An Ecological Approach for Reducing Violence in the Community The Incredible Years 31st Annual Cross

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An Ecological Approach for Reducing Violence in
the Community The Incredible Years31st Annual
Cross Cultural ConferenceYouth, Family and
Community ViolenceStrategies for Prevention,
Intervention and Post-Treatment Support

• Dianna Inman, MS, APRN, CPNP
• Instructor College of Nursing
• Medical University of South Carolina

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Overview of Youth Violence
The intentional use of physical force or power,
threatened or actual, exerted by or against
children, adolescents or young adults, ages
10-29, which results in or has a high likelihood
of resulting in injury, death, psychological
harm, maldevelopment, or deprivation. Mercy
et al. 2002
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Individual Protective Factors

• Intolerant attitude toward deviance
• High IQ or high grade point average
• Religiosity

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Family Protective Factors

• Connectedness to family or adults outside of the
  family.
• Ability to discuss problems with parents
• Perceived parental expectations about school
  performance are high
• Frequent shared activities with parents
• Consistent presence of parent during at least one
  of the following when awakening, when arriving
  home from school, at evening mealtime, and when
  going to bed
• Involvement in social activities

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Peer/School Protective Factors

• Commitment to school
• Involvement in social activities

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Risks Factors for Youth

• Low socioeconomic status
• Poor parental supervision
• Harsh and erratic discipline
• Delinquent peers

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Delinquent Youth

• Drug abuse
• Difficulties at school
• Mental health problems
• CBCL clinically significant behaviors
• Help socialize other potential delinquents

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Early Aggression

• Most significant social behavior characteristic
  to predict delinquent behavior before age 13

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Ecologic framework used to categorize risk
factors for delinquency and violent behavior
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Healthy People 2010 Objectives

• Injury prevention
• Violence and Abuse prevention

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My Story

• PNP practice in a University Based Clinic
  evaluating children with Developmental and
  Behavioral Problems
• HRSA Extension Grant for SBC to provide Mental
  Health Services

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Year 1

• Established Developmental/Behavioral Clinic
• Transitioned from University practice to school
  based practice

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Year 2 School personnel

• Stressed, Overwhelmed, Immobilized
• Change in Principal in the middle of the school
  year. Assistant Principal transferred to another
  school in the Spring
• Poor teacher retention rate
• 2007 - New Assistant Principal left within 8
  weeks of school.
• (3) Fifth grade teachers have left since the
  beginning of the school year

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Teacher Survey Spring 2007

• 668 office referrals written
• 208 were due to physical aggression
• 301 due to defiance/disrespect, insubordination
  and non-compliance
• Misbehavior interfered with instruction 50 of
  the time
• Teachers identified- need more training in
  classroom management

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Observations in classroom

• One student can disrupt the entire classroom
• Teachers reinforced negative behaviors

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Searching for Evidenced Based Programs
The Incredible Years Program
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References

• Krug,E.G., Mercy, J.A., Dahlberg, L.L., Zwi, A.B.
  (2002). The world report on violence and health.
  The Lancet. Vol. 360 pp. 1083-1088.
• Hahn RA, Fuqua-Whitley DS, Lowy J. Et al.
  Effectiveness of universal school-based program
  to prevent violent and aggressive behavior A
  systematic review. American Journal of Preventive
  Medicine 2007 33 (supp2) S114-S129
• CDC MMWR (2007). The effectiveness of Universal
  School-Based Programs for the Prevention of
  Violent and Aggressive Behavior. Vol. 56.
• www.incredibleyears.com
• U.S. Department Health Human Services. (2001).
  Mental Health Culture, Race, and Ethnicity- A
  Supplement to Mental Health A report of the
  Surgeon General., MD U.S. Department Health
  Human Services, Public Health Service, Office of
  the Surgeon General.