Alana M Vivolo-Kantor

• PhD, MPH
• Researcher at Centers for Disease Control and Prevention

Teen dating violence (TDV) is a significant public health problem that can have lifelong consequences. Using a longitudinal, cluster randomized controlled trial (RCT), this study examines whether the Dating Matters comprehensive prevention model, implemented in middle school, prevented TDV and negative relationship behaviors and promoted positive r...

Introduction US drug overdose deaths are at historic levels. For every fatal drug overdose, there are many more non-fatal; however, minimal nationally representative data exist on trends in the ratio of fatal to non-fatal drug overdoses and how this differs by drug type. Methods Data from the Centers for Disease Control and Prevention’s National V...

To understand trends in U.S. cannabis-involved emergency department (ED) visits (i.e., those for which cannabis use was documented in the chief complaint or a discharge diagnosis) among young persons aged <25 years during the COVID-19 pandemic, CDC used National Syndromic Surveillance Program data to examine changes in ED visits during 2019-2022. M...

The U.S. adolescent mental and behavioral health crisis is ongoing,* with high pre-COVID-19 pandemic baseline rates† (1) and further increases in poor mental health (2), suicide-related behaviors (3), and drug overdose deaths (4) reported during 2020-2021. CDC examined changes in U.S. emergency department (ED) visits for mental health conditions (M...

IntroductionTo characterize and compare opioid-only, cocaine-only, methamphetamine-only, opioid-and-cocaine exposure, and opioid-and-methamphetamine exposure and to examine clinical presentations, leading to a better understanding of overdose effects involving these drug exposures.Methods We examined drug exposures in the Toxicology Investigators C...

Synthetic opioids, including illicitly manufactured fentanyls, are driving recent increases in US overdose deaths. Beginning October 2020, the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) code for poisonings involving synthetic narcotics (T40.4X) was split into three codes: fentanyl (T40.41), tramadol (...

Background Cannabis policies are rapidly changing in the United States, yet little is known about how this has affected cannabis-associated emergency department (ED) visits. Methods We studied trends in cannabis-associated ED visits and identified differences by visit characteristics. Cannabis-associated ED visits from 2006–2018 were identified fr...

This study examined the population-based incidence of firearm homicide in the United States to identify geographic concentrations and to determine whether such concentrations have changed over time. It further examined the simultaneous associations of urbanization, poverty, and ethnicity/race with firearm homicide incidence. Using county-level data...

Purpose Emergency department (ED) syndromic surveillance and hospital discharge data have been used to detect and monitor nonfatal drug overdose, yet few studies have assessed the differences and similarities between these two data sources. Methods The Centers for Disease Control and Prevention Drug Overdose Surveillance and Epidemiology (DOSE) sy...

Importance: The coronavirus disease 2019 (COVID-19) pandemic, associated mitigation measures, and social and economic impacts may affect mental health, suicidal behavior, substance use, and violence. Objective: To examine changes in US emergency department (ED) visits for mental health conditions (MHCs), suicide attempts (SAs), overdose (OD), an...

A Correction to this paper has been published: 10.1007/s11121-020-01183-7

Background: Emerging data indicate a resurgence of availability and harms of amphetamine-type stimulant (ATS) use. This study examined ATS overdose-involved emergency department (ED) visit trends and visit characteristics associated with ATS overdose. Methods: Data from the Healthcare Cost and Utilization Project's (HCUP) 2010-2017 Nationwide Em...

Sexual violence (SV), including sexual harassment (SH), is a significant public health problem affecting adolescent health and well-being. This study extends prior research by evaluating the effectiveness of a comprehensive teen dating violence prevention model, Dating Matters, on SV and SH perpetration and victimization, inclusive of any victim-pe...

Sexual violence (SV), including sexual harassment (SH), is a significant public health problem affecting adolescent health and well-being. This study extends prior research by evaluating the effectiveness of a comprehensive teen dating violence prevention model, Dating Matters, on SV and SH perpetration and victimization, inclusive of any victim-pe...

The article “Middle School Effects of the Dating Matters® Comprehensive Teen Dating Violence Prevention Model on Physical Violence, Bullying, and Cyberbullying: a Cluster-Randomized Controlled Trial”, written by Alana M. Vivolo-Kantor, Phyllis Holditch Niolon, Lianne Fuino Estefan, Vi Donna Le, Allison J. Tracy, Natasha E. Latzman, Todd D. Little,...

Teen dating violence (TDV) is associated with a variety of delinquent behaviors, such as theft, and health- and delinquency-related risk behaviors, including alcohol use, substance abuse, and weapon carrying. These behaviors may co-occur due to shared risk factors. Thus, comprehensive TDV-focused prevention programs may also impact these other risk...

Suicide is a growing public health problem in the United States, claiming approximately 47,000 lives in 2017 (1). However, deaths from suicide represent only a small part of a larger problem because each year millions of persons experience suicidal ideation and engage in suicidal and nonsuicidal self-directed violence, both risk factors for suicide...

Few comprehensive primary prevention approaches for youth have been evaluated for effects on multiple types of violence. Dating Matters®: Strategies to Promote Healthy Teen Relationships (Dating Matters) is a comprehensive teen dating violence (TDV) prevention model designed by the Centers for Disease Control and Prevention and evaluated using a lo...

Introduction: Teen dating violence is a serious public health problem with few effective prevention strategies. This study examines whether the Dating Matters comprehensive prevention model, compared with a standard of care intervention, prevented negative relationship behaviors and promoted positive relationship behaviors. Study design: This long...

Objectives: This study prospectively examined binge drinking's effect on prosocial bystander behavior and indicators of bystander behavior: intentions to intervene, self-efficacy to intervene, and positive outcome expectancies for intervening. Participants: College men were recruited from February to April 2010. Methods: Pre- and posttest surv...

The articles included in this collection on bullying provide a wide lens through which to view this complexity.

This study examined the process by which a web-based sexual violence (SV) prevention program (i.e., RealConsent) prevents SV perpetration and increases bystander behaviors. Data from 743 college men who participated in a randomized controlled trial were analyzed. Simple and multiple-mediation models were estimated, using several theoretical constru...

Objective This paper analyzes emergency department syndromic data in the Centers for Disease Control and Prevention’s (CDC) National Syndromic Surveillance Program’s (NSSP) BioSense Platform to understand trends in suspected heroin overdose.IntroductionOverdose deaths involving opioids (i.e., opioid pain relievers and illicit opioids such as heroin...

Discrepancy stress, stress about being perceived to not conform to one’s gender role (i.e., gender role discrepancy), has demonstrated effects on risky sexual and violent behaviors. However, evidence of these effects has been limited to men and boys, neglecting the impact gender role discrepancy and discrepancy stress may have on girls. In addition...

Introduction: From 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination. Methods: Emergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016-September 2017...

We conducted systematic review and content analysis of measurement strategies related to child exposure to intimate partner violence (IPV). We searched nine electronic databases and supplementary sources for studies published between January 1984 and March 2016. Eligible studies were those that described a measurement strategy that was administered...

Gender role discrepancy (GRD), or nonconformity to socially prescribed gender roles, has been linked to a multitude of adverse mental and behavioral health outcomes. Masculine discrepancy stress (MDS), stress about being perceived not to conform to one's gender role, may explain the relationship between GRD and deleterious health outcomes. However,...

Suicide is the second leading cause of death for youth aged 11 to 15, taking over 5,500 lives from 2003 to 2014. Suicide among this age group is linked to risk factors such as mental health problems, family history of suicidal behavior, biological factors, family problems, and peer victimization and bullying. However, few studies have examined the...

Lesbian, gay, and bisexual (LGB) youth are at risk for many negative behaviors associated with teen dating violence victimization (TDVV). This study describes the prevalence of physical and sexual TDVV by sexual identity and quantifies the increased risk for TDVV among LGB youth compared with heterosexual youth. The participants for this study were...

Objectives: To compare changes over time in prevalence of school victimization among lesbian, gay, and bisexual (LGB) students compared with heterosexual students. Methods: We analyzed data from 11 Youth Risk Behavior Surveys conducted among representative samples of students in grades 9 through 12 in Massachusetts during 1995 to 2015. We used m...

INTRODUCTION: South Africa (SA) implemented the Global Youth Tobacco Survey (GYTS) four times between 1999 and 2011. Data from the four surveys indicated that downward trends in cigarette use among students may have stalled. Understanding the effect of school anti-smoking education on current smoking among students within schools and variability ac...

Teen dating violence (TDV) is unstable across dating relationships, suggesting that characteristics of the relationship could be related to TDV. Few empirical studies have examined these links. This study examined associations between relationship characteristics and TDV perpetration among teens and sex differences in those associations. Relationsh...

To combat the high rates of sexual violence on college campuses, prevention programming should be theoretically driven, persuasive, and salient, and should provide messages that counter negative normative beliefs supportive of sexual violence. We describe qualitative formative research that identifies themes as a means to inform messages and conten...

Background: Teen dating violence (TDV) negatively impacts health, mental and physical well-being, and school performance. Methods: Data from a nationally representative sample of high school students participating in the Centers for Disease Control and Prevention (CDC)'s 2013 Youth Risk Behavior Survey (YRBS) are used to demonstrate associations...

The high risk of perpetrating physical dating violence, bullying, and sexual harassment by adolescents exposed to domestic violence points to the need for programs to prevent these types of aggression among this group. This study of adolescents exposed to domestic violence examined whether these forms of aggression share risk factors that could be...

When you think about violence in the United States in recent years, it is clear that we have been transfixed by a seemingly unending series of tragedies associated with mass shootings. While those events deserve our utmost attention, what has been largely ignored is the fact that we lose an average of 12 youth 10–24 years of age to homicide each da...

Objective: This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Method: Health departments in 4 communities are partnering with middle schools in...

Exposure to adult intimate partner violence (IPV) places youth at risk for a range of outcomes, including perpetration of adolescent dating violence (ADV). However, there is variability in the effect of IPV exposure, as many youth who are exposed to IPV do not go on to exhibit problems. Thus, research is needed to examine contextual factors, such a...

This short-term longitudinal study examined whether the association between bullying perpetration and later physical dating violence perpetration and mediators of that association (via anger, depression, anxiety, and social status), varied depending on level of bullying victimization. Differences have been noted between those who bully but are not...

The Centers for Disease Control and Prevention's Division of Violence Prevention (DVP) funded eight National Academic Centers of Excellence (ACEs) in Youth Violence Prevention from 2005 to 2010 and two Urban Partnership Academic Centers of Excellence (UPACEs) in Youth Violence Prevention from 2006 to 2011. The ACEs and UPACEs constitute DVP's 2005-...

National estimates of teen dating violence (TDV) reveal high rates of victimization among high school populations. The Centers for Disease Control and Prevention's national Youth Risk Behavior Survey has provided often-cited estimates of physical TDV since 1999. In 2013, revisions were made to the physical TDV question to capture more serious forms...

Purpose: This study describes the lifetime prevalence of teen dating violence (TDV) perpetration in a sample of middle school students from high-risk urban communities and examines the relation between TDV and related cognitive and behavioral risk factors. Methods: Surveys were administered to 2,895 middle school students in four U.S. cities; 1,67...

Purpose: This study describes the lifetime prevalence of teen dating violence (TDV) perpetration in a sample of middle school students from high-risk urban communities and examines the relation between TDV and related cognitive and behavioral risk factors. Methods: Surveys were administered to 2,895 middle school students in four U.S. cities; 1,673...

Teen dating violence (TDV) has emerged as a serious public health problem that can have detrimental long-term impacts on both victims and perpetrators. Particular subgroups, such as sexual minority (e.g., gay or lesbian and bisexual) adolescents, may experience TDV at different rates from their heterosexual counterparts. Little research exists quan...

Introduction: Dating violence negatively affects the mental and physical health of youth, as well as their school performance. CDC’s 2013 national Youth Risk Behavior Survey (YRBS) included a new question on physical teen dating violence (TDV) among a nationally representative sample of U.S. high school students. This study analyzes the prevalence...

Background Bystander intervention approaches offer promise for reducing rates of sexual violence on college campuses. Most interventions are in-person small-group formats, which limit their reach and reduce their overall public health impact. Objective This study evaluated the efficacy of RealConsent, a Web-based bystander approach to sexual violen...

Much criminological research has focused on male violence and delinquency, but females are increasingly involved in similar types of violent and delinquent behavior. While rates of violence have been decreasing over the past decade, there is evidence that rates of female violence have declined at a slower pace or, in some cases, increased. Thus, it...

Youth are at high risk of suicide during adolescence. According to the National Violent Death Reporting System (NVDRS), 657 youths aged 11-15 died by suicide from 2005-2010 in 7 US states. Recently, there has been public attention on youth suicide in the media, specifically on the link between bullying and suicide. This study examines bullying-rela...

One suggested approach to preventing adolescent dating violence is to prevent behavioral precursors to dating violence, such as bullying. However, no longitudinal study has examined bullying as a behavioral precursor to dating violence. In this study, longitudinal data were used to examine (1) whether direct and indirect bullying perpetration in th...

School-based victimization has short- and long-term implications for the health and academic lives of sexual minority students. This analysis assessed the prevalence and relative risk of school violence and bullying among sexual minority and heterosexual high school students. Youth Risk Behavior Survey data from 10 states and 10 large urban school...

Bullying is one type of violence that threatens youths’ well-being. The impacts of bullying are felt by individuals, families, schools, and society and may result in youth feeling powerless, intimidated, and humiliated. Bullying occurs in many settings such as schools, after-school programs, or in a youth’s neighborhood. It emerges from an interact...

Background and objectives: Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. Methods: We sear...

Some evidence suggests that childhood emotional abuse (CEA) may serve as a risk factor for sexual violence (SV) perpetration; however, little is known about the mechanisms by which CEA may influence SV. This study examined the relationship between CEA and SV by assessing the mediating role of hostility toward women (HTW) in a sample of adjudicated...

To prevent youth violence, the GREAT Families program was implemented with a selective sample of 1,196 families of sixth-grade children from low-income schools in 4 cities making the transition to adolescence. To assess intervention effects, we used pre- and posttest data to estimate a structural model to test the hypothesis that random assignment...

This article discusses female delinquency and offending. It reviews some related literature in order to update the prevention efforts. The first section presents data on the rates and patterns of offending among girls and shows how these have developed over the years. It then studies the predictors and correlates of involvement among females that s...

Background Violence is a leading cause of death and disability for youth in the US, and it affects the health of individuals as well as entire communities. By utilizing the socio-ecological and public health models, CDC's Division of Violence Prevention (DVP) strives to prevent youth violence by building effective research-community partnerships....

Violence, including its occurrence among youth, results in considerable physical, emotional, social, and economic consequences in the US. Youth violence prevention work at the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) emphasizes preventing youth violence-related behaviors, injuries, and deaths by...

In the last 10 years, several reviews of research on violence among girls have been conducted. This research helps to determine the extent of girls' use of violence however, it has not been translated into effective prevention programs for girls. This article reviews the research on risk and protective factors associated with violence, with particu...

The Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) is committed to preventing youth violence. For the past decade, DVP has supported research on risk and protective factors associated with youth interpersonal violence and the development and evaluation of prevention programs. This commentary addresses...

Annual rates of dating violence and forced sex have increased in Kentucky over the past 5 years, yet the Kentucky Association of Sexual Assault Programs and the University of Kentucky are working to reduce this trend. CDC recently funded an evaluation of a primary prevention intervention termed Green Dot which has recently been implemented in high...

Background. Adolescent dating violence (DV) is a serious public health problem. Research has shown that adolescents are at higher risk of DV victimization than any other age group. Little is known about the role of Internet use, particularly with sexually explicit media sites, with regard to DV perpetration. Method. Data were collected from a natio...

Background: The Centers for Disease Control and Prevention (CDC), Division of Violence Prevention (DVP) funded eight National Academic Centers of Excellence (ACEs) on Youth Violence (YV) Prevention from 2005-2010. A web-based Information System (IS) was established to collect, document, and detail the variety and magnitude of ACE-related research a...

Sexual violence (SV) is a significant public health problem with multiple negative physical and emotional sequelae for both victims and perpetrators. Despite substantial research and program activity over the past 20 years, there are few programs with demonstrated effectiveness in preventing SV. As a result, the field may benefit from considering e...

Violence is a leading cause of death and disability for U.S. youth. The U.S. Centers for Disease Control and Prevention (CDC)'s Division of Violence Prevention (DVP) is committed to developing communities' capacity to engage in evidence-based youth violence (YV) prevention. We discuss the characteristics of communities that exert influence on the d...

Motor vehicle crashes are the leading cause of death among U.S. teens; a single passenger doubles the risk of fatal car crashes for teens, and 3 or more passengers increases the risk by 4-5 times. A better understanding of the relationship between teen driver's risk perceptions related to passengers and actual driving behaviors with dangerous passe...