School-Based Violence Prevention

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What is school-based violence prevention?

Universal school-based violence prevention programs provide students and school staff with information about violence, change how youth think and feel about violence, and enhance interpersonal and emotional skills such as communication and problem-solving, empathy, and conflict management. These approaches are considered “universal” because they are typically delivered to all students in a particular grade or school.[1, 2] Focus may vary among prevention programs according to the ages of the target student population, and programs may focus on either general violence or specific forms of violence such as bullying or dating violence.[3, 4]

Universal school-based violence prevention can be supported at the state level and implemented by school districts for all students at all grade levels.[1] Moving toward making universal school-based violence prevention available, in 2013 Oregon enacted a law requiring school districts to incorporate bullying prevention into existing student training programs.[5] The purpose of universal school-based violence prevention is to reduce both violence and victimization among students.[4]

What is the public health issue?

Youth violence is a serious problem that can have lasting harmful effects on victims and their families, friends, and communities.[6] Violence is the intentional use of physical force or power against another person, group, or community, with the behavior likely to cause physical or psychological harm.[7] Youth violence refers to harmful behaviors that can start early and continue into young adulthood. The young person can be a victim, an offender, or a witness to the violence. Youth violence includes aggressive, violent, disruptive and problem behaviors, among others.[8] Some violent acts—such as bullying, slapping, or hitting—can cause more emotional harm than physical harm. Others, such as robbery and assault (with or without weapons), can lead to serious injury or even death.

In a nationwide survey of high school students, about six percent reported not going to school on one or more days in the 30 days preceding the survey because they felt unsafe at school or on their way to and from school.[9] In 2014, more than 200,000 school-aged youth between the ages of 5 and 18 sustained non-fatal injuries from physical assaults, and nearly 2,000 were killed in homicides.[10] In addition to causing injury and death, youth violence affects communities by increasing the cost of health care, reducing productivity, decreasing property values, and disrupting social services.[11]

What is the evidence of health impact and cost effectiveness?

A systematic review of 53 studies found that universal school-based violence prevention programs were associated with reductions in violent behavior at all grade levels. Median relative reductions were 29 percent for high school students, seven percent for middle school students, 18 percent for elementary school students, and 32 percent for pre-kindergarten and kindergarten students.[1] The review also found that the programs appeared to be effective in reducing violent behavior among students in all school environments, regardless of socioeconomic status, race and ethnicity, or crime rate. The evidence also shows that specific programs have been associated with reductions in delinquency and alcohol and substance abuse, and improvements in academic performance.[12]

Benefit-cost analyses conducted by the Washington State Institute for Public Policy (WSIPP) on three evidence-based school violence prevention programs—Life Skills Training, the Good Behavior Game, and Promoting Alternative Thinking Strategies (PATHS)—found that they were all associated with positive benefit-to-cost ratios.[13] All three programs were rated “effective” by the National Institute of Justice.External[14] Life Skills Training—a classroom-based intervention designed for children and adolescents ages 11 to 18 that aims to reduce the risks of violence and substance use by addressing psychosocial factors associated with risky behaviors—costs $99 (in 2014 dollars) per student each year and resulted in a total benefit-to-cost ratio estimate of $15:1.[15] The Good Behavior Game—a classroom management strategy that is designed to reduce aggression among children ages 6 to 10—costs $166 (in 2014 dollars) per student each year and resulted in a total benefit-to-cost ratio estimate of $81:1.[12] PATHS—a classroom-based social-emotional learning program designed to reduce aggression and to improve self-control, interpersonal relationships, and social problem-solving skills among elementary school students—costs $354 (in 2014 dollars) per student each year and resulted in a total benefit-to-cost ratio estimate of $22:1.[16]

For questions or additional information, email healthpolicynews@cdc.gov.

  1. Community Preventive Services Task Force. School-based programs to reduce violence. 2005. Available from: School-Based Programs to Reduce ViolenceExternal. Accessed 2016 Feb 8.
  2. Farrington D, Baldry A. Individual risk factors for school bullying. Journal of Aggression, Conflict and Peace Research 2010;2(1):4–16.
  3. Hahn R, Fuqua-Whitley D, Wethington H, et al. Effectiveness of universal school-based programs to prevent violent and aggressive behavior: a systematic review. Am J Prev Med 2007;33(2):S114-S129.
  4. Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute. County health rankings & roadmaps: school-based programs to reduce violence and bullying. 2014. Available from: School-based programs to reduce violence and bullyingExternal. Accessed 2016 Feb 8.
  5. Oregon Revised Statutes, 2015 Edition, with 2016 Amendments. § 339.359: Harassment, intimidation and bullying: training programs. 2015. Available from: Harassment, Intimidation and Bullying: Training ProgramsExternal. Accessed 2017 June 6.
  6. CDC. Youth violence: prevention strategies. 2016. Available from: Youth Violence: Prevention Strategies. Accessed 2016 Jun 23.
  7. CDC. Youth violence: definitions. 2016. Available from: Youth Violence: Definitions. Accessed 2016 Jul 11.
  8. CDC. Youth violence. 2016. Available from: Youth Violence. Accessed 2016 Jun 21.
  9. Kann L, McManus T, Harris W. Youth risk behavior surveillance—United States, 2015. MMWR Surveillance Summaries 2016;65:9-10.
  10. CDC, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). 2013. Available from: Web-based Injury Statistics Query and Reporting System (WISQARS). Accessed 2017 June 6.
  11. Mercy JA, Butchart A, Farrington D, Cerdá M. Youth violence. In: The world report on violence and health. Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R., eds. Geneva (Switzerland): World Health Organization; 2002. p. 25–56.
  12. Washington State Institute for Public Policy. Good behavior game. Benefit-cost results. 2015. Available from: Good Behavior GameExternal. Accessed 2016 Feb 8.
  13. Washington State Institute for Public Policy. Benefit-cost technical documentation: Washington State Institute for Public Policy benefit-cost model. 2015. Available from: Benefit-Cost Technical Documentation: Washington State Institute for Public Policy Benefit-Cost ModelCdc-pdfExternal. Accessed 2016 Feb 8.
  14. National Institute of Justice, Office of Justice Programs. How we review and rate a program from start to finish. 2016. Available from: How We Review and Rate a Program From Start to FinishExternal. Accessed 2016 Jun 9.
  15. Washington State Institute for Public Policy. Life skills training. Benefit-cost results. 2015. Available from: Life Skills TrainingExternal. Accessed 2016 Feb 8.
  16. Washington State Institute for Public Policy. Promoting Alternative Thinking Strategies (PATHS). Benefit-cost results. 2015. Available from: Promoting Alternative Thinking Strategies (PATHS)External. Accessed 2016 Feb 8.