Nurses' Logs as an Evaluation Tool for School-Based Violence Prevention Programs

By Brener, Nancy D.; Krug, Etienne G. et al. | Journal of School Health, May 1997 | Go to article overview

Nurses' Logs as an Evaluation Tool for School-Based Violence Prevention Programs


Brener, Nancy D., Krug, Etienne G., Dahlberg, Linda L., Powell, Kenneth E., Journal of School Health


Violence among youth is an important public health problem in the United States, and violence in schools has become a particular concern. Results from a 1995 survey indicated that 15.5% of high school students nationwide had been involved in a physical fight on school property in the preceding 12 months, and 9.8% had carried a weapon on school property in the preceding 30 days.[1] To reduce youth violence, primary prevention programs should be developed and implemented in schools and communities. Such programs must be evaluated so that ineffective programs can be discontinued and those that most effectively prevent youth violence can be more widely implemented.

Evaluation of violence prevention programs for youth is a relatively new endeavor. In conducting such studies, researchers have used a variety of measurement tools such as student self-report instruments, classroom or playground observations of student behavior, and routinely-collected data like attendance and disciplinary records.[2-6] While the reliability and validity of some methods have been established,[7] more research is needed to develop and determine the best evaluation methods for youth violence prevention programs.

In a recent study,[8] a new tool -- school nurses' logs -- was used to evaluate a school-environment violence prevention program for elementary school students called PeaceBuilders.[R] (Use of trade names is for identification only and does not constitute endorsement by the Public Health Service or the U.S. Dept. of Health and Human Services.) PeaceBuilders[R] was developed for elementary schools (grades K-5) and fosters prosocial behavior. Activities are designed to improve daily interactions among students, teachers, administrators, support staff, and parents. Children learn five simple principles: praise people, avoid put-downs, seek wise people as advisors and friends, notice and correct hurts, and right wrongs. Children are provided with models of positive behavior, environmental cues to signal this behavior, opportunities to rehearse it, and rewards for practicing it.[9,10]

As part of a larger evaluation of the PeaceBuilders[R] program in Tucson, Arizona, the study examined nurses' logs to assess whether the program was associated with a change in visits to the school nurse. Schools had been matched on demographic factors and randomly assigned as intervention or comparison schools. Results from the preliminary investigation showed that, relative to comparison schools, the rate of injury-related visits decreased in schools with the program. In addition, the rate of fighting-related visits showed little change in the intervention schools, but increased dramatically in the comparison schools.

There are several reasons to expect that a decrease in the number of visits to the school nurse might be associated with implementation of a violence prevention program. First, such a program should reduce the number of fights, thereby reducing the number of fighting-related injuries requiring a nurse's attention. Second, various program components could reduce the incidence of unintentional injuries. For example, in PeaceBuilders[R] schools, "PeaceFeet" are placed in the hallways to show children where and in whit direction to walk, thereby making shoving and collisions less likely.[9,10] Third, it is possible that a violence prevention program that creates an environment where students receive positive reinforcement from peers, teachers, and other adults may reduce the number of nonmedical visits to the school nurse.[11-14]

Past research has demonstrated the effectiveness of using medical records for evaluating injury-prevention programs,[15] but nurses' logs apparently had not been used previously to evaluate school-based violence prevention-programs. This paper describes nurses' logs, explains how they can be used to evaluate school-based violence prevention programs, and compares the strengths and limitations of this tool with those of other tools. …

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