and e) self-identified perpetrators will report predominantly positive reactions on an exit questionnaire following a simple health care intervention.

Screening positive for either victimization or perpetration on the computer-based survey will branch into questions assessing potential danger as part of the computer screening. Investigators will track all potential danger and harm to the patient and/or their cohabiting partner in three time periods (1-week, 3-month, and 6-month prearranged follow-up visits).

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Mary A. Kernic, PhD, MPH
University of Washington
Harborview Injury Prevention and Research Center
325 9th Avenue, Box 359960
Seattle, WA 98104-2499
Phone: 206-521-1556
Fax: 206-521-1562
E-mail: mkernic@u.washington.edu

Project Title: Prevention of IPV: Victim Support Team Evaluation
Project Period: 09/30/03–09/29/06

Description: Many studies have evaluated interventions for IPV, but they have lacked rigorous designs, critically affecting their interpretability. This study seeks to address this gap by evaluating the preventive effects of an existing crisis intervention program, the Victim Support Team (VST), developed through the Seattle Police Department’s Domestic Violence Unit to meet the needs of victims immediately after an incident of police-reported IPV. Team members assist victims by identifying needed resources (e.g., emergency shelter, domestic violence agency services, food and clothing), providing relevant referrals, and developing a safety plan. The VST is also intended to alleviate some of the burden of attending to victim needs thereby allowing responding officers additional time to focus on investigating the crime. This, in turn, is intended to provide better evidence collection for increasing the odds of successful prosecution.

The broad aim of this study is to examine the effectiveness of Seattle’s Domestic Violence VST in lessening future adverse outcomes by promoting improved evidence collection, prosecution, and access to preventive services related to IPV. The investigation will be accomplished through two complementary projects: a retrospective cohort to examine long-term uncommon adverse outcomes and a smaller randomized controlled trial examining short-term, more frequently occurring outcomes. The specific aims of the retrospective component are—

1. To compare the relative risk of subsequent incidents of police-involved IPV incidents among victims receiving VST services with that among victims not receiving these services;
2. To estimate the relative risk in measures of police evidence collection (e.g., proportion of cases with photos and victim statements taken) among cases where VST services were involved as compared with cases without these services;
3. To estimate the relative risk of adverse outcomes including hospitalizations and death resulting from abuse-related injury.

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Guy Diamond, PhD
Children’s Hospital of Philadelphia
Joseph Stokes Jr. Research Institute
3615 Civic Center Boulevard
Philadelphia, PA 19104-4318
Phone: 215-590-7550
Fax: 215-590-7410
E-mail: Gdiamond@psych.upenn.edu

Project Title: Preventing Youth Suicide in Primary Care: A Family Model
Project Period: 8/1/04–7/31/07

Description: Suicide among adolescents is a serious public health problem and clinical challenge for medical and behavioral health providers. Yet few preventive interventions have been tested for this population. This project addresses this deficit by testing the efficacy of brief family therapy for adolescents presenting with serious risk for suicide in a primary care setting.

Several innovations characterize this study:

1. Patients will be identified and treated directly in the primary care setting. Integrating behavioral health services into primary care may—

   a. reduce burden on physicians by promoting parents as safety monitors,
   b. increase behavioral health treatment adherence, and
   c. address many underlying family problems associated with suicide.

2. To identify high-risk adolescents, the study will assess severe and persistent suicidal ideation and co-occurring depression. Patients who take part in the study must score above clinical cutoffs on both ideation (SIQ > 31) and depression (BDI-II >20) at two consecutive appointments (generally within 3 days of each other).
3. Treatment will target two of the most critical suicide risk factors: depression and family conflict. Depression is the most consistently associated risk factor for suicide and family conflict is the most common precipitant of completed suicide (20%) and non-fatal suicidal episodes (50%).
4. The intervention approach will be Attachment-based Family Therapy (ABFT), an efficacious and manualized family therapy model designed specifically for adolescent depression. ABFT has been successful in reducing suicidal ideation, hopelessness, depression, anxiety, and family conflict.

The Children's Hospital of Philadelphia's Adolescent Care Center will be the performance site, where typically one to three adolescents a week present with severe and current ideation. Eighty-seven percent of patients are African American and 60% are females. One hundred and twenty adolescents will be randomized to 6 to 10 weeks of either ABFT or enhanced usual care. Patients will be evaluated at baseline and 6, 12, 24, and 52 weeks.

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Madelyn S. Gould PhD, MPH
Research Foundation for Mental Hygiene, Inc.
New York State Psychiatric Institute
1051 Riverside Drive, Unit 72
New York, NY 10032
Phone: 212-543-5329
Fax: 212-543-5966
E-mail: gouldm@childpsych.columbia.edu

Project Title: Help Seeking by At-Risk Youth after Suicide Screenings
Project Period: 8/1/04–7/31/07

Description: A suicide screening procedure is only as effective as its ability to get at-risk students the care they need. Unfortunately, little is known about service use by vulnerable youth following a suicide screening program. This project will conduct a retrospective cohort study of youth identified as at-risk for suicidal behavior. The cohort of at-risk teenagers (N=273) was identified during a two-stage screening program that was conducted in six schools in Nassau, Suffolk, and Westchester counties in New York State from fall 2002 through winter 2004. Each at-risk youth and his/her parent will be interviewed approximately 2 years after the screen to assess information about service use during the intervening period, barriers that may have interfered with seeking or receiving treatment, and the risk status of the youth at follow-up. The present project will expand efforts to optimize youth suicide screening programs by establishing a better understanding of the natural course of both suicidal adolescents' improvement and use of services after a screening program. This information is critically needed to guide efforts to develop optimal help-seeking strategies tailored to at-risk youth and their parents in order to establish effective screening programs to prevent suicidal behavior in youth.

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Neil B. Guterman, PhD
Columbia School of Social Work
622 West 113th Street
New York, NY 10025
Phone: 212-854-5371
Fax: 212-854-2975
E-mail: nbg2@columbia.edu

Project Title: Building Social Support to Enhance Home Visitation
Project Period: 8/1/04–7/31/07

Description: Physical child abuse and neglect remains a serious public health concern, with more than 5 million children suspected as victims in the United States each year. In addition to immediate medical consequences, physical child abuse and neglect predicts some of society's most intractable social problems, including an increased risk violence perpetration later in life. In this context, early home visitation services have emerged as one promising primary prevention strategy that aims to stop physical child abuse and neglect and its later consequences. Although prior research indicates the generally positive impact of such services, growing evidence indicates that social contextual factors and most especially qualities of parents' social networks, long identified as playing a key role in the etiology of physical child abuse and neglect, also play a substantial role in shaping the degree to which such services succeed in preventing maltreatment.

The present study will examine the efficacy of a social networking enhancement integrated within home visitation services. Initial pilot work has yielded a manualized intervention that has been showing highly promising preliminary trends on child maltreatment proxies, social network qualities, parenting stress, and related factors. The present study proposes a cross-over wait-list control group design. Two hundred families will be randomly assigned to either a home visitation plus social network enhancement condition or to a wait-list control group of families only receiving home visitation services for 4 months, later to receive the social networking enhancement component. Data on physical child abuse and neglect risk, social networks, parents’ sense of control, participation in home visitation, and associated other factors will be collected at baseline and at 3- and 9-month follow-up points. This study will be conducted in close collaboration with two of the major home visitation programs in New York City that served as pilot sites: Best Beginnings of Alianza Dominicana, and Healthy Families Staten Island of the New York Foundling Hospital.
 

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Lourdes Oriana Linares, PhD
NYU Child Study Center
215 Lexington Avenue, 13th Floor
New York, NY 10016
Phone: 212-263-8847
Fax: 212-263-3690
E-mail: Oriana.linares@med.nyu.edu

Project Title: The Study of Sibling Violence among Foster Children
Project Period: 8/1/04–7/31/07

Description: This investigation builds on prior work. Researchers will collect two assessments on 260 African American and Latino maltreated siblings placed in foster care for whom two assessments were obtained 1 year apart, and who were 7 years old when the study began. Given their substantiated histories of exposure to past familial violence, the sample is at high risk for psychological problems, disruptions in school competence, and perpetration of sibling violence.
Researchers, working closely with participating child welfare agencies in NYC and with biological and foster mothers, retained 82% of the siblings and completed clinically meaningful analyses of a complex data set. Preliminary studies indicate that 68% reported moderate to high sibling conflict, 41% showed elevated behavior problems, and 62% met criteria for a child mental disorder. In random regression analyses, sibling conflict, foster caregiving warmth, and less rejecting caregiving contributed independently to increased sibling problems.

Building on this unique, recruited sample, the research objectives of this project are:

1. To examine correlates of sibling violence, namely, past familial victimization (exposure to child neglect, abuse, and/or intimate partner violence), child mental disorder (particularly disruptive behavior disorders), and placement variables (together or apart; and foster home instability) over time.
2. To examine the contribution of sibling violence on increased psychological symptoms (increased internalizing, externalizing) and disruptions in school competence, over time.
3. To evaluate the moderating role of sibling positivity, foster caregiving quality, and differential warmth and responsive management in the linkage between sibling violence and increased symptoms and disruptions in school competence, over time.

The identification of modifiable risk and protective factors in the social ecology of foster care is a crucial first step in effective prevention of sibling violence among foster children.

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Michael Miner, PhD
Regents of the University of Minnesota
Program in Human Sexuality
1300 South Second Street, Suite 180
Minneapolis, MN 55455
Phone: 612-625-1500
Fax: 612-626-8311
E-mail: miner001@umn.edu

Project Title: Risk for Sexual Abuse: A Study of Adolescent Offenders
Project Period: 8/1/04–7/31/07

Description: Healthy People 2010 prioritized sexual violence and child maltreatment (including sexual abuse) as important targets for prevention and intervention. In its Injury Agenda for 2004, the Centers for Disease Control and Prevention indicates that a major barrier to prevention efforts is the lack of information about the causes and correlates of child sexual abuse, especially in young perpetrators. This project addresses this gap by applying attachment theory to identify the unique and shared risk factors for child sexual abuse, sexual assault, and youth violence. This objective will be accomplished through a multi-method, cross-sectional study of 300 adolescent males: those who have sexually abused children, those who have sexually assaulted peers or adults, and those who have committed other, non-sexual types of delinquent behavior. Data will be collected through a review of available records, semi-structured and structured interviews, and a computer-administered questionnaire.

The project will identify the unique and shared risk factors for perpetrating child sexual abuse, sexual assault, and delinquent behavior by investigating perpetrator group differences in the following constructs:

• Aim 1 will examine attitudes toward intimate relationships (attachment style) and their involvement with peers, including consensual sexual experiences.
• Aim 2 will examine attitudes toward masculinity, including beliefs about the importance of competition, violence, and face-saving as an indication of masculinity and confidence in their own masculinity, and beliefs about sexuality, self-reported sexual behavior (including paraphilias), and sexual interest and fantasies (including various paraphilias).
• Aim 3, a collaboration between the Program in Human Sexuality, treatment programs for juvenile sex offenders, and juvenile probation departments, will promote primary and secondary prevention through dissemination of project results in collaboration with Stop It Now, Minnesota, which is a primary prevention program.

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Lydia Nuelander O’Donnell, EdD
Center of Research on High Risk Behaviors
Educational Development Center, Inc.
55 Chapel Street
Newton, MA 02458
Phone: 617-969-7100x2368
Fax: 617-969-3995
E-mail: lodonnell@edc.org

Project Title: Violence Over Time: Growing Up and Parenting in Poverty
Project Period: 8/1/04–7/31/07

Description: This study examines developmental pathways of violence perpetration among young women and men who have grown up in severely distressed neighborhoods of the inner city and are now mothers and fathers. It focuses on young parents' resiliency in challenging circumstances, as demonstrated by their ability to avoid violence with family members and others and to engage in pro-social parenting practices that are negatively associated with child maltreatment and the development of aggression in the next generation. Researchers will survey a sample of young African-American and Latino parents who began participation in a longitudinal study, Reach for Health (RFH), when they were in middle school, about a decade ago. With funding from National Centers for Disease Control (CDC) and the National Institute of Child Health and Human Development (NICHD), researchers have followed more than 1,000 young people from adolescence into high school and beginning adulthood, documenting multiple forms of violence perpetration and victimization, including high levels of physical aggression, as well as suicidal behaviors, and most recently, intimate partner and sexual violence. Findings from this work highlight the need to better understand shared and unique risk and protective factors for violence perpetration among young adults who have grown up in violent contexts and become parents in their teens and early twenties.

Two primary research questions are addressed in this project: How do past experiences with violence shape parenting attitudes and practices as well as ongoing involvement in violence? What protective factors foster resiliency in the face of adversity, leading to less violent pathways among young mothers and fathers? To answer these questions, RFH participants who have become mothers and fathers will be re-contacted and surveyed to investigate the inter-relationships among multiple forms of violence toward self and others during the critical developmental stage of early parenting.

The specific aims are:

1. Identify concurrent protective factors that foster resiliency in young mothers and fathers, as demonstrated by low levels of multiple forms of violence perpetration (i.e., intimate partner violence, sexual violence, violence toward other adults, violence toward self).
2. Identify concurrent protective factors that foster resiliency in young mothers and fathers, as demonstrated by parenting attitudes and practices associated with low risk of child maltreatment and nonaggressive behavior in offspring.
3. Examine interconnections among multiple forms of violence perpetration and parenting attitudes and practices associated with low risk of child maltreatment and nonaggressive behavior in offspring.
4. Identify developmental pathways that lead to lower violence perpetration and parenting attitudes and practices associated with low risk of child maltreatment and nonaggressive behavior in offspring.
5. Determine whether protective factors, interconnections among forms of violence, and developmental pathways differ for mothers and fathers.
6. Use findings to inform strategies for addressing multiple forms of violence in young parents' lives, including key messages that can be incorporated into parent education and community violence prevention programs.

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Jane F. Silovsky, PhD
University of Oklahoma
940 NE 13th Street
CHO 3B-3406
Oklahoma City, OK 73104
Phone: 405-271-8858
Fax: 405-271-2931
E-mail: Jane-silovsky@ouhsc.edu

Project Title: Preventing Child Maltreatment in High-Risk Families
Project Period: 8/1/04–7/31/07

Description: The greatest potential for child maltreatment prevention effects is with high-risk populations. Unfortunately, home-visiting programs have failed to prevent child maltreatment in the highest-risk populations, such as families with parental substance use disorders, intimate partner violence (IPV), parental depression, or other multiple risk factors. These discouraging results with high-risk populations may be best understood as a mismatch of service aims and family needs. In many respects, high-risk child maltreatment prevention populations have more in common with child welfare cases than with perinatal prevention populations. Reductions in child maltreatment recidivism with child welfare populations have been found with the home-based intervention model SafeCare, a promising intervention for high-risk child maltreatment prevention.

Oklahoma University Health and Science Center (OUHSC) has conducted a randomized pilot and feasibility trial of SafeCare, enhanced with specific components to address substance abuse, IPV, and depression in high-risk prevention populations (SC+). The initial results are encouraging. The overarching goal of this project is to extend current work by conducting a full-scale randomized efficacy trial of the SC+ protocol with a high-risk child maltreatment prevention population. The main hypotheses are:

• Hypothesis 1: Compared with services as usual (SAU), high-risk parents randomized to receive SC+ will have improved survival for future child welfare reports and will have lower rates of out-of-home placements due to child maltreatment.
• Hypothesis 2: Compared with SAU, families randomized to receive SC+ will show greater improvements on factors proximal to child maltreatment, including observed measures of the home environment, home safety, physical child care, and self-reports of verbal and physical aggression toward children.
• Hypothesis 3: Compared with SAU, high-risk parents randomized to receive SC+ will show greater improvements on risk factors, including measures of child abuse potential, levels of IPV, depression, and substance abuse.
   

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Jay Silverman, PhD
Harvard School of Public Health
1552 Tremont Street
Boston, MA 02120
Phone: 617-432-0081
Fax: 617-495-8543
E-mail: jsilverma@hsph.harvard.edu

Project Title: Development of Partner Violence Perpetration Among Men
Project Period: 8/01/04–7/31/07

Description: Data on the risk and protective factors that contribute to the development of intimate partner violence (IPV) perpetration among adult males is woefully lacking. The few previous studies in this area have failed to include major social contexts for IPV, have typically included a very narrow range of factors within these ecologic strata, and have failed to examine protective factors. Identifying protective factors is considered especially critical to constructing effective prevention programming.

This project uses a mixed-methods retrospective cohort study of men ages 18 to 35 (age group found to perpetrate IPV at the highest rates; N=4,000) attending eight community health centers within racially/ethically diverse neighborhoods in the Boston area to assess risk and protective factors for perpetration of IPV. Quantitative survey data will be collected regarding developmental pathways and social contexts (including individual, family, peer, and community levels) hypothesized to relate to IPV perpetration. Additionally, qualitative data will be collected from in-depth interviews with men (n=80) participating in quantitative surveys selected for both perpetration and non-perpetration of IPV, but reporting similar risk profiles, to elucidate protective factors/mechanisms and provide context/meaning for quantitative data.

The researcher will also use this mixed data set to assess interrelations of IPV perpetration and perpetration of other forms of violence (suicide, sexual violence, child maltreatment, general violence). Finally, the researcher will assess the relevance of findings regarding risk and protective factors for IPV perpetration to the population of men enrolled in treatment programs from these same communities via quantitative surveys of men ages 18 to 35 (n=450) participating in five batterer intervention programs situated within communities served by participating community health centers. This comparison will be vital to determining whether the risk and protective factors identified are relevant to present interventions for men who batter their female partners.

Matthew Chinman, PhD
RAND Corporation
PO Box 2138
Santa Monica, CA 90407-2148
Email: chinman@rand.org

Project Title: Building Community Capacity to Conduct Effective Violence Prevention
Project Period: 9/1/05-8/31/08

Description: Youth violence exacts a high toll in local communities. Effective violence prevention programs can improve community safety, but only when they are implemented well. This can be challenging given the advanced capacity needed to implement high quality prevention, resulting in a large gap between the positive outcomes often achieved by prevention science and the lack of these outcomes at the local level. This project will assess the effects of community participation by implementing a capacity-building model in schools, called “Getting to Outcomes” (GTO).

This study will test whether using GTO leads to better implementation of an evidenced-based violence prevention program, “Too Good for Drugs and Violence” (TGDV), and as a result, decreased violent behavior in schools. Investigators will use a quasi experimental design. Six high schools in Santa Barbara County will administer TGFDV during six semesters over a three-year period. Three high schools will be assigned to the intervention group (i.e., receive the capacity building tool, GTO) and three in the same county will serve as comparison sites (TGFDV only). The intervention will consist of delivery of the GTO manual, an annual training in GTO, and biweekly technical assistance to violence prevention school staff delivering the TGFDV curriculum. Standardized assessments of GTO use and TGFDV implementation will be administered each semester across the life of the proposed project. The investigators will assess school violence behaviors and perceptions at the intervention and comparison sites prior to TGFDV and GTO implementation and up to two years later using school records on disciplinary actions and a bi annual cohort survey of 9th and 11th graders. They will also measure the financial costs associated with implementing GTO over and above TGFDV. This project proposes to narrow the gap between prevention science and practice by empirically testing a tool to build capacity to implement evidence-based violence prevention in the community. As such, this project is consistent with the cross-cutting and youth violence research priorities developed by CDC, which also emphasizes capacity issues.

Ann Coker, MPH, PhD
The University of Texas
Health Science Center at Houston
1200 Herman Pressler Dr, RAS E643
Houston, Texas 77030
Email: Ann.l.coker@uth.tmc.edu

Project Title: Using Batterer Psychological Profiles for Prevention of Partner Violence
Project Period: 9/1/05-8/31/08

Description: This project will use psychological profiles described by Holtzworth-Munroe & Stuart to identify batterer typologies in a population-based, cross-sectional study of partner violence (PV) perpetration.The three subtypes that will be employed (GVA, BD, and RO) have all been described. All participants will be asked about their violence perpetration, victimization, and their psychological profile. These data will be used to assess batterer subtypes and grouped as (a) current IPV perpetrators by batterer subtype, and (b) those with psychological profile of a batterer yet do not report physical PV (labeled high-risk non-perpetrators). Identifying the last group will allow for applying batterer typologies that may have important implications for prevention research. The investigators will explore protective factors for PV among this high-risk, non-perpetrator group.

Researchers will estimate the prevalence of and risk factors for both PV perpetration by batterer subtypes and high-risk, non-perpetration among 2000 students sampled from a large community college system in Houston, Texas. Measures of distal and proximal risk factors based on a theoretical model will be used to guide the assessment of correlates of both perpetrator and high-risk, and non-perpetrators by psychological batterer subtypes over three levels of influence (individual, family, and ethnic community). Point estimates and confidence intervals for PV typologies and perpetration will be estimated by gender. Multinomial logistic regression will be used to assess risk factors (e.g., childhood abuse and witnessing IPV, substance abuse, affect) for the three PV typologies by level of influence. To determine whether the novel, high-risk, non-perpetrator group is at increased risk of using force against a partner, a short-term (eight month) cohort study will be conducted to prospectively estimate PV risk among those not reporting perpetration in the cross-sectional interview by psychological profile. All respondents scoring as high-risk, having the psychological profile consistent with a battering subtype, yet not perpetrating PV will be included. A similar number of low-risk (no batterer psychological profile and non-perpetrators) will also be included as unexposed. Cox proportional hazards modeling will be used to estimate time to first use of physical force by psychological profile. Project outcomes will lead to more effective strategies for preventing partner violence.

Howard Dubowitz, MS, MD
University of Maryland
Division of Child Protection
520 W Lombard St., 1st Floor
Baltimore, MD 21201
Email: hdubowitz@peds.umaryland.edu

Project Title: Preventing Child Maltreatment: Community Pediatrians' Role
Project Period: 9/1/05-8/31/08

Description: Child maltreatment (CM) and intimate partner violence (IPV) jeopardize the health and safety of many children and families. The primary focus has been on addressing these problems “after the fact.” There is a need to rigorously evaluate prevention strategies. This project proposes to enhance pediatric primary care to help prevent CM and to address IPV.

This study involves training pediatricians to identify and assist families at high risk for CM and to implement Model Care, which includes screening parents at their preschooler’s check-ups; assessing problems; initial pediatric and/or social work intervention; and referral to community resources. Investigators will evaluate the impact of training on pediatricians’ attitudes, knowledge, comfort, competence, and practice, and will also evaluate the effectiveness of Model Care. The proposed project will take place in 20 pediatric private practices in Maryland, involving 80 pediatricians. These practices cover a diverse patient population; approximately one third are low income, and one third are minority. The first component involves training pediatricians to identify and assist families at high risk for CM. The second component involves the Model Care, which represents a modest, but important modification of the existing child health care system. Via random assignment, half will be trained to implement the Model Care. The control group will provide standard care. Investigators will evaluate the impact of training on pediatricians' attitudes, knowledge, comfort, competence, and practice; evaluate the effectiveness of the Model Care upon screening practices; and identify risk factors for CM and whether they are addressed; and will also examine the rates and severity of both CM and IPV. This project meets both the “Healthy People 2010” and CDC Research Agenda goals. It applies sound theory and clinical experience, attending to common psychosocial problems, and contributes to knowledge and practice. This model can be replicated if the risk factors are identified and the problems of CM and IPV are effectively addressed.

Nadine Kaslow, PhD
Emory University
Office of Sponsored Programs
1784 N Decatur Road, Suite 510
Atlanta, GA 30322
Email: nkaslow@emory.edu

Project Title: Preventing Suicidal Behavior in Abused Black Women
Project Period: 9/1/05-8/31/08

Description: Given prior research of the link between intimate partner violence (IPV) and suicide attempts among low income, African American women, secondary preventive interventions are needed for abused women with suicidal ideation to reduce the likelihood of their attempting suicide and to decrease associated morbidity.

This study will evaluate the efficacy of a group empowerment psychoeducational intervention (PEI) versus enhanced treatment as usual (ETAU) at post-intervention and follow-up in reducing suicidal behavior and its correlates; compare the efficacy of PEI versus ETAU at post-intervention and follow-up in reducing IPV; compare the effectiveness of PEI versus ETAU at post-intervention and follow-up in reducing individual, family-social, and community-level risk factors; compare the effectiveness of PEI versus ETAU at post-intervention and follow-up in enhancing individual, family-social, and community-level protective factors; and determine those individual, family-social, and community-level background variables that moderate the group assignment–outcomes link.
A hybrid efficacy-effectiveness trial using a mixed model design will be used to explore the aims of this study. Between-subjects variables are intervention condition (PEI, ETAU) and within-subject variable is time (pre-intervention, post-intervention, six months and one year follow-ups). The sample consists of two groups (95 each) of low income, African American women currently in an abusive relationship with suicidal ideations. The ETAU includes a compliance enhancement intervention, treatment as usual in the community, and suicidal and IPV behavior monitoring. The PEI includes the ETAU plus a 10-session, culturally-competent and gender-sensitive empowerment group intervention. The data for the first four specific aims will be analyzed with multiple linear and logistic regressions. Intent-to-treat analyses will also be conducted. This study is innovative in its focus on suicidal ideation among abused women; its inclusion of low income, African American women; and in its use of culturally-competent assessments and interventions.

Elizabeth Letourneau, PhD
Medical University of South Carolina
Dept. Of Psychological & Behavioral Sciences-FSRC
261 Calhouns Street –Suite 243
Charleston, SC 29401
Email: letourej@musc.edu

Project Title: Preventing Sexual Violence: Does Sex Offender Registration and Notification Work?
Project Period: 9/1/05-8/31/08

Description: Reducing sexual violence is one of the research priorities identified in CDC’s Healthy People 2010 and its Research Agenda. This study will examine whether sex offender registration and notification policies have the intended effects of reducing sexual violence by juveniles; and whether these policies have an unintended effect of reducing the probability that youths who commit serious sexual offenses will be adjudicated. Registration and notification laws have largely escaped empirical investigation, thus this study will represent the first of which to examine the effects of sex offender-specific policies on juvenile offenders.

Researchers will examine whether South Carolina registration and notification polices have the intended effect of preventing sexual offending and of reducing sexual recidivism; and whether the unintended effect of reducing the probabilities that youth who commit sexual crimes will be prosecuted or adjudicated. To accomplish these aims, 12 years of juvenile justice data from South Carolina will be examined for changes in trends of first-time sexual offending and sexual recidivism. Victim reports of sexual violence over this same time period will also be examined to determine whether changes in adjudication rates parallel changes in victim reports. Data on nonsexual crimes will be explored to determine whether changes in rates of sexual offending simply parallel changes in other types of offending or appear due to sex offender-specific policy changes. Ultimately, researchers will conduct research comparing the impact of less restrictive versus more restrictive registration and notification policies on juvenile sex offenders throughout the U.S., including research detailing the specific mechanics of the effects of these policies. Study outcomes will help detect whether broad policies that impact thousands of juvenile sexual offenders have, in any way reduced sexual violence. If so, this information must be communicated to policy makers who have thus far, acted with little, if any empirical data. If not, the resources required to maintain these policies should be redirected towards more promising violence prevention programs.

Lourdes Oriana Linares, PhD
NYU Child Study Center
215 Lexington Avenue, 13th Floor
New York, NY 10016
Email: Oriana.linares@med.nyu.edu

Project Title: Early Prevention of Youth Violence Among Foster Children
Project Period: 9/1/05-8/31/08

Description: Despite the strong links between early childhood aggression and future youth violence, little attention has been given to promoting and disseminating effective childhood violence prevention for young (< 10 years of age) urban African American and Latino maltreated children raised in foster homes. Preliminary studies support the feasibility of training foster care staff in manualized interventions delivered in their agency, retaining families through the duration of the intervention, and obtaining high ratings of consumer satisfaction.
The PI proposes to adapt, integrate, and experimentally evaluate a child centered intervention of two existing, protocol driven, empirically supported child programs called “The Dina Dinosaur's Curriculum for Young Children Social Skills” and “Problem Solving and the Kids Club: An Intervention Group for Children Exposed to Domestic Violence.”

Researchers will examine the short-term impact of the 12-week intervention to reduce early physical aggression and its correlates (problems in social competence, emotional regulation, and social cognitions about violence) in the foster home and classroom; the reduction of foster placement instability; and will explore the impact of quality implementation (dosage and adherence) and initial level of child aggression on intervention effects. The sample under study consists of 102 foster children ages 5 to 8 years with substantial neglect, exposure to domestic violence or physical abuse nested with six agencies. A randomized field trial will be used to assign children to intervention (n=62) or a “usual care” comparison (n=40) condition. Primary outcomes include measures of early physical aggression and behavior correlates, and the stability of the placement assessed by multiple agents (the child, foster parent(s), trained observer, and teacher) and across settings (foster home, classroom) at pre-test, post-test, and three-months follow-up. Postive project outcomes will aid the development of effective violence prevention programs for underserved children in Latino and African American communities.

John MacDonald, PhD
RAND Corporation
1776 Main St., PO Box 2138
Santa Monica, CA 90407-2138
Email: John_MacDonald@rand.org

Project Title: Treatment Effects on Desistance from Youth Violence
Project Period: 9/1/05-8/31/08

Description: Youth violence presents a public health challenge of critical importance. There is growing optimism that violence prevention efforts can be effective. However, the mechanisms by which treatment and prevention programs exert lasting violence reduction effects are not well understood. For this proposed project, investigators will examine whether effective treatment encourages desistance by facilitating the kinds of positive life events related to peers, family, workplace, and romantic relationships associated with desistance from violence in populations with serious youthful offenders.

Researchers will identify the pathways to desistance from crime and violence as the sample enters young adulthood; identify the psychosocial events during young adulthood that are associated with desistance pathways for this cohort; examine whether any direct effects of treatment on desistance from crime and violence exist; and test if treatment effects on desistance are mediated by treatment effects on key developmental events of young adulthood. This research builds on an ongoing study of drug abuse among serious juvenile offenders and draws on developmental models of criminal behavior to examine the long-term effects of an effective adolescent treatment model on desistance from serious offending and violence. RAND’s Adolescent Outcomes Project is an ongoing study of 449 youth referred by probation to the Phoenix Academy of Los Angeles (PHA; n=175), or to one of six residential group homes (n=274). The sample is representative of youths sent to large residential treatment programs by the Los Angeles Probation Department. Now, as part of a separate NIDA???)-funded study, survey waves are being conducted 72, 87 and 102 months after the baseline interviews, creating the opportunity to examine transitions to young adulthood when desistance from crime and violence is most likely to occur. This project will be one of the few longitudinal studies of serious youthful offenders to examine desistance during the transition into early adulthood, and the only one to examine the effect of treatment on desistance during this period.

Pamela Orpinas, MPH, PhD
University of Georgia
Health Promotion and Behavior
300 River Road
319 Ramsey Center
Athens, GA 30602
Email: porpinas@uga.edu

Project Title: Healthy Teens: Understanding Social Development from Middle to High School
Project Period: 9/1/05-8/31/08

Description: The goal of Healthy Teens is to examine protective factors that influence the development trajectories (i.e., patterns of continuity or patterns over time) that children and adolescents follow from 6th to 11th grade of single and combined violence-related behaviors. This study will follow into high school, a cohort of 800 middle school students who were evaluated in 6th, 7th, and 8th grade as part of a CDC-funded project: the “GREAT Schools and Families Program.”

Researchers will administer a laptop student survey each spring; request that teachers annually complete a standardized, nationally- normed student behavioral rating on participating students (BASC); collect archival data (attendance, standardized test scores, and discipline records); survey and conduct semi-structured interviews with school dropouts; and conduct interviews and focus groups with students to understand the meaning violence-related behaviors and of the factors that protect them from aggression. This mixed method approach will provide a comprehensive and in-depth description of the most significant factors that protect students from violence and their impact on trajectories and turning points.
 

Guterman, Neil
Columbia University
1210 Amsterdam Avenue; MC 2205
New York, NY 10027
E-mail: nbg2@columbia.edu

Project Title: Fathers and Risk for Physical Child Maltreatment: Prevention Pathways
Project Period: 9/1/2006 – 8/31/2009

Despite the fact that fathers and father surrogates are disproportionately represented as perpetrators in the most severe and sometimes fatal incidents of physical abuse and neglect, little is known about their specific role in the etiology of physical child abuse and neglect, hindering prevention efforts. The proposed study will conduct a series of interrelated analyses that will isolate the fathering pathways that shape a family's risk for physical child abuse and neglect, drawing data from a national prospective longitudinal population-based birth cohort of families across 20 U. S. cities (N=4,800 at baseline). The design of this study provides unique opportunities as it draws from a nationally representative, rather than local problem-based, sample, and permits the identification of fathering factors prospectively before any maltreatment has occurred, from birth
through three years of age, the period of children's greatest vulnerability to the most severe forms of physical child abuse and neglect. Self-report and in-home observational data on physical child abuse and neglect risk and predictors were collected from both mothers and fathers, and include data on father surrogates, permitting in-depth examination in corroboration and comparison across informants. Four interrelated substudies are proposed that will examine fathers' and father surrogates' roles in a longitudinal fashion across levels of concern (i.e. community, parent subsystem, parent-child interaction), progressing from: 1) multivariate regression analyses that control for maternal and other background factors to identify unique fathering predictors linked to physical child abuse and neglect risk; 2) path analyses that trace the important father related direct and mediating pathways shaping both mothers and fathers risk for physical child abuse and neglect; 3) analyses of community factors as they are related to the parenting subsystem and shape individual level fathering factors related to physical child abuse and neglect risk; and 4) :multivariate regression analyses that include non-biological father-figures as well as fathers and use longitudinal
data to examine pathways to risk. Given differing etiological processes, father-related factors will be examined differentially in their capacity to predict young children's risk for exposure to physical child abuse as contrasted with physical child neglect. Findings from this study will provide scientific information that identifies specific modifiable father related pathways linked with maltreatment risk promoting the development of preventive interventions that alter parent-child interactions away from physical child abuse and neglect risk.
 

Ludwig, Jens
Georgetown University
3520 Prospect Street, NW - Suite 426
Georgetown Public Policy Institute
Washington, DC 20007
Email: ludwigj@georgetown.edu

Project Title: Long-Term Effects of the Moving-to-Opportunity Experiment on Youth Violence
Project Period: 9/1/2006 – 8/31/2009

Importance: Youth violence varies dramatically across neighborhoods in the U.S. These patterns highlight the potential value of "place-based" interventions to prevent youth violence.

Objectives: We propose to evaluate one notable place-based intervention: The Moving to Opportunity (MTO) randomized housing-mobility experiment, which randomly assigns some public housing families but not others the chance to relocate to less disadvantaged and dangerous neighborhoods. We seek to
understand the intervention's long-term effects on youth violence perpetration and victimization (9-12 years after randomization), how these impacts evolve over time, whether effects are larger for youth participants who are very young children at random assignment as recent research would suggest, and the behavioral or environmental mechanisms through which MTO affects youth violence.

Study Design: Comparison of average violence victimization and perpetration rates for youth randomly assigned to different MTO mobility treatment groups.
Setting: Since 1994 a total of 4600 low-income, mostly minority public housing families have enrolled in MTO in 5 cities (Baltimore, Boston, Chicago, Los Angeles, and New York City).

Participants: All youth and their parents or other adults in MTO households at random assignment.

Interventions: MTO changes youth exposure to a wide variety of risk and protective factors that may vary systematically across neighborhood contexts, including peer and adult norms about violence and community-level organizations such as schools and public health or criminal justice agencies.

Outcome Measures: We seek funding to collect administrative data on violent crime and other arrests for all MTO youth and adults to measure youth violent behavior, as well as child maltreatment by parents or other adult guardians 9-12 years after randomization. We also seek funding to expand our planned surveys
of up to 6800 youth ages 10-20 at the end of 2006 to include measures of violent and risky behavior violence victimization, sexual abuse and other forms of child maltreatment.

van der Kolk, Bessel A.
The Trauma Center at Justice Resource Institute
1269 Beacon Street
Brookline, MA 02446
E-mail: jkershner@jri.org

Project Title: RCT of Urban Improv-lntensive, A Youth Violence Prevention Program
Project Period: 9/1/2006 – 8/31/2009

Importance: The aim of this project is to advance the development of a promising new youth violence prevention program, Urban Improved Intensive (UI-I), through a rigorous evaluation of its effectiveness in preventing high risk, young, urban adolescents from engaging in youth physical and sexual violence. This research is critical because UI-I advances the field of youth violence prevention by targeting the root causes of violence, integrating physical and sexual violence prevention for middle school youth, and addressing the violence and trauma to which this population has been exposed.

Objectives: UI-I and this study aim to: 1) Build interpersonal problem-solving skills and empathy, and reduce emotional constriction and the psychological impact of violence exposure; 2) Change youths' beliefs about aggression so that prosocial means of resolving conflict are viewed as acceptable, while violence is viewed as unacceptable;3) Reduce aggressive behaviors and problem behaviors at school, and build general prosocial skills ;and 4) Enhance general classroom climate.

Study Design: We will conduct a randomized, controlled trial of UI-I in order to evaluate its effectiveness at reducing risk factors linked to youth violence and preventing sexual and physical violence perpetration by high-risk youth.

Participants: All students enrolled in 14 selected seventh grade Boston Public School classrooms within a single school district will participate. Based on random assignment, six classrooms (120 students) will receive UI-I and eight(120 students) will serve as controls. Intervention: UI-I is a 24-session program that is based on a clinically informed and empirically supported theater- and action-based violence prevention program integrated with evidence-based intervention components for children exposed to chronic violence or trauma. Initial pilots of UI-I have supported its feasibility and positive effect on youth.

Outcome Measures: Psychometrically sound student-and teacher-report measures as well as a school based Behavioral tracking system of students' disciplinary actions, attendance, and grades, will be used to Asses study aims and hypotheses.
 

Rheingold, Alyssa Ann
National Crime Victims Research and Treatment Center
Medical University of South Carolina
Department of Psychiatry and Behavioral Sciences
Charleston, South Carolina
E-mail: rheingaa@musc.edu

Project Title: CSA Prevention Training for Child Care Professionals: Stewards of Children
Project Period: 9/1/2006 – 8/31/2009

Given the significant rates of child sexual abuse (CSA) in the United States (12%), as well as the deleterious consequences for victims exposed to such maltreatment, identifying an effective prevention program is clearly
a priority. As discussed in Healthy People 2010, "the evaluation of ongoing programs is a major component to help identify effective approaches for violence prevention." There is growing awareness that child care professionals, such as teachers, child care personnel, and clergy, are in a unique position to identify possible sexual abuse cases and intervene on behalf of children by virtue of their accessibility to children and their expertise in child development. Programs to train child care professionals about child maltreatment have received insufficient attention and evaluation. The primary goal of this study is to conduct a multi-site
controlled evaluation of an already existing CSA prevention program, Darkness To Light's Stewards of Children, on impacting child care professionals' knowledge, attitudes, and behavior related to CSA. Darkness to Light (DTL), a national non-profit organization seeking to protect children from sexual abuse, has developed a three hour training program for child care professionals to assist them in understanding, recognizing, and appropriately responding to CSA. DTL's sexual abuse prevention training is offered via an m-person training format and soon via a web-based training format. Investigating best implementation
strategies is also a key issue in developing and implementing cost effective programs aimed to prevent CSA. This proposed project involves 300 child care professionals recruited from children advocacy centers across three states to be randomly assigned to one of three conditions: (1) in-person training, (2) web- based training, or (3) no training exposure. Dependant variables will include measures of CSA knowledge, attitudes about CSA, self report preventative behaviors, response to hypothetical behavioral vignettes, and organizational
policy and behavior changes. The current proposal involves a joint collaboration between well-established researchers at the Medical University of South Carolina's National Crime Victims Research and Treatment Center, a non-profit community organization Darkness to Light, as well as partnering children's advocacy centers across several states.



Salazar, Laura F.
Emory University
Rollins School of Public Health
1784 N. Decatur Road, Suite 510
Atlanta, GA 30322
E-mail: OSP@Emory.edu

Project Title: Preventing Violence against Women: A Web-based Approach
Project Period: 9/1/2006 – 8/31/2009

Violence against women is a serious public health problem, young women are disproportionately assaulted or raped by men indicating a need for effective and innovative prevention programs. A newly emerging trend in the violence against women (VAW) prevention field is the design of programs that move beyond targeting individual characteristics only or male perpetrators only by addressing the broader context in which violence against women occurs. This type of environmental approach acknowledges that the vast majority of young men does not engage in violence, but rather comprises a culture where normative influences contribute to the victimization of women. The proposed study will seek to develop and test an innovative prevention program designed to have an impact on VAW by targeting young men and focusing on affecting personal as well as environmental influences. The program will be guided by empirical research and social cognitive theory and will incorporate a social norms approach. Specifically, the program will attempt to dispel misperceptions regarding normative beliefs and behaviors related to VAW while enhancing the knowledge and skills necessary for engaging in behaviors that reduce risk for women. The program will be adapted for a web-based modality. There are two primary goals; (1) to prevent psychologically, physically, and sexually abusive behaviors toward women, and (2) to increase the "intervening" behaviors that reduce risk for VAW perpetration (e.g., express disapproval when a peer is verbally disparaging toward women; attempt to stop a peer who tries to be coercive/abusive). These primary goals will be achieved by affecting theoretically and empirically derived mediators such as: correcting misperceptions in normative beliefs, attitudes, and behaviors, increasing knowledge of the elements constituting informed consent to have sex, increasing knowledge of legal definitions of assault, enhancing communication skills, and increasing empathy for female victims. The program will incorporate web-based activities designed to modify these theoretical and empirical constructs. The program will be tested for its efficacy by using a randomized controlled design implemented among a randomly selected sample of 680 male college students. Study outcomes to be assessed will be the psychological, physical, and sexual perpetration of women and intervening behaviors. These outcomes will be assessed via web-administered interviews at baseline, post intervention, and at 6 months.

Slep, Amy M. Smith
The Research Foundation of SUNY Stony Brook
Dept. of Psychology
State University of NY at Stony Brook
Stony Brook, NY 11794-2500
Email: Amy.slep@stonybrook.edu

Project Title: Risk and Protective Factors for Partner Abuse, Child Maltreatment, & Suicidality
Project Period: 9/1/2006 – 8/31/2009

Partner abuse, child abuse and neglect, and suicidal behavior are costly occurrences in American society, in terms of both human suffering and economics. Healthy People 2010 targets all three problems for reduction. However, prevention of each of these areas is hampered by inadequate knowledge about the relative relations of risk and protective factors to the problems. The purpose of this project is to use a large (over 100,000 respondents), representative archival sample of 83 communities to provide effect sizes of risk factors at various levels (i.e., individual, family, work, and community), to test hypotheses about the buffering effects of protective factors, and use these results to create exploratory models of risk and resilience for these problems. The archival data set contains detailed assessments of suicidality, partner and child physical assaults and their impacts, partner and child emotional assaults and their impacts, and child neglectful omissions. We will test the effect sizes of risk factors using correlations, the buffering effects of protective factors using correlations and backward stepwise logistic and linear regressions, and overall models using structural equation modeling. We will use statistical packages that can appropriately estimate standard errors in a complex data set collected at 83 communities. Prevention science is guided by a five stage, recursive research cycle: (1) defining the problem and measuring its prevalence; (2) establishing risk and protective factor relations with the problem; (3) efficacy trials; (4) effectiveness trials; and (5) dissemination trials (Mrazek & Haggerty, 1994). Large gaps remain in the risk factor literature on all forms of partner abuse and child maltreatment (Slep & Heyman, 2001); very little is known at all about putative protective factor relations. Because this knowledge provides the bedrock on which to build effective prevention activities, reaching the Healthy People 2010 objectives is unlikely without improvements. This project is unique and innovative because (a) it is large enough to have very high power and low standard errors in its estimations of risk and protective factor effect sizes and additive effects; (b) it will examine risk and protective relations for injury as well as lower level behaviors (e.g., assault); (c) it will test these relations for partner and child physical abuse, partner and child emotional abuse, child neglectful omissions (lack of supervision and exposure to physical hazards), and suicidality; (d) t will examine risk and protective factors for comorbid conditions; and (e) it is large enough to examine these relations for children in different age groups.
 

Gidycz, Christine A.
Ohio University
Psychology Dept.
231 Porter Hall
Athens, OH 45701
Email: gidycz@ohio.edu

Project Title: An Investigation of a Sexual Assault Prevention Program
Project Period: 9/1/2006 – 8/31/2009

The problem to be addressed in the proposed investigation is the high rates of sexual violence on college campuses. Typically, very brief psycho educational interventions have been administered to groups of men and women, often in a mixed-sex format. Despite the inherent problems with conducting mixed-sex and brief interventions, most efforts on college campuses have utilized this format. The purpose of the proposed project is to investigate a comprehensive sexual assault prevention program for men and women, utilizing theoretically-derived interventions administered in a single-sex format. Participants will be 1,200 college students (600 men and 600 women) living in dormitories on the campus of a mid-sized university. Dorms will be randomly assigned to either the intervention dorm or the waiting-list control dorm. Interventions for men will involve a program based on a social norms model of change and the women's intervention includes the teaching of self-defense and risk reduction strategies. It is hypothesized that the intervention group men will evidence positive attitude changes as they relate to the acceptance of sexual aggression, decreases in bystander behavior, a clearer understanding of consent, more prosocial behavioral intentions, and decreases in rates of sexual perpetration over a seven-month follow-up period compared to the waiting-list control group. For the women, it is hypothesized that they will evidence
greater assertiveness in responding to threatening situations, a better understanding of risky situations, greater use of protective behaviors, increases in self-efficacy, and experience lower rates of sexual victimization over a seven-month follow-up period compared to the control group women. Analyses will be conducted using Analyses of Variance and Regression techniques. If proven effective, the program can easily be disseminated to other universities throughout the country.

Peek-Asa, Corinne
The University of Iowa
Occupational and Environmental Health
C21M GH
200 Hawkins Drive
Iowa City, IA 52242
Email: corinne-peek-asa@uiowa.edu

Project Title: Is motivational interviewing an effective intervention for women coping with IPV
Project Period: 9/1/2006 – 8/31/2009

This will be a randomized controlled clinical trial to motivate women who screen positive for IPV to develop and achieve specific goals that will help them address the violence in their lives. This intervention trial will be integrated into the setting of a busy family planning clinic in the rural Midwest. This clinic is unique in that it serves a rural population with a relatively high proportion of minority residents. The study's first aim is to evaluate the integration of IPV screening through self-administered touch-screen computer surveys from all clinic clients. IPV will be screened using the Women's Experiences with Violence (WEB), the Index of
Spousal Abuse - Physical and the Danger Assessment Screen (DAS). Based on analyses of the clinic population and the investigators experience with similar samples of Iowa women, an expected 250 women who screen positive will be recruited, randomized into the intervention (n=150) and control groups
(n=100), and will complete the study. The intervention will include a tailored domestic violence intervention that uses motivational interviewing to guide the patient towards identifying feasible goals and steps she can take to increase her self-efficacy and control over her relationship. Motivational interviewing is a client-driven communication technique that has been effective in increasing many types of health behaviors. The trained interviewer will help participants identify local resources that can help them meet their self-efficacy goals. Follow-up interviews using a CATI will be conducted at one and three months post-intervention to reinforce the intervention and assess the participants' level safety. A Safety Monitoring Committee will continuously monitor safety risks. The control group will receive usual clinic care, which includes talking with a domestic violence advocate and receiving a list of domestic violence resources. Six-months after enrollment, all participants will return to the clinic to complete a self-administered follow-up survey. The effectiveness of the intervention will be increased self-efficacy, as measured by the Domestic Violence Coping and Self-Efficacy Scale, a validated tool for use among women with a recent history of domestic abuse. The impact of the intervention be assessed as an increase in participants' readiness-to-change, and extent of their involvement in a wide variety of self-help and coping activities over the follow-up period. If successful, this screening and intervention program will be translated to other clinical settings.

Craig Anderson
Iowa State University
Department of Psychology
W112 Lagomarcino Hall
Iowa State University
Ames, IA 50011-3180
Email: caa@iastate.edu

Project Title: Center for the Study of Violence
Project Period: 9/01/05–8/31/06

Description: This grant provides core support for the Center for the Study of Violence. The objective of the Center is to improve the scientific knowledge base about factors that contribute to the development of violence-prone individuals versus factors that promote the development of healthy, productive citizens. The Center will foster collaborative research efforts across Iowa State University, and with state and federal agencies; communicate findings to citizens, communities, public policy officials, and scientists through extension, consultation, conferences, and publications; and will enhance undergraduate and graduate training for the next generation of violence researchers.

Anthony Fabio, PhD
University of Pittsburgh
Department of Neurological Surgery
Suite B400, UPMC Presbyterian
200 Lothrop Street
Pittsburgh, PA 15213
Phone: 412-648-3901
Fax: 412-648-8924
Email: fabioa@msx.upmc.edu


Project Title: Why Some Generations Are More Violent Than Others
Project Period: 9/30/04–9/29/07

Description: Violence rates fluctuate from generation to generation. Are some generations more violent than others because of differences among cohorts or variations in social and environmental factors? The aim of this project is to further the knowledge about why violence rates fluctuate. Currently, violence trends are not clearly understood, and a diversity of contrasting explanations exists, including increased prevalence in certain age cohorts (the cohort effect) and social risk factors occurring during certain periods of time (the period effect). A major reason that so many explanations exist is that the causes for violence trends are multifactorial and occur at different levels, such as the community and individual levels. The study of these various factors and levels are rooted rather independently in public health, sociology, psychology, medicine, and other disciplines. Understanding these multifactorial public health problems can be improved if the gap between various disciplines is bridged. Previous analyses have shown that cohort effects are rendered insignificant by period effects, suggesting the importance of social factors on violence trends. This research program will undertake a series of analyses culminating in the development of a second-generation model, the proposed contextual-developmental model for violence. This model will expand on the individual developmental pathways identified by Rolf Loeber by incorporating social and environmental factors. Research findings will help to integrate public health and criminal justice prevention efforts into an effective overall program that will improve on past efforts and foster development of primary, secondary, and tertiary strategies aimed at the human, environmental, and instrumental elements of violence.


Paul Smokowski, MSW, PhD
University of North Carolina
School of Social Work, Room 324-L
CD# 3550, 301 Pittsboro Street
Chapel Hill, NC 27599-3550
Phone: 919-843-8281
Fax: 919-962-0890
Email: smokowsk@email.unc.edu

Project Title: Acculturation and Health Protection in Latino Youth
Project Period: 9/30/04–9/29/07

Description: The aim of this investigation is to study acculturation, health protection, and health risk behavior in Latino adolescents residing in North Carolina and Arizona. Researchers will map modifiable risk factors that lead Latino adolescents to engage in negative health behaviors, such as alcohol, tobacco, and drug use, aggressive behavior, and suicide. Using a prospective, longitudinal design, researchers will assess these negative health behaviors in 300 Latino adolescents (150 in NC and 150 in AZ) four times over a three-year period. Mixed-methods analyses using Hierarchical Linear and Nonlinear Modeling (HLM) growth curve modeling and qualitative interview data will be used to examine how acculturation processes and health behaviors evolve over time in different environmental settings.