Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model

HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and "pop-up" street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team's experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related "space" as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming.

Prime and prejudice: The effect of priming context and prejudicial attitudes on post-traumatic stress disorder symptoms following immigrant violence

The recent arrival of immigrants into many western countries has become common. Clashes between immigrants and local residents may produce acts of violence. In two studies we assessed post-traumatic stress disorder (PTSD) symptoms in local residents exposed to immigrant violence, while addressing possible effects of priming context and prejudicial attitudes. In Study 1, context was either reminiscent/non-reminiscent of experiencing African immigrant violence (researcher with same/different ethnic origin to that of perpetrators). In Study 2, context was manipulated as a negative ("illegal-migrant") or neutral ("working-immigrant") framing for African immigrants. We also examined if effects of context on trauma symptoms are moderated by prejudicial attitudes towards African immigrants. As expected, higher PTSD symptom levels were evident in the presence of traumatic (Study 1) and negative (Study 2) context, yet only in residents with high prejudicial attitudes. Results suggest that both contexts and prejudice play a role in assessment of PTSD stemming from cultural conflicts. Theoretical implications of the data in terms of PTSD memory theories, are discussed including the notion of a PTSD context theory. Practical implications pertaining to the potential compatibility of researchers and therapists with trauma victims are also addressed.

Evidence for arrogance: On the relative importance of expertise, outcome, and manner

Arrogant behavior is as old as human nature. Nonetheless, the factors that cause people to be perceived as arrogant have received very little research attention. In this paper, we focused on a typical manifestation of arrogance: dismissive behavior. In particular, we explored the conditions under which a person who dismissed advice would be perceived as arrogant. We examined two factors: the advisee's competence, and the manner in which he or she dismissed the advice. The effect of the advisee's competence was tested by manipulating two competence cues: relative expertise, and the outcome of the advice dismissal (i.e., whether the advisee was right or wrong). In six studies (N = 1304), participants made arrogance judgments about protagonists who dismissed the advice of another person while the advisees' relative expertise (compared to the advisor), their eventual correctness, and the manner of their dismissal were manipulated in between-participant designs. Across various types of decisions and advisee-advisor relationships, the results show that less expert, less correct, and ruder advisees are perceived as more arrogant. We also find that outcome trumps expertise, and manner trumps both expertise and outcomes. In two additional studies (N = 101), we examined people's naïve theories about the relative importance of the aforementioned arrogance cues. These studies showed that people overestimate the role of expertise information as compared to the role of interpersonal manner and outcomes. Thus, our results suggest that people may commit arrogant faux pas because they erroneously expect that their expertise will justify their dismissive behavior.

Far from fairness: Prejudice, skin color, and psychological functioning in Asian Americans

OBJECTIVES

We explored the moderating role of observed skin color in the association between prejudice and concurrent and lagged psychological functioning (i.e., depression, ingroup/outgroup psychological connectedness). We further aimed to understand gender differences in these processes.

METHOD

Data from 821 Asian American undergraduate students (57.5% female and 42.5% male) were drawn from the National Longitudinal Survey of Freshman. Cross-sectional and longitudinal regression-based moderation models were conducted with PROCESS 2.13 for SPSS.

RESULTS

Lighter skin color nullified the association between prejudice and recent depression for Asian American females. This moderating effect did not hold over time with regards to depression symptoms 1 year later. Additionally, prejudice predicted psychological distance to other Asian students 1 year later among females rated as lighter in skin color, whereas prejudice was tied to psychological closeness for females with darker skin ratings.

CONCLUSIONS

Results highlight skin color as a pertinent factor relevant to the short-term and long-term mental health and social experiences of Asian American women in particular. (PsycINFO Database Record

When does activating diversity alleviate, when does it increase intergroup bias? An ingroup projection perspective

The question how intergroup bias can be alleviated is of much theoretical and practical interest. Whereas diversity training and the multiculturalism ideology are two approaches prominent in practice, most theoretical models on reducing intergroup bias are based on social-identity theory and self-categorization theory. This social-identity perspective assumes that similar processes lead to intergroup bias in very different intergroup contexts if people identify with the respective social groups. A recent prominent model based on these theories is the ingroup-projection model. As this model assumes, an ingroup’s norms and standards are applied to outgroups included in a common superordinate category (this is called ingroup projection). Intergroup bias results because the outgroup fulfils these norms and standards less than the ingroup. Importantly, if the diversity of the superordinate category is induced as the norm, ingroup projection and thus intergroup bias should be reduced. The present research delineates and tests how general this process is. We propose that ingroup prototypicality is not only an outcome variable, as the ingroup-projection model originally assumes, but can also be an important moderator. We hypothesize that for members considering their ingroup highly prototypical (“pars pro toto”, large majorities), the superordinate group’s diversity may question their ingroup’s position and thus elicit threat and intergroup bias. In contrast, for members who consider their group as less prototypical (one among several, or “una inter pares” groups), activating diversity should, as originally assumed in the ingroup-projection model, reduce intergroup bias. Three experiments (total N = 345) supported these predictions in the contexts of groups defined by gender or nationality. Taken together, the ingroup-projection model can explain under which conditions activating superordinate-category diversity induces tolerance, and when it may backfire. We discuss in how far the ingroup-projection model can integrate conflicting findings on the multiculturalism ideology.

Empathy and moral emotions in post-apartheid South Africa: an fMRI investigation

Moral emotions elicited in response to others' suffering are mediated by empathy and affect how we respond to their pain. South Africa provides a unique opportunity to study group processes given its racially divided past. The present study seeks insights into aspects of the moral brain by investigating behavioral and functional MRI responses of White and Black South Africans who lived through apartheid to in- and out-group physical and social pain. Whereas the physical pain task featured faces expressing dynamic suffering, the social pain task featured victims of apartheid violence from the South African Truth and Reconciliation Commission to elicit heartfelt emotion. Black participants' behavioral responses were suggestive of in-group favoritism, whereas White participants' responses were apparently egalitarian. However, all participants showed significant in-group biases in activation in the amygdala (physical pain), as well as areas involved in mental state representation, including the precuneus, temporoparietal junction (TPJ) and frontal pole (physical and social pain). Additionally, Black participants reacted with heightened moral indignation to own-race suffering, whereas White participants reacted with heightened shame to Black suffering, which was associated with blunted neural empathic responding. These findings provide ecologically valid insights into some behavioral and brain processes involved in complex moral situations.

Demographic Differences in PrEP-Related Stereotypes: Implications for Implementation

Qualitative interviews about pre-exposure prophylaxis (PrEP) stereotypes were conducted with a subsample of 160 MSM who participated in a PrEP messaging study. Negative stereotypes about PrEP users were identified by 80 % of participants. Two types of stereotypes were most common: PrEP users are HIV-infected (and lying about it), and PrEP users are promiscuous and resistant to condom use. Participants' identification of these stereotype categories differed significantly by demographic factors (i.e., race/ethnicity, education). Expanding access to PrEP requires recognizing potential differences in the experience or anticipation of PrEP-related stereotypes that might impact willingness to discuss PrEP with providers, friends, or partners.

Looking the part (to me): effects of racial prototypicality on race perception vary by prejudice

Less racially prototypic faces elicit more category competition during race categorization. Top-down factors (e.g. stereotypes), however, affect categorizations, suggesting racial prototypicality may enhance category competition in certain perceivers. Here, we examined how prejudice affects race category competition and stabilization when perceiving faces varying in racial prototypicality. Prototypically low vs high Black relative to White faces elicited more category competition and slower response latencies during categorization (Experiment 1), suggesting a pronounced racial prototypicality effect on minority race categorization. However, prejudice predicted the extent of category competition between prototypically low vs high Black faces. Suggesting more response conflict toward less prototypic Black vs White faces, anterior cingulate cortex activity increased toward Black vs White faces as they decreased in racial prototypicality, with prejudice positively predicting this difference (Experiment 2). These findings extend the literature on racial prototypicality and categorization by showing that relative prejudice tempers the extent of category competition and response conflict engaged when initially perceiving faces.

Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care

The authors propose reinvigorating and extending the traditional social history beyond its narrow range of risk behaviors to enable clinicians to address negative health outcomes imposed by social determinants of health. In this Perspective, they outline a novel, practical medical vulnerability assessment questionnaire that operationalizes for clinical practice the social science concept of "structural vulnerability." A structural vulnerability assessment tool designed to highlight the pathways through which specific local hierarchies and broader sets of power relationships exacerbate individual patients' health problems is presented to help clinicians identify patients likely to benefit from additional multidisciplinary health and social services. To illustrate how the tool could be implemented in time- and resource-limited settings (e.g., emergency department), the authors contrast two cases of structurally vulnerable patients with differing outcomes. Operationalizing structural vulnerability in clinical practice and introducing it in medical education can help health care practitioners think more clearly, critically, and practically about the ways social structures make people sick. Use of the assessment tool could promote "structural competency," a potential new medical education priority, to improve understanding of how social conditions and practical logistics undermine the capacities of patients to access health care, adhere to treatment, and modify lifestyles successfully. Adoption of a structural vulnerability framework in health care could also justify the mobilization of resources inside and outside clinical settings to improve a patient's immediate access to care and long-term health outcomes. Ultimately, the concept may orient health care providers toward policy leadership to reduce health disparities and foster health equity.

Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults

BACKGROUND

Discrimination promotes multisystem physiological dysregulation termed allostatic load, which predicts morbidity and mortality. It remains unclear whether weight-related discrimination influences allostatic load.

PURPOSE

The aim of this study was to prospectively examine 10-year associations between weight discrimination, allostatic load, and its components among adults 25-75 years in the Midlife Development in the US Biomarker Substudy.

METHODS

Participants with information on weight discrimination were analyzed (n=986). At both timepoints, participants self-reported the frequency of perceived weight discrimination across nine scenarios as "never/rarely" (scored as 0), "sometimes" (1), or "often" (2). The two scores were averaged and then dichotomized as "experienced" versus "not experienced" discrimination. High allostatic load was defined as having ≥3 out of 7 dysregulated systems (cardiovascular, sympathetic/parasympathetic nervous systems, hypothalamic pituitary axis, inflammatory, lipid/metabolic, and glucose metabolism), which collectively included 24 biomarkers. Relative risks (RR) were estimated from multivariate models adjusted for sociodemographic and health characteristics, other forms of discrimination, and BMI.

RESULTS

Over 41% of the sample had obesity, and 6% reported weight discrimination at follow-up. In multivariable-adjusted analyses, individuals who experienced (versus did not experience) weight discrimination had twice the risk of high allostatic load (RR, 2.07; 95 % CI, 1.21; 3.55 for baseline discrimination; 2.16, 95 % CI, 1.39; 3.36 for long-term discrimination). Weight discrimination was associated with lipid/metabolic dysregulation (1.56; 95 % CI 1.02, 2.40), glucose metabolism (1.99; 95 % CI 1.34, 2.95), and inflammation (1.76; 95 % CI 1.22, 2.54), but no other systems.

CONCLUSIONS

Perceived weight discrimination doubles the 10-year risk of high allostatic load. Eliminating weight stigma may reduce physiological dysregulation, improving obesity-related morbidity and mortality.

Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. adults

OBJECTIVE

Obesity has been shown to increase risk of depression. Persons with obesity experience discrimination because of their body weight. Across 3 studies, we tested for the first time whether experiencing (perceived) weight-based discrimination explains why obesity is prospectively associated with increases in depressive symptoms.

METHOD

Data from 3 studies, including the English Longitudinal Study of Ageing (2008/2009-2012/2013), the Health and Retirement Study (2006/2008-2010/2012), and Midlife in the United States (1995/1996-2004/2005), were used to examine associations between obesity, perceived weight discrimination, and depressive symptoms among 20,286 U.S. and U.K. adults.

RESULTS

Across all 3 studies, Class II and III obesity were reliably associated with increases in depressive symptoms from baseline to follow-up. Perceived weight-based discrimination predicted increases in depressive symptoms over time and mediated the prospective association between obesity and depressive symptoms in all 3 studies. Persons with Class II and III obesity were more likely to report experiencing weight-based discrimination, and this explained approximately 31% of the obesity-related increase in depressive symptoms on average across the 3 studies.

CONCLUSION

In U.S. and U.K. samples, the prospective association between obesity (defined using body mass index) and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination. (PsycINFO Database Record

Stigma toward psychosis and its formulation process: prejudice and discrimination against early stages of schizophrenia

BACKGROUND

Stigma toward psychosis can prevent social attendance and help-seeking behavior. Early detection and intervention has been shown to improve patient outcome in schizophrenia. The aim of this study was to reveal the characteristics and formulation process of stigma toward each clinical stage of schizophrenia, taking people's backgrounds into consideration.

METHODS

The participants consisted of three groups: general public, patients with mental illness, and psychiatric professionals. We performed a survey examining stigmas toward people with psychotic-like-experiences (PLE), at-risk mental state for psychosis (ARMS), schizophrenia, or depression. Prejudice was measured using a 21-item questionnaire, and discrimination was measured using the Social Distance Scale.

RESULTS

The participants consisted of 149 people from the general public, 97 patients, and 119 psychiatric professionals. Generally, a similar pattern was observed among the groups in which prejudice and discrimination against PLE was mildest, followed by that against ARMS and depression, and finally schizophrenia. When the stigma of the general public was compared with that of psychiatric professionals, the prejudice and discrimination against PLE of the general public were both lower than those of the psychiatric professionals. However, the prejudice of the general public was stronger than that of the professionals for ARMS. Furthermore, the discrimination of the general public was stronger than that of the professionals for schizophrenia.

CONCLUSIONS

The stigmas of mental illness differed according to the clinical stage, although the pattern of severity was similar among the three groups. A formulation process is suggested in which stigma toward schizophrenia develops from an attitudinal property (prejudice) against ARMS and a behavioral property (discrimination) against schizophrenia.

Perceptions of mistreatment among trainees vary at different stages of clinical training

BACKGROUND

Mistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training.

METHODS

Based on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests.

RESULTS

Four hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect.

CONCLUSIONS

Perceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon.

[Violence and discrimination in the workplace. The effects on health and setting-related approaches to prevention and rehabilitation]

Violence in the workplace is a widespread problem that manifests itself in very different forms. The consequences for victims and companies are equally diverse. Sexual harassment is a special form of violence at the workplace. Violence may come from external perpetrators (attacks on cashiers) or from persons inside a company or establishment (colleagues, patients, people in care). Statutory accident insurance institutions in Germany (UV, "Unfallversicherungsträger") receive approximately 16,000 occupational injury reports per year that resulted from violence and led to extended incapacity to work. The numbers are increasing steadily. Particularly affected by violence are people working in healthcare and social welfare. Both psychological and physical violence can lead to severe disorders such as post-traumatic stress disorder (PTSD). To avoid violence, technical, organisational, and personal protective measures are needed. The training of de-escalation officers in the areas affected can be helpful. For victims of psychological and physical violence in the workplace, the UV offers special psychotherapeutic support and recommends the training of first-aiders.

Negotiating Violence in the Context of Transphobia and Criminalization: The Experiences of Trans Sex Workers in Vancouver, Canada

A growing body of international evidence suggests that sex workers face a disproportionate burden of violence, with significant variations across social, cultural, and economic contexts. Research on trans sex workers has documented high incidents of violence; however, investigations into the relationships between violence and social-structural contexts are limited. Therefore, the objective of this study was to qualitatively examine how social-structural contexts shape trans sex workers' experiences of violence. In-depth semistructured interviews were conducted with 33 trans sex workers in Vancouver, Canada, between June 2012 and May 2013. Three themes emerged that illustrated how social-structural contexts of transphobia and criminalization shaped violent experiences: (a) transphobic violence, (b) clients' discovery of participants' gender identity, and (c) negative police responses to experiences of violence. The findings demonstrate the need for shifts in sex work laws and culturally relevant antistigma programs and policies to address transphobia.

Weight Bias: A Systematic Review of Characteristics and Psychometric Properties of Self-Report Questionnaires

BACKGROUND

People living with overweight and obesity often experience weight-based stigmatization. Investigations of the prevalence and correlates of weight bias and evaluation of weight bias reduction interventions depend upon psychometrically-sound measurement. Our paper is the first to comprehensively evaluate the psychometric properties, use of people-first language within items, and suitability for use with various populations of available self-report measures of weight bias.

METHODS

We searched five electronic databases to identify English-language self-report questionnaires of weight bias. We rated each questionnaire's psychometric properties based on initial validation reports and subsequent use, and examined item language.

RESULTS

Our systematic review identified 40 original self-report questionnaires. Most questionnaires were brief, demonstrated adequate internal consistency, and tapped key cognitive and affective dimensions of weight bias such as stereotypes and blaming. Current psychometric evidence is incomplete for many questionnaires, particularly with regard to the properties of test-retest reliability, sensitivity to change as well as discriminant and structural validity. Most questionnaires were developed prior to debate surrounding terminology preferences, and do not employ people-first language in the items administered to participants.

CONCLUSIONS

We provide information and recommendations for clinicians and researchers in selecting psychometrically sound measures of weight bias for various purposes and populations, and discuss future directions to improve measurement of this construct.

Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less

AIM

Currently, health care professionals plead for stabilization of weight and improving health conditions rather than focusing on weight loss only. Individuals with obesity have been shown to report weight loss goals that are much higher than what has been suggested by guidelines. The aim was to determine whether weight discrimination and body dissatisfaction have an impact on how much weight an individual with obesity wants to lose.

METHODS

In this representative telephone survey, 878 participants with obesity were asked about their experiences with weight stigma, their body image concerns, and about the amount of weight they would like to weigh using random digital dialing and Kish selection grid to ensure random selection of participants.

RESULTS

Regression analysis reveals that being female, having a higher BMI, being younger, and trying to lose weight was related to a greater discrepancy between current weight and desired weight. The discrepancy between current weight and desired weight was greater when participants reported discrimination due to their weight as well as internalized stigma and body image concerns.

CONCLUSION

Independent on the weight loss method, treating obesity should include realistic weight loss goals without being affected by social pressure or weight stigma, especially since stigma can result in further weight gain and decline health issues related to obesity and overweight.

An injection of confidence: Scientists explore new and old methods to counter anti-vaccine propaganda and overcome vaccine hesitancy so as to increase vaccination rates

An increasing number of people are declining to have their children vaccinated. What are the reasons for their hesitancy and what could be done to convince them of the safety of vaccines?

Framing and source effects on White college students' reactions to racial inequity information

OBJECTIVES

This study addressed: (a) Do professors' race/ethnicity and the race-related inequity information they present influence students' evaluations of the professors, acknowledgment of racial inequity, or motivation to respond without prejudice (MRWP)? (b) Do collective guilt and students' evaluations of professors mediate these relationships?

METHOD

White American undergraduate students (N = 614, 66.3% females, 64.7% first year, mean age of 19.3 years [age SD = 1.5]) completed an anonymous online survey. Students imagined they were taking a racial diversity course with either a Black or a White male professor who presented either White privilege or Black disadvantage statements. Participants then completed surveys that assessed their evaluations of the professor, collective guilt, beliefs regarding racial inequity, and MRWP.

RESULTS

Students evaluated White professors as having lower expertise, learning conduciveness, and warmth/intelligence but rated Black professors as more biased. Consistent with the inequality-framing model, intergroup sensitivity effect (ISE), and findings from prejudice confrontation research, White professors induced greater acknowledgment of racial inequity when they discussed White privilege rather than Black disadvantage. But, Black professors induced more external MRWP when they presented White privilege rather than Black disadvantage. Students' perceptions of the professors' warmth/intelligence determined the effectiveness of the inequity message while perceptions of the professors' expertise, judgmental, and conduciveness to learning determined students' concerns about appearing prejudiced.

CONCLUSIONS

The presenters' race/ethnicity and how they frame racial inequity information affect students' evaluation of the presenters, the message effectiveness, and students' external MRWP. (PsycINFO Database Record

Structural Violence in Health Care: Lived Experience of Street-Based Female Commercial Sex Workers in Kathmandu

Thirty-five in-depth, semi-structured interviews were conducted with female, street-based, commercial sex workers in Kathmandu, Nepal. The framework of structural violence guided this study in identifying the structural context that impacts the female sex workers' lives and may cause harm to their health. Structural violence in health care was revealed through thematic analysis as (a) discrimination, (b) forced choice, and (c) limitations to health information sources. Lived experiences highlight how the sex workers engaged with structural limitations in health care access, services, and utilization. Structural violence conveys a message about who is entitled to health care and what a society emphasizes and expects regarding acceptable health behavior. Examining the structural violence highlighted how the sex workers negotiated, understood, and engaged with structural limitations in health care access, services, and utilization.

School Indicators of Violence Experienced and Feeling Unsafe of Dutch LGB Versus Non-LGB Secondary Students and Staff, 2006-2010

Gender and sexual orientation are expressed in heterosexual, lesbian (L), gay (G), bisexual (B), transgender (T), or queer (Q) interests and behavior. Compared with heterosexual persons, LGBTQ persons seem to experience more antisocial behavior, including negative discrimination and violence. To assess differences in LGBTQ-related discrimination in schools, the question for this research is "Do the degrees of violence experienced and feeling unsafe of LGBTQ students and staff in a school differ from those of non-LGBTQ students and staff in the same school?" Secondary analysis was carried out on data from a Dutch national digital monitor survey on safety in secondary schools. In 2006, 2008, and 2010, participation amounted to 570 schools, 18,300 teaching and support staff, and 216,000 students. Four indicators were constructed at the school level: two Mokken Scale means assessing severity of violence experienced and two Alpha Scale means assessing feeling unsafe. Analysis of mean differences showed that LGB students experienced more violence and felt less safe than non-LGB students; LGB staff felt less safe in school than non-LGB staff. When LGB students experienced more violence at school than non-LGB students, LGB students also felt less safe than non-LGB students for all 3 years. No such relationships existed for LGB staff, or between LGB staff and LGB students. No significant relationships were found between the four LGB school indicators and contextual school variables. The outcomes and uniqueness of the study are discussed. Recommendations are made to improve assessment and promote prosocial behavior of students and staff in schools.