Canadian Injury Prevention & Control ConferenceHalifax, NS
November 1, 2005
A PILOT STUDY ON INTENTIONAL ASSAULT INJURIES IN CHILDREN
AGES 10 TO 17 YEARS, IN CANADA
Project Team:
Fahra Rajabali, MScMhairi Nolan, RNLise Olsen, BSN, MPH, PhD (cand.) Guanghong Han, PhDMariana Brussoni, PhDDorry Smith, MPH
Project objectives
• Understand the characteristics and patterns of intentional physical assault injuries among children and youth aged 10 to 17 years
• Identify how and why the assaults occurred• Examine relevant demographic variables of
the assault victims
Why this came about
• Intentional Injury Among Children and Youths at BC Children’s Hospital 1997-2001 (CHIRPP poster)
• Majority of intentional injuries were assault-related (39.5%)
• More males than females (79.7%)• 10-14 year olds (n=131)• Friday (52%) and Tuesday (45%)
Intentional injuries among children and youth visited emergency department, 1997-2001
0
20
40
60
80
100
1997 1998 1999 2000 2001
year
Inte
nti
onal
0
2000
4000
6000
8000
10000
All
Inju
ries
Assault- related Injury MaltreatmentSexual violence Self harmSuicide All Injuries
Methods
• Integrated two different methodologies of research; quantitative and qualitative
• Quantitative approach:– Aimed at better understanding the risk factors
such as age, sex, location, etc.– Data from emergency departments (CHIRPP)
• Qualitative approach:– Gather in-depth interview data from youth – Obtain a fuller account of the events leading
up to the assault
Quantitative Methods
• Emergency department data– 14 hospitals in CHIRPP– Years 1998-2002– Included
• Siblings, cousins, peers• All sports
– Excluded• Parents, relatives or caregivers, • Police, teachers and security officers
• Emergency department data
– Frequencies and percentages • Age, sex, location, cause, nature, body part,
mechanism of injury, weapons, alcohol involvement and treatment
– Chi-square and test for proportions • Test for the significance of any differences
between groups and proportions in the distribution
Quantitative Methods
Qualitative Methods
• Interview data– Open-ended qualitative interviews– Interview criteria
• Between 10 and 17 years• Presenting to B.C. Children’s Hospital
Emergency Department in 2002• Provided written permission to be
contacted for follow-up
– 7 agreed to be interviewed• CHIRPP form coded for physical assault
Qualitative Methods
• Interview data– Interviews were audio-taped – with permission– Participants described the incident in their own
words– Interview data
• Analyzed using thematic analysis (Boyatzis, 1998)• NVivo software - used to assist with the coding
process, organization of the data and identified themes
Quantitative Findings
Weekdays - 12:00pm - 1:00pm (14.3%) 3:00pm - 4:00pm (12.5%)
Weekend - 8:00pm – 10:00pm (22.1%)
Activity when assaulted -quarrel, aggression, fight or riot (55.9%)
Place of Injury Occurrence
Other home/ instituition 5%
Play and recreation area
4%
Own home/ apartment 6%
Other public area 7%
Commercial/ service area
3%
Other 1%
School 32%
Unspecified/ missing 20%
On the way to/ from school
22%
Type of Weapon Used
Stick-like objects, 7%
Sharp Objects, 4%
Others, 4%
Head, 2%
Unknown, 19%
Foot, knee, leg, 9%
Bitten - mouth, 1%
Guns - real, bb or pellets, 1%
Hand, fists, elbow, 49%
Rocks, balls, 2%
Bottles, Broken glass, 2%
Quantitative Findings
• Alcohol/drug related - common among males and youth aged 15-19 years (4.3%)
• Most common body part injured: – Head/neck (66.4%)
• required treatment, a short observation stay in the emergency room or transferred to another hospital
Qualitative Findings
• Most occurred in schools - after class and when unsupervised
• In several of the assaults - there had been previous conflicts, arguments or verbal intimidation between the students
• Some students - knew the assailant (classmates) • Non school assaults – random attacks
Qualitative Findings
• Help received - from friends, parent, coach, teachers and adult supervisors
• Bystanders - Their lack of action was quite notable in this set of interviews
• Weapons used were scissors, screwdriver and bottle
Limitations
• The hospitals participating in CHIRPP are not uniformly distributed across the country, therefore, the data are not representative of all regions in Canada.
• Complete accuracy and consistency of data cannot be assumed
• The small sample size for the interviews. • The time lag between the assault and the
interview
Recommendations for Additional Research
• School program and policies• Role of bystanders • Role of physical environment • Perception from family, peers and teachers• Gender issues• Perpetrator demographics and circumstances• Characteristics of different assault situations and their
outcomes• Sport-related assault considered separately
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