RESEARCH TEAMRESEARCH TEAMSusan Goodwin Gerberich, Ph.D.Susan Goodwin Gerberich, Ph.D.

Nancy M. Nachreiner, Ph.D.Nancy M. Nachreiner, Ph.D.

Andrew D. Ryan, M.S.Andrew D. Ryan, M.S.

Timothy R. Church, Ph.D.Timothy R. Church, Ph.D.

Patricia M. McGovern, Ph.D.Patricia M. McGovern, Ph.D.

Mindy S. Geisser, M.S.Mindy S. Geisser, M.S.

Steven J. Mongin, M.S.Steven J. Mongin, M.S.

Gavin D. Watt, B.A.Gavin D. Watt, B.A.

Denise Feda, M.S., Ph.D. CandidateDenise Feda, M.S., Ph.D. Candidate

Evette Pinder, M.P.H., Ph.D. CandidateEvette Pinder, M.P.H., Ph.D. Candidate

Starr Kelley Sage, M.P.H., Ph.D. StudentStarr Kelley Sage, M.P.H., Ph.D. Student____________________________________________________________________________________

Center for Violence Prevention and Control and Regional Injury Prevention Research CenterCenter for Violence Prevention and Control and Regional Injury Prevention Research CenterDivision of Environmental Health Sciences, School of Public HealthDivision of Environmental Health Sciences, School of Public Health

University of MinnesotaUniversity of MinnesotaMinneapolis, Minnesota USAMinneapolis, Minnesota USA

Violence in the Schools: Teachers at RiskViolence in the Schools: Teachers at Risk

ABSTRACTABSTRACT

While school violence has been identified as a problem among students, little is known about violence against teachers. A two-phase study was implemented to determine the magnitude and consequences of physical assault (PA) and non-physical violence (NPV) and risk factors for PA in randomly selected state-licensed, working kindergarten-grade 12 educators (n = 6,469). Phase 1 (mailed 12-month retrospective survey) collected information about demographics, personal characteristics, and violent occurrences and consequences; Phase 2 (mailed case-control survey) collected exposure data regarding: activities; others in the environment; school infrastructure and administration; and community socioeconomic status. Cases (n=372) reporting at least one PA were questioned about exposures in the month before and during the incident; controls (n=1,116), were questioned about exposures on a randomly selected working month from all months during the study period. Potentially confounding variables were selected for multiple logistic regression from directed acyclic graphs; re-weighting adjusted for non-response in the presence of unknown eligibility. From initial results (78% response), rates per 100 persons per year were: PA, 7.9; NPV, 38.9. Rates for the subcategories of NPV included: threat, 20.3; verbal abuse, 33.4; sexual harassment, 4.5; bullying, 11.7. Perpetrators were primarily: students, colleagues, and parents. Consequences included treatment: PA, 22%, NPV, 16%-27%; restricted activity: PA, 4%, NPV, 4%-8%; and change in work status: PA, 8%, NPV, 13%-25%. Among the NPV events, the highest percentages were for bullying. This unique study provides new knowledge that identifies the magnitude and consequences of violence experienced by teachers; identifying associated risk factors is integral to intervention development.

MINNESOTA EDUCATORS’ STUDY MINNESOTA EDUCATORS’ STUDY

CONCEPTUAL MODEL FOR WORK-RELATED VIOLENCECONCEPTUAL MODEL FOR WORK-RELATED VIOLENCE

PHYSICAL ASSAULTPHYSICAL ASSAULT

TEACHERSTEACHERSPersonal CharacteristicsPersonal Characteristics::• Demographics (gender; Demographics (gender; age; race; marital status; age; race; marital status;

socioeconomic status)socioeconomic status)• Body MassBody Mass• StressStress• Education, including Education, including specialty trainingspecialty training• Illness/injury history, Illness/injury history, including assaultsincluding assaults• Violence Violence management/conflict management/conflict resolution trainingresolution training

Work-related Work-related CharacteristicsCharacteristics• Work experienceWork experience• Job typeJob type• Workload; hours Workload; hours worked/weekworked/week• Student contact/week Student contact/week (hours; numbers)(hours; numbers)

OTHERSOTHERSCo-workersCo-workers::• Demographics (age; Demographics (age; gender; race)gender; race)• Number/types of staffNumber/types of staff• Interaction/supportInteraction/support

StudentsStudents• Demographics (age; Demographics (age; gender; race)gender; race)• Number/typesNumber/types• Mental Mental status/impairmentstatus/impairment• History of assaultive History of assaultive behaviorbehavior• • Other relevant Other relevant behaviors/activitiesbehaviors/activities

ENVIRONMENTENVIRONMENTFacilityFacility::• Type/Level/Size of SchoolType/Level/Size of School• • Area socioeconomic Area socioeconomic statusstatus• LocationLocation• • Physical design/attributes Physical design/attributes (openness; visibility;(openness; visibility; crowding; lighting;crowding; lighting; barriers; room barriers; room configurations)configurations)• Security (systems;Security (systems; personnel; access personnel; access controls; parking; controls; parking; responsiveness)responsiveness)

Administration/Administration/ManagementManagement• Administration attitudeAdministration attitude• Tolerance of violenceTolerance of violence• Support for employeesSupport for employees• Employee Employee assistance/resourcesassistance/resources• Support/resources for Support/resources for studentsstudents• Policies/protocolsPolicies/protocols

Potential for:Potential for: Strategies to Control:Strategies to Control:• • Recall biasRecall bias - 12-month recall: violent events- 12-month recall: violent events

- 1-month recall: exposures- 1-month recall: exposures- Validation substudies- Validation substudies

• • Response biasResponse bias Adjustment: nonresponse; probability of Adjustment: nonresponse; probability of eligibilityeligibility (Mongin, 2001; Horvitz and (Mongin, 2001; Horvitz and Thompson, 1952Thompson, 1952

• • MisclassificationMisclassification Rigorous development and testing of data Rigorous development and testing of data collection instruments; validation and collection instruments; validation and reliability substudies; sensitivity analyses reliability substudies; sensitivity analyses (Rothman and Greenland, 1999)(Rothman and Greenland, 1999)

• • ConfoundingConfounding Use of Directed Acyclic Graphs to select Use of Directed Acyclic Graphs to select confounders (Greenland et al., 1999)confounders (Greenland et al., 1999)

MINNESOTA EDUCATORS’ STUDYMINNESOTA EDUCATORS’ STUDYLIMITATIONSLIMITATIONS

MINNESOTA EDUCATORS’ STUDY MINNESOTA EDUCATORS’ STUDY

ACKNOWLEDGMENTSACKNOWLEDGMENTS

Support for this effort is provided, in part, by the: NationalSupport for this effort is provided, in part, by the: National Institute for Institute for Occupational Safety and Health, Centers for Disease Control and Occupational Safety and Health, Centers for Disease Control and Prevention, Department of Health and Human Services (R01 Prevention, Department of Health and Human Services (R01 OH007816); Center for Violence Prevention and Control, University of OH007816); Center for Violence Prevention and Control, University of Minnesota; Regional Injury Prevention Research Center, University of Minnesota; Regional Injury Prevention Research Center, University of Minnesota; and Zayas Graphics.Minnesota; and Zayas Graphics. The authors also wish to The authors also wish to acknowledge the support of our Advisory Consulting Team members: acknowledge the support of our Advisory Consulting Team members: Willarene Beasley; Charles Goodwin; Donald Hilts; Laura R. Langhoff; Willarene Beasley; Charles Goodwin; Donald Hilts; Laura R. Langhoff; and Joseph P. Miller.and Joseph P. Miller.

REFERENCESREFERENCES

Church TR, Yeazel MW, Jones RM, et al. A randomized trial of direct mailing of fecal occult blood tests to increase Church TR, Yeazel MW, Jones RM, et al. A randomized trial of direct mailing of fecal occult blood tests to increase colorectal cancer screening. colorectal cancer screening. Journal of National Cancer Institute Journal of National Cancer Institute . 2004; 96:770-780.. 2004; 96:770-780.

Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. American American Statistical Association Journal.Statistical Association Journal. 1952; 47:663-685. 1952; 47:663-685.

Gerberich SG, Church, TR, McGovern PM, et al. An epidemiological study of the magnitude and consequences of Gerberich SG, Church, TR, McGovern PM, et al. An epidemiological study of the magnitude and consequences of work-related violence: The Minnesota nurses’ study, work-related violence: The Minnesota nurses’ study, Occupational and Environmental Medicine.Occupational and Environmental Medicine. 2004; 61:495-503. 2004; 61:495-503.

Greenland S, Pearl J, Robins J. Causal diagrams for epidemiologic research. Greenland S, Pearl J, Robins J. Causal diagrams for epidemiologic research. Epidemiology. Epidemiology. 1999; 10:37-48. 1999; 10:37-48.

Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. American American Statistical Association Journal.Statistical Association Journal. 1952; 47:663-685. 1952; 47:663-685.

Maldonado G, Greenland S. Estimating causal effects, Maldonado G, Greenland S. Estimating causal effects, International Journal of Epidemiology.International Journal of Epidemiology. 2002; 31:422-429. 2002; 31:422-429.

Hernan MA, Hernandez-Diaz S, Werler MM, Mitchell AA. Causal knowledge as a prerequisite for confounding Hernan MA, Hernandez-Diaz S, Werler MM, Mitchell AA. Causal knowledge as a prerequisite for confounding evaluation: An application to birth defects epidemiology, evaluation: An application to birth defects epidemiology, American Journal of EpidemiologyAmerican Journal of Epidemiology. 2002; 155:176-184. . 2002; 155:176-184.

Mongin SJ. Adjustment for nonresponse in the Minnesota Nurses Study.Mongin SJ. Adjustment for nonresponse in the Minnesota Nurses Study. Division of Environmental and Division of Environmental and Occupational Health, University of Minnesota, 2001.Available at: Occupational Health, University of Minnesota, 2001.Available at: http://www1.umn.edu/eoh/NewFiles/resreports.html

WEBSITESWEBSITESDivision of Environmental Health Sciences:Division of Environmental Health Sciences: http://enhs.umn.eduhttp://enhs.umn.edu http://enhs.umn.edu/files/facultypages/gerberich.htmlhttp://enhs.umn.edu/files/facultypages/gerberich.html

Regional Injury Prevention Research Center:Regional Injury Prevention Research Center: http://enhs.umn.edu/riprc/riprc.htmlhttp://enhs.umn.edu/riprc/riprc.html

Center for Violence Prevention and Control:Center for Violence Prevention and Control: http://www1.umn.edu/cvpchttp://www1.umn.edu/cvpc

Occupational Injury Prevention Research Training Occupational Injury Prevention Research Training Program:Program: http://enhs.umn.edu/oiprtphttp://enhs.umn.edu/oiprtp

Contact:Contact:

Susan Goodwin Gerberich, PhD gerbe001@umn.eduSusan Goodwin Gerberich, PhD gerbe001@umn.edu