Focus On Pediatrics-Violence prevention goal of educational program
Start young to avoid intervention mode
Violence is a public health problem, says Andrea Iger, LCSW, MPH, director of the violence prevention program at the Connecticut Children’s Medical Center Injury Prevention Center in Hartford. "It affects people’s well-being. It is a stress issue and physical issue whether a person is a bystander, victim, or perpetrator," she explains. It also can be expensive, with people involved in violent acts incurring huge medical bills and lost time from work.
The focus of the center is to identify ways to prevent violence and it focuses on four areas - interpersonal violence, child abuse, domestic violence, and youth suicide.
To prevent interpersonal violence, the center works with the public school system and has implemented a curriculum for first-graders called Second Step - A Violence Prevention Curriculum. (For information on this program, see source box, p. 2.) The program focuses on empathy development, problem solving, impulse control, and anger management.
"We are trying to help first-graders learn these interpersonal skills that will help them prevent violence in their life as they get older," says Iger. The center staff not only teach the children, but the teachers as well so they can continue to reinforce the lessons learned. To prevent violence, it is important to start young before kids are already violent. Otherwise, it is intervention rather than prevention, Iger adds.
In addition, parents are invited to come to the school to observe and participate. Letters usually are sent home with the children at the beginning of the program and before each unit, inviting parents to attend or contact their child’s teacher, principal, or the violence prevention curriculum instructor with questions. "The school is our access point, but we need the parent to support what the children are learning in the classroom in order for them to practice their skills at home and in school," says Iger. If the parents give their children instructions that contradict the violence prevention curriculum, the kids will do what the parents say, she explains.
Iger currently is working on obtaining a grant to see if the same curriculum is as effective with fourth- through sixth-graders. It has been proven effective in grades first through third but many believe that by the time children reach middle school, they have established their way of coping with issues such as violent confrontations. "Our program is not just educational. Our goal is to link the programs we do with research in either the way they are implemented, an evaluation of the process, or an evaluation of the results and how they affect the knowledge and behavior changes in the people that receive the information," explains Iger.
Using a variety of prevention methods
In an effort to stop domestic violence, the center is conducting a study in which parents are interviewed at pediatric visits or after delivering a baby at a local hospital to determine if their medical provider screened for domestic violence. If the study reveals that the screening does not occur as often as it should or clinicians are being judgmental in deciding whom to screen, recommendations for improvement will be made.
Domestic violence also is addressed in the center’s support of the Violence Intervention Project for Children in Hartford. The city’s program provides counselors who are dispatched by the police when they go to the scene of the crime and find that a child witnessed violence. The counselors provide support to the parents and children, educating them about post-traumatic stress disorder. The crime might be a domestic dispute, burglary, or assault.
Although the Injury Prevention Center does not have curriculum that addresses youth suicide, Iger is a member of the Connecticut Youth Suicide Advisory Board, which is part of the state’s child protection agency. The board advises the agency on training and grants pertaining to youth suicide prevention.
The violence prevention program also is part of the Greater Hartford Violence Prevention Coalition, a group of organizations that focus on violence prevention but have varied purposes. Some target domestic violence, some gun violence, others sexual assault. The goal is to bring these groups together for statewide educational efforts. In the 18 months since it was formed the group has held a legislative workshop teaching people how to use the process to stop violence.
It also hosted a safe night out program for middle school kids. To help end gun violence, the coalition organized an event that included the viewing of a national documentary, a discussion by a panel of experts on the topic, and a candlelight vigil attended by many legislators who gave speeches.
The events were quite varied, with one for kids, one for community, and another helping people understand that they have a voice, says Iger. "A lot of what we are trying to do is encourage people to get more involved in whatever it might be that they have an interest in," she says.
At the Injury Prevention center, the focus is to identify ways to prevent violence or ways to prevent unintentional injury. "We come at the topic in different ways with our programs," says Iger.
[Editor’s note: The Seattle-based Committee for Children created Second Step-A Violence Prevention Curriculum. The Second Step 1-3 kit and staff training videos cost $414. The curriculum without training materials costs $269. For more information or to order contact: Committee for Children, 2203 Airport Way S., Suite 500, Seattle, WA 98134. Telephone: (800) 634-4449 or (206) 343-1223. Fax: (206) 343-1445. Web: www.cfchildren.org.] n
For more information on the Violence Prevention Program, contact:
• The Violence Prevention Program, Connecticut Children’s Medical Center, Injury Prevention Center, 282 Washington St., Hartford, CT 06106. Telephone: (860) 545-9988. Fax: (860) 545-9975.
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