title: An analysis of inner-city students' attitudes towards violence before and after participation in the "Cradle to Grave" programme.
abstract: BACKGROUND
  Cradle to Grave (C2G), a hospital-based violence prevention programme, brings inner-city youth into an urban Level I trauma centre to follow the path of an adolescent gunshot victim from trauma bay to morgue. We hypothesised that C2G alters student attitudes towards gun violence.
  
  
  METHODS
  Eighty-eight adolescents were prospectively enrolled. With parental and student consent, students completed the Attitudes Towards Guns and Violence Questionnaire (AGVQ), a previously validated and reliable social science assessment tool. Two weeks later, the students participated in C2G. The survey was re-administered four weeks after C2G participation. AGVQ results are reported both as a total score and as a breakdown of the four component subscales. Higher AGVQ scores indicate proclivity towards violence. ANOVA compared scores with respect to demographics and type of school (public vs. charter).
  
  
  RESULTS
  C2G altered student's attitudes towards guns and violence. Of 43 public school students, total scores decreased following C2G (p=0.02). The greatest attitudinal change occurred in subscale 1, "Aggressive Response to Shame" (p<0.01). C2G failed to produce significant changes AGVQ scores in the 45 students attending a city charter school. The two groups were found to have baseline differences, with public school students showing higher baseline tendencies towards violence.
  
  
  CONCLUSIONS
  Our hospital-based programme is capable of positively impacting adolescents' attitudes towards guns and violence. This effect is most pronounced in subjects who already display increased tendencies towards violence. These results suggest that hospitals offer a unique opportunity to address the public health crisis posed by inner-city firearm violence.
authors.affiliation: Department of Surgery, Temple University Hospital and School of Medicine, Philadelphia, PA 19140, USA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Goldberg
authors.forename: Julia M
authors.initials: JM
authors.lastname: Toto
authors.forename: Heather R
authors.initials: HR
authors.lastname: Kulp
authors.forename: Michael E
authors.initials: ME
authors.lastname: Lloyd
authors.forename: John P
authors.initials: JP
authors.lastname: Gaughan
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Seamon
authors.forename: Scott P
authors.initials: SP
authors.lastname: Charles
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000374:Aggression; D001290:Attitude; D005006:Ethnicity; D005260:Female; D005389:Firearms; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015143:Philadelphia; D015397:Program Evaluation; D012381:Role Playing; D012752:Shame; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D014505:Urban Population; D014754:Violence / Q000517:prevention & control / Q000523:psychology*; D055815:Young Adult