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

Thank you