Space-time study of youth and school violence

School violence including violence en route to and from school can make students afraid to go to school and frequently results in serious injury, with an estimated 7,397,301 youth in America receiving treatment in an emergency department between 2001-2008 for violent injuries sustained at or near school. These assaults occur in a context where the landscape that students navigate each day often includes bullying, substance use, and weapon carrying. Although many U.S. schools use metal detectors, security cameras, and security guards, these efforts have not been shown to effectively prevent violence. Understanding the locations and times when students are vulnerable to assault as they proceed through their school-day routine will identify opportunities for more targeted, evidence-based prevention strategies. We propose a mixed-methods study that employs an innovative case-time-control design with GIS-assisted activity path mapping to understand risk factors and protective factors for school assault. Subjects will be males and females (ages 12 18 years) requiring treatment at the emergency department of The Children's Hospital of Philadelphia or the Hospital of the University of Pennsylvania for an assault-related injury. Each subject will be interviewed using portable, computerized GIS technology to recreate details of the path of their activities, indoors during school and outdoors before and after, from the time they awoke in the morning up until the time they were assaulted. At the same time, each subject will be asked to describe his or her activities sequentially during that period, including companions and weapon carrying, and site-line features of each location (prospect, refuge, and escape) that indicate the subjects ability to see their surroundings clearly or the potential for someone to be concealed and hiding nearby. Each subjects path will be appended with data characterizing streets, buildings, neighborhood populations, and the weather that day. These rich secondary data will be linked by latitude and longitude coordinate and time of day to the path of each subjects activities. Doing so will produce detailed records of the individual- and environmental-level context that each subject experienced at each point over the course of their day. With this study design, mixed-effects conditional regressions will compare each subject at the time they were assaulted to times earlier in their day, thereby identifying risk and protective factors for school assault. Qualitative analyses will inform our understanding of mechanisms by which these factors operate. Then, environmental design strategies to prevent school violence can be formulated using an evidence-based approach. ca/ncf