Five Questions With: Dr. Alison Riese

Dr. Alison Riese is an attending physician at Hasbro Children’s Hospital as a pediatrician in the division of General Pediatrics and Community Health, and a faculty member within the hospital’s Injury Prevention Center. Clinically, she runs the Hasbro Children’s Hospital Primary Care Clinic’s Urgent Care. As a researcher, her interests include youth violence, particularly increasing screening and counseling in primary care, as well as strengthening support for victims post-injury. Here she discusses a Rhode Island spring bullying prevention program sponsored by Hasbro and Dunkin’ Donuts.

PBN: Hasbro Children’s Hospital and Dunkin’ Donuts launched the 4-Safety program last fall and recently announced bullying prevention as its latest focus topic this spring. How does this program raise awareness?
RIESE:
The 4-Safety program is a partnership between Hasbro Children’s Hospital and Dunkin’ Donuts that seeks to reduce childhood and young adult injuries in Rhode Island and southeastern Massachusetts. The program focuses on a different injury topic each season, and, as you noted, bullying is the focus this spring.
The key component of the program is the 4-Safety van, which contains a large flat-screen TV, sound system, and tablet computers. The 4-Saftey program sets up at family-oriented community events and engages children and parents, using the interactive technology, games, and giveaways.
The goal for 4-Safety’s bullying prevention focus is to increase parental awareness of the high prevalence of bullying, signs that their child may be bullied or bullying others, and first steps to take. We also aim to promote actions that children can do to be an “upstander” (a bystander who may intervene on behalf of a bullying target) in their school environment.

PBN: What led you to focus in your medical career on youth violence? How is this field expanding?
RIESE:
Prior to medical school, I was a 7th and 8th grade science teacher at an inner-city grammar school. The impact that violence in the streets played in my students’ ability to function in the classroom has always stayed with me.
During my medical training, it became even more apparent how community violence impacts health in so many ways – from lacking safe places to play outside and get physical activity to the mental health effects. This spurred me to complete an injury prevention research fellowship, where I could focus on this topic further and hone my research skills.
The biggest shift in the field of youth violence is that it is now being more and more recognized as a public health issue. In the past, it was considered to be the purview of criminologists and the judicial system; however, currently, the medical and public health fields have taken notice and are weighing in. The American Academy of Pediatrics, along with numerous other overarching medical organizations, has now issued position statements and recommendations for youth violence prevention.

PBN: You recently completed a study on the impact of extracurricular studies on bullying. When will the study be published, and what are your key findings?
DR. RIESE:
I recently conducted an analysis of a large nationally-representative dataset called the National Survey of Children’s Health, examining the association between children’s extracurricular participation and bullying perpetration. We grouped school-age children into four categories: those who participated in sport activities only, non-sport activities only, sport plus non-sport activities, and no activity. It was a cross-sectional analysis, therefore cause and effect cannot be established. However, we found a significant association between extracurricular participation, specifically the combination of sports plus non-sport activities and non-sport activities alone, and decreased bullying behaviors, compared to children who do not participate in any extracurricular activities. This suggests that engagement in a variety of extracurricular activities may establish pro-social skills that could reduce bullying perpetration.
These findings were presented at the American Academy of Pediatrics National Conference in 2013 and the full journal article is currently being prepared for publication.

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PBN: How is bullying online different than bullying in person and what can parents do to protect children online?
RIESE:
One of the most significant differences between online versus in person bullying is that, with cyber-bullying, a child who is bullying can reach their target 24/7 no matter where they are, when in the past, bullying was limited to the school grounds or wherever children were congregating. Another significant difference is that cyber-bullying, when conducted using social media, allows for an even larger audience and can magnify the impact on a bullied child.
Parents should be aware that bullying is occurring frequently using technology, thus it should be on their minds when allowing their child to have or use a cell phone, tablet, or computer. Parents should supervise use of electronics and make rules about appropriate and unacceptable sites. There are controls that can be utilized to prevent inappropriate activity. Parents should also encourage their children to come to them with any concerns regarding online contact.

PBN: What techniques can doctors and parents use to elicit information from youth who might be afraid to share that they are struggling with bullying?
RIESE:
It is true that children who are being bullied often do not tell their parents or caregivers, due to a myriad of reasons including embarrassment, feeling that no one can help them, and fear of retaliation.
By regularly talking to your child about what is going on at school and other settings with peers, children may feel more comfortable sharing. Similarly, parents should ask specifically about bullying and let their child know that they are aware of its widespread presence and emphasize that they would listen and support. Never tell your child to ignore bullying or suggest that it is a normal part of growing up.
Likewise, physicians should consistently ask school-aged children about bullying as part of their well-child exams. Physicians should probe further particularly when a child lacks friends in their peer group, reports depressive symptoms, or has recurrent somatic complaints without organic cause.

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