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Am Fam Physician. 2003;67(1):161

School violence has a significant impact on students and teachers. The following are statistics from 1998 in the United States: 43 of every 1,000 children were victims of nonfatal violent crimes at school or on their way to or from school; more than 250,000 serious violent crimes such as rape, sexual assault, and aggravated assault were reported; and 31 of every 1,000 teachers were victimized by violent crimes. Various prevention programs have been developed by schools to reduce this violence. Mytton and colleagues performed a systematic review and meta-analysis of the reported trials to evaluate the quality and effectiveness of school-based violence prevention programs in children identified as being at high risk for aggressive behavior.

Studies included in the analysis were found through a systematic review of electronic databases and bibliographies. Mytton and colleagues contacted the study authors and organizations to identify randomized trials. The settings included elementary, middle, and high schools, and the participants were children identified as being at risk for aggressive behavior. Outcome measures included violent injuries, aggressive behavior, and school and agency responses to acts of aggressive behavior.

Forty-four studies were identified, but none reported data on violent injuries. In the 28 trials that reported aggressive behaviors, the participants who were in the intervention groups showed a greater reduction in aggressive behaviors than those in the nonintervention groups. There was also a reduction in aggressive behavior when schools or agencies responded to aggressive behavior. The analysis found that there was greater effectiveness in the interventions when they were administered to older children and to mixed-sex groups rather than to boys alone.

The authors conclude that school-based violence prevention programs may reduce violent and aggressive behaviors in children who already exhibit a tendency toward such behaviors. The authors stress the need for the results of this study to be confirmed by large, high-quality trials.

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