This study adheres to the tenets of a community based participatory research model as part of the Philadelphia Collaborative Violence Prevention Center (PCVPC). The PCVPC is an Urban Partnership Academic Center of Excellence funded by the Centers for Disease Control and Prevention which brings together academic and community partners to design, implement, and evaluate programs to enhance the resiliency of communities affected by violence (Philadelphia Collaborative Violence Prevention Center, n.d.). Three neighborhoods in West/Southwest

Philadelphia were the focus of the PCVPC because of the high crime rates, high youth homicide rates, and high numbers of juvenile arrests for drug-related offenses. These neighborhoods are predominately low-income and African American. As part of a larger cross-sectional study design examining assets and stressor in youth, a convenience sample of 110 youth was recruited from community settings and recreation centers in West/Southwest Philadelphia. The analysis presented here focuses on survey items for CVE, family functioning, self-esteem, and confrontational coping. Parental consent and youth assent were obtained. Youth responded to a paper and pen survey. The results of the larger study were intended to inform a larger primary prevention intervention trial within the PCVPC to reduce youth violence. Consistent with community based participatory research, academic and community partners collaborated every phase of the research design. The Institutional Review Board at the University of Pennsylvania approved this study.

The sample had an average age of 13.1 (sd 1.97), was 46% male, and was 96% African American. Table 1 reports descriptive statistics of key study variables.

Over 90% of the youth reported some type of CVE (victimization and/or witnessing) in their lifetime. In bivariate relationships, increased CVE was associated with: lower self-esteem (r= −.22, p=.03); increased use of confrontational coping (r= .49, p<.001); and unhealthier family functioning (r= .29, p<.01). Healthy family functioning was associated with: increased self-esteem (r= −.72, p<.001); and decreased use of confrontational coping (r=.35, p<.001). Table 2 reports the regression models for self-esteem (Model 1) and confrontational coping (Model 2).

In Model 1, controlling for age and gender, older youth and those with healthier family functioning had higher self-esteem (F=30.11, p<.001). CVE was no longer associated with self-esteem. In Model 2, healthier family functioning was associated with decreased use of confrontational coping, though increasing amounts of CVE was still associated with increased confrontational coping (F=13.25, p<.001).

Results in our sample of predominately African American youth living in environments of pervasive violence indicate that family matters. Family acts as a protective factor for self-esteem for youth exposed to increasing community violence: healthier family functioning was associated with better self-esteem. Although healthy family functioning was associated with decreased confrontational coping, CVE held greater relative importance. Confrontational coping strategies used in response to CVE such as carrying a weapon or joining a gang can be ineffective and perpetuate the cycle of violence (Rosario, Salzinger, Feldman, & Ng-Mak, 2008). Youth describe ways in which they use strategies for safety in violent communities, and honing in on healthy ways to deal with CVE is needed (Teitelman, et al., 2010). Further research is warranted to determine how to work with youth to use more positive coping strategies in response to CVE. Limitations with this analysis include the cross-sectional design and convenience sampling which affect the generalizability of results.

Examining both positive and negative domains of youth development in relationship to CVE is critical to understanding how youth are doing well while living in violent environments and provides essential information for the development of programs aimed at youth development. Psychiatric and mental health nurses working with youth exposed to varying levels of violence have the opportunity to capitalize on assets that augment healthy development. Intervening in the pathways to promote healthy self-esteem and coping skills in response to CVE is challenging yet critical. Consistent with the findings from our study, the youth violence prevention intervention trial with the PCVPC has a problem-solving, anger management component, as well as a leadership component for youth ages 10–14 (Leff, et al., 2010). Family is a point of intervention in this program, bringing in an important asset that can help augment healthy behaviors. The sustainability of violence programs is a critical goal of the PCVPC, and as such, targeting family as an asset for youth in violent environments can help to facilitate healthy outcomes in youth development that can be long-term and have a lasting impact.

The findings of this study also inform the practice of psychiatric and mental health nurses. Youth between the ages of 10–16 years are undergoing major developmental changes and when coupled with living within communities of pervasive violence, the challenges can be exacerbated. Although peer pressure assumes increasing importance as youth age, our findings reinforce that healthy (functional) families are important for healthy youth. Thus, the holistic focus of nurses on youth as members of family systems rather than a focus on the individual youth is time and effort well-spent.