PITTSBURGH, Sept. 13, 2019 - Among teen boys in urban neighborhoods with low resources, the presence of adult social support is linked to significantly fewer occurrences of sexual violence, youth violence and bullying, and to more positive behaviors, including school engagement and future aspirations, according to a new study from researchers at UPMC Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine.

The study, published today in JAMA Network Open, suggests that prevention efforts that focus on adult support can mitigate patterns of co-occurring violent behavior.

"Teen boys in urban neighborhoods are disproportionately exposed to violence and consequently are at higher risk of violence perpetration and victimization," said the study's senior author Alison Culyba, M.D., Ph.D., M.P.H., a physician at UPMC Children's Hospital and assistant professor of pediatrics at Pitt's School of Medicine. "Historically, research often has focused on a single type of violence, but our study shows that there are complex co-occurring behavior patterns and shared protective factors that we need to pay attention to."

The researchers analyzed survey data from a recently completed sexual violence prevention trial that enrolled 866 adolescent boys aged 13- to 19-years-old from lower-resource neighborhoods in the Pittsburgh region. More than three fourths of the participants self-identified as black and six percent self-identified as Hispanic.

The survey included data on 40 "risk" and 18 "protective" behaviors that were classified into one of seven categories -- youth violence, bullying, sexual and/or dating violence, violence exposure and adversities, substance use, school engagement, and career and future aspirations. The participants also rated their personal level of dependable adult social support.

When it came to the data analysis, Culyba and her colleagues took a less conventional approach. "We borrowed methods that have proven effective for large scale genetic analyses," she said.

The analysis revealed interesting patterns. Teen boys with high social support engaged in approximately eight of the 40 risk behaviors -- significantly fewer than those with low social support who engaged in around 10 risky behaviors. Those who had high social support and reported more career and future aspirations were less likely to report all types of violent behavior. In contrast, among those with low social support, school engagement was an important protective factor. Feeling happy at a school that promoted diversity was strongly correlated with fewer instances of both physical and sexual partner violence and dating abuse.

The researchers also found patterns in how different violent behaviors co-occurred. The strongest correlations were between different types of sexual violence perpetration behaviors. For example, teens who endorsed posting sexual pictures of partners were 14 times more likely to also report having coerced someone who they were going out with to have sex. On the other hand, while gang involvement was infrequently associated with violence perpetration, it was more frequently reported among those who had been exposed to sexual violence, bullying or substance use.

"Our analysis revealed how interconnected these behaviors are," said Culyba. "By creating programs that help parents and mentors support teen boys, we may be able to reduce multiple types of violence at once."

The authors caution that the study is limited in that the findings don't demonstrate causative links, and further analysis of the associations is required. "It's a starting point for beginning to understand detailed patterns of violence at a much deeper level -- and for offering new opportunities for prevention," said Culyba.

Culyba notes that the findings align with the recommendations of the Centers for Disease Control and Prevention's Connecting the Dots Initiative, which encourages prevention programs that identify and address these common underlying factors through community involvement to keep kids safe.

###

Additional authors on the study included Elizabeth Miller, M.D., Ph.D., of Pitt and UPMC Children's Hospital, and Steven Albert, Ph.D., and Kaleab Abebe, Ph.D., both of Pitt.

The study was funded by National Institutes of Health Grant T21 TR001856, Centers for Disease Control and Prevention grant U01CE002528, and the Children's Hospital of Pittsburgh Foundation.

To read this release online or share it, visit http://www. upmc. com/ media/ news/ 091319-culyba-jama [when embargo lifts].

About UPMC Children's Hospital of Pittsburgh

Regionally, nationally, and globally, UPMC Children's Hospital of Pittsburgh is a leader in the treatment of childhood conditions and diseases, a pioneer in the development of new and improved therapies, and a top educator of the next generation of pediatricians and pediatric subspecialists. With generous community support, UPMC Children's Hospital has fulfilled this mission since its founding in 1890. UPMC Children's is recognized consistently for its clinical, research, educational, and advocacy-related accomplishments, including ranking in the top 10 on the 2019-2020 U.S. News & World Report Honor Roll of America's Best Children's Hospitals. UPMC Children's also ranks 15th among children's hospitals and schools of medicine in funding for pediatric research provided by the National Institutes of Health (FY2018).

About the University of Pittsburgh School of Medicine

As one of the nation's leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.

Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region's economy. For more information about the School of Medicine, see http://www. medschool. pitt. edu .

http://www. upmc. com/ media

Contact: Arvind Suresh

Office: 412-647-9966

Mobile: 412-509-8207

E-mail: SureshA2@upmc.edu

Contact: Andrea Kunicky

Office: 412-692-6254

Mobile: 412-439-5264

E-mail: KunickyA@upmc.edu