Citation

Aalsma MC. JAMA Netw. Open 2019; 2(9): e1911374.

Affiliation

Adolescent Behavioral Health Research Program, Department of Pediatrics, Indiana University School of Medicine, Indianapolis.

Copyright

(Copyright © 2019, American Medical Association)

DOI

10.1001/jamanetworkopen.2019.11374

PMID

31517960

Abstract

Violence continues to be a major cause of early mortality among adolescents1 despite a proliferation of prevention efforts. There is increasing recognition that a public health approach to violence prevention is necessary. A public health approach recognizes that violence needs to be addressed holistically (eg, policy considerations, social context). Rather than focusing solely on individual risk behavior, a public health approach appropriately accounts for not only individual risk factors but also the environmental and social context in which violence occurs. A public health perspective guides prevention programming, community-based interventions, and public policy through the identification of contextual factors related to violence.2 The article by Culyba and colleagues3 helps further our understanding of a public health approach to adolescent violence by studying not only individual risk behavior of youth but also the social context in which violence occurs.

The article by Culyba et al3 assesses individual and social factors that interact among different types of violence. For instance, a variety of social context protective factors (eg, social support and school engagement) were measured. The inclusion of social context protective factors furthers a public health focus on violence prevention by simply understanding that social context matters for youth. Moreover, the authors take a novel approach to depicting co-occurrence of these variables through dendrograms and heatmaps. These visualization tools are helpful in showing how context matters when exploring patterns of violence. For example, while previous research4 has consistently shown a reciprocal association between violence perpetration and being a victim of violence, hot spots (ie, clusters of strong associations) identified by Culyba and colleagues3 did not depict this association. Instead, clustered variables showed the strongest associations among types of violence perpetration, including sexual violence, dating violence, weapon-related violence, and bullying. Interestingly, gang affiliation and delinquency (eg, school suspension) were associated more closely with being a victim of violence than other types of violence perpetration. The authors rightly point out that examining more nuanced association profiles—like those that emerged in their research—can have important implications for violence prevention efforts...

Language: en