Reciprocal Dating Violence and Injury Occurrence Swahn et al. Table 1. Demographic characteristics of involvement in nonreciprocal versus reciprocal dating violence.1 Participant’s sex Boys Girls Participant’s Race/ethnicity Hispanic Non-Hispanic African American Non-Hispanic White Non-Hispanic Other Participant’s grade 7th 9th 11/12th 1Missing non-reciprocal/reciprocal items: 97, n=1056. 2 Pearson’s Chi-Square test of association. the national studies of family violence, about half of the cases had reciprocal violence7 and similar results were observed in the National Survey of Families and Households.8 However, there is little information about reciprocal dating violence among youth, especially with regard to the prevalence, context, or severity. Based on research with adults, reciprocity of dating violence is more likely to lead to injury outcomes.5 Accordingly, reciprocal violence may implicate different kinds of prevention and intervention strategies than those typically used.5,9,10 It is, therefore, critically important to determine the scope and prevalence of dating violence reciprocity among teens where most prevention efforts are targeted.11 METHODS The “Youth Violence Survey: Linkages among Different Forms of Violence” was administered in 2004 to all public school students enrolled in grades 7, 9, 11 and 12 in a school district in a high-risk community in the U.S. The details of the study have been described elsewhere.2-4,12,13 Briefly, the school district was identified and selected using community indicators of risk (i.e., poverty, unemployment, single-parent households, and serious crimes), was racially and ethnically diverse, and located in a city with a population of less than 250,000. This district operated 16 schools (elementary, middle, high schools, alternative schools), which all agreed to participate in the study. Within these 16 schools, all students Western Journal of Emergency Medicine 265 Volume XI, no. 3 : August 2010 No violence n 1378 1500 1257 774 667 127 821 823 1231 % 47.9 52.1 44.5 27.4 23.6 4.5 28.6 28.6 42.8 Adolescents who date (n=2,888) Any dating violence perpetration or victimization (n=1,158) Nonreciprocal dating violence Victimization Perpetration Reciprocal dating violence n 242 130 163 103 83 17 103 107 162 % 49.8 22.8 33.7 35.2 38.3 34.7 36.2 33.6 35.6 n 55 153 99 61 38 8 52 70 85 % 11.3 26.8 20.5 20.8 17.5 16.3 18.3 22.0 18.7 n 189 287 221 129 96 24 129 141 208 % 38.9 50.4 45.8 44.0 44.2 49.0 45.4 44.3 45.7 P-value2 <.0001 0.8867 0.7734 in grades 7, 9, 11, and 12 were invited to participate. Because of the high drop-out rate, students in grades 11 and 12 were grouped to produce a sufficient number of participants in the oldest of the three age groups. Data collection occurred in April 2004. Students voluntarily completed the anonymous, self-administered questionnaire in classrooms during a 40-minute class period. The questionnaire, an optically scannable booklet in multiple- choice format, was administered by field staff. Prior to data collection, active, signed, written parental permission, and student assent were required for all students under 18 years of age to participate in the study. Students 18 years of age or older provided written consent prior to participating in the survey. Parental permission forms were provided in English, Spanish, and other major languages as requested by the schools. Return of the parental permission forms by invited students was high (14% of students did not return the form), and parent and student refusals were very low (approximately 1% each). Of the 5,098 students who met eligibility criteria, 4,131 participated, yielding a participation rate of 81%: 1,491 in 7th grade (83.0%), 1,117 in 9th grade (73.4%), and 1,523 in 11th and 12th grades combined (79.0%). The study received IRB approval from the Centers for Disease Control and Prevention and ORC Macro International. Secondary analyses of the study were also approved by the local institutional review committee.