Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Clin Child Fam Psychol Rev. 2009 Jun;12(2):127-56. doi: 10.1007/s10567-009-0051-6.
Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health, 2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children's chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research.
社区暴力被认为是一个主要的公共卫生问题(世界卫生组织,《世界暴力与健康报告》,2002 年),美国人越来越意识到,它的负面影响不仅限于市中心。然而,大多数关于长期社区暴力暴露的研究都集中在少数民族、贫困和/或犯罪猖獗的社区,而治疗和预防则侧重于暴力的实施者,而不是直接或间接成为受害者的青年。需要针对有较高接触社区暴力风险的儿童开展基于学校的治疗和预防干预措施。为此,一项名为“卓越的多种机会”(MORE)的纵向社区流行病学研究正在进行中,以解决之前研究中存在的一些方法学缺陷。这项研究旨在更好地了解儿童长期接触社区暴力对其情绪、行为、物质使用和学业功能的影响,其总体目标是确定可在预防和干预计划中针对的可变风险和保护因素。本文介绍了 MORE 项目,包括其概念基础、目标和方法,以及对治疗和预防干预措施及未来研究的意义。