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Escola Anna Nery

versão impressa ISSN 1414-8145versão On-line ISSN 2177-9465

Esc. Anna Nery vol.21 no.4 Rio de Janeiro  2017  Epub 07-Ago-2017 


Institutional links to cope with school violence: an exploratory study

Vínculos institucionales para el afrontamiento de la violencia escolar: un estudio exploratorio

Maria das Graças Carvalho Ferriani1 

Diene Monique Carlos1 

Andressa Janerini Oliveira1 

Michelly Rodrigues Esteves1 

José Eurípedes Martins1 

1Universidade de São Paulo. Ribeirão Preto, SP, Brasil.



Identify and analyze the institutional links of secondary schools to cope with school violence.


Qualitative, descriptive and exploratory study, based on the concept of social network. Twelve secondary school administrators and coordinators were interviewed. The links established between the schools and other institutions were mapped using minimum maps of social institutional external network and semi-structured interviews. Data were analyzed through thematic content analysis.


The category "Mapping institutional links" showed important deficiencies in the institutional links between the studied schools and other sectors to cope with school violence.


In methodological terms, the study considers social and institutional networks to cope with contemporaneous phenomena and presents important contributions to nursing, warning to current health needs of adolescents.

Keywords: Violence; Social network; School health; Nursing



Identificar y analizar los vínculos institucionales de las escuelas estaduales secundarias para el afrontamiento de la violencia escolar.


Investigación cualitativa, descriptiva y exploratoria, basado en el concepto de la red social. Se entrevistaron doce directores y coordinadores. Los vínculos que se establecen entre la escuela y otras instituciones fueron identificados empleando el Mapa Mínimo de la Red Social Institucional Externa y entrevistas semiestructuradas. Los datos fueron analizados mediante el análisis de contenido, modalidad temática.


La categoría "Mapeo de los Vínculos Institucionales" ha dado a conocer las debilidades importantes en los vínculos institucionales entre las escuelas y otros sectores para afrontar la violencia escolar.


El estudio metodológicamente se dirige a mirar a la red y otras directrices científicas para hacer frente a los fenómenos contemporáneos, y aporta importantes contribuciones a la enfermería con el fin de que identifique las necesidades actuales de la salud de los adolescentes.

Palabras clave: Violencia; Red Social; Salud Escolar; Enfermería



Identificar e analisar os vínculos institucionais das escolas estaduais de ensino médio para o enfrentamento da violência escolar.


Pesquisa de abordagem qualitativa, descritiva e exploratória, ancorada pelo conceito de rede social. Foram entrevistados 12 diretores e coordenadores pedagógicos de escolas estaduais de ensino médio. Os vínculos estabelecidos entre a escola e outras instituições foram mapeados empregando-se o Mapa Mínimo da Rede Social Institucional Externa e entrevistas semiestruturadas. Os dados foram analisados por meio da análise de conteúdo, modalidade temática.


A categoria "Mapeando os vínculos institucionais" desvelou importantes fragilidades nos vínculos institucionais entre as escolas estudadas e os demais setores para o enfrentamento da violência escolar.


O estudo metodologicamente se direciona para o olhar em rede e outras diretrizes científicas para o enfrentamento dos fenômenos contemporâneos, e traz contribuições importantes para a Enfermagem no sentido de alertar para as atuais demandas de saúde dos adolescentes.

Palavras-chave: Violência; Rede social; Saúde escolar; Enfermagem


Accidents and violence are the main public health problem among adolescents aged between 10 and 19 years old, as indicated by the World Health Organization (WHO). These are the major causes of worldwide morbidity and mortality in this population, which presents uneven distribution and higher rates in underdeveloped and developing countries.1 The WHO identifies three types of violence, according to the relationship between the victim and the author: self-inflicted, collective and interpersonal. Interpersonal violence can take place in the community environment, in which the school stands out due to the characteristics of adolescence.1

School violence is expressed in a more explicit perspective of violence, such as aggression between individuals, and in the symbolic violence that occurs by means of rules, norms and cultural habits of an unequal society.2 The latest National Survey on Students' Health (PeNSE, as per its acronym in Portuguese) showed that situations of violence experienced by adolescents have become worse. According to the PeNSE, one of ten adolescents reported feeling unsafe commuting between home and school and at school, with a higher percentage among adolescents of public schools, which are usually located in places of risk, with high rates of violence in their surrounding areas.3 School violence appears as a paradoxical problem, since school institutions should provide protection and security to adolescents, ensuring a healthy environment of individual and collective achievements and assertion to these actors.3

The WHO proposes an ecological model to understand violence, based on the evidence that no single factor can explain a greater risk to or greater protection from interpersonal violence for some people or groups. This phenomenon results from the interaction of multiple factors at individual, relational, community and social levels,1 requiring coordinated actions and interventions among different care levels that consider the aspects mentioned above. The concept of social network has been considered as a new process in opposition to traditional approaches of public policies, which are based on fragmented, punctual and compensatory actions, generating simplified and segmented interventions in the face of complex phenomena.4,5 Networks are types of social organization, for both the society and the State, which involve an intense flow of information and are structured through cooperation of autonomous units.6 The concept of network has the following characteristics: recognition of the existence and importance of the other; awareness of the actions of the other; mutual collaboration; cooperation through sharing of knowledge, actions and powers; and association with common goals and projects.4

Thus, the concept of social network is strongly associated with the current legal and scientific mechanisms to cope with school violence involving adolescents and with concepts of prevention of violence and promotion of a culture of peace. This is an emerging theme in health and nursing, due to the importance of the school institution in the life of adolescents and the serious violent incidents that occur in it involving these actors. It should be noted that adolescence is a key period in human development that enables the implementation of actions that will promote a healthy adult life.3,5

Considering that building a social network can provide a new role for the school nowadays and new mechanisms to cope with school violence, the aim of this study was to identify and analyze the institutional links of public secondary schools to cope with school violence.


Study design

This is a qualitative, descriptive and exploratory study. This approach allows to study plural social relationships experienced in the contemporaneous world, recognizing the perspectives of all participants involved in a certain phenomenon, and respecting their diversities and singularities. The particular, local and temporal context is important for a concrete and historical description of knowledge and practice systems.7

The methodological approach was based on the concept of social network.4,6

Study site

The study site was the West District of the municipality of Ribeirão Preto, in the state of São Paulo, Brazil, which has around 141,998 inhabitants, representing 22% of the total population of the municipality in 2014. This district had 18 public health units, one district basic health unit, 8 basic health units, and 9 family health units, as well as 9 public secondary and elementary schools with approximately 4,100 students. Each school had one general administrator and 2 coordinators, one coordinator for high school and one for elementary school.

Data collection and analysis

Elementary education coordinators and administrators from 6 public schools located in the West District of the municipality of Ribeirão Preto, São Paulo, were interviewed, totaling 12 social actors, called heads. All guests accepted to participate in the study once its objectives were explained and the researcher that would perform data collection was introduced.

Data collection was conducted using minimum maps of social institutional external network and semi-structured interviews, from March to June 2014. The map construction and the interviews were conducted by one of the researchers, a nursing undergraduate student, who received training on data collection techniques and conducted a pilot study before data collection. The schools were identified by letters A-F, according to the sequence of data collection. Minimum maps helped evaluate which institutions constituted the external network of the school and the quality of the links established between the school and these institutions.6 They were performed on A4 papers with the participants, and their construction took approximately 30 minutes.

Quadrants were created to analyze the minimum maps of social institutional external network, which represented the various sectors that constituted the institution, according to the specificity of each situation. The quality of the links in each sector, department or secretariat, was classified into three levels, represented graphically by means of lines: (i) significant links - continuous black line; (ii) fragile links - dotted black line; (iii) broken or nonexistent links - continuous gray line. The graphical representation of the map, at the personal and institutional levels, allows to identify the quality of the links and their distribution across the quadrants.7 The parameters obtained in the analysis of the maps are: size, density, distribution/composition, dispersion, homogeneity/heterogeneity.6

To complement data collection, semi-structured interviews were conducted using a script containing the following open-ended questions related to the quadrants of the map in construction: (a) Is the school an environment that can offer adequate security to all students? (b) Do you think there is integration between the family and the school? (c) How do you evaluate the relevance of the collective efforts from various sectors aiming to cope with school violence? The interviews, which took about one hour, were recorded in MP3 with the permission of the participants, and transcribed in full. Data were analyzed according to the method of thematic content analysis.8 The following criteria were set up for this method operationalization: pre-analysis, material exploration, and treatment of results. A comprehensive reading of the documents (map images and interview reports) was conducted to identify core ideas, from which thematic nuclei were organized. This study presents only the category "Mapping the network". Then, the relationships among data, legal provisions and the literature that addresses school violence were established. It should be noted that, besides performing a specific analysis of the minimum maps observing the criteria mentioned above, the collected information was analyzed together with the interview data.

Ethical aspects

The study protocol was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing at the University of São Paulo, on February 12, 2014, under protocol no. 528.246. Consent was requested from the participants by signing of free and informed consent forms.


Characterization of infrastructure surrounding the schools

School A was close to and kept a partnership with an important university, and on weekends, it had a partnership with a non-governmental organization (NGO). The district was created recently, and it was urbanized, but it had poor infrastructure, and simple and poorly maintained houses and no leisure areas for the population. Schools B and C were located in neighborhoods close to downtown, which had better commercial infrastructure, basic health units, and homes in better condition. Schools D, E and F were located in peripheral districts, farther from downtown, with stores, and old and poorly maintained houses. The area surrounding these schools had poor lighting. School D had classes at night as well, and it was located near an unlit square; with poor lighting as a factor favoring violence.

After analyzing data from minimum maps and interviews, the category "Mapping the institutional links" was created, and it is presented below.

Mapping the institutional links

Although they are inserted in different areas and contexts, the schools have some characteristics in common, such as expanded network, with links in all quadrants, as illustrated in Figures 1 to 3.

Figure 1 Minimum maps of social institutional external network of Schools A and B. Ribeirão Preto, 2014. 

Figure 2 Minimum maps of social institutional external network of Schools C and D. Ribeirão Preto, 2014. 

Figure 3 Minimum maps of social institutional external network of Schools E and F. Ribeirão Preto, 2014. 

For a better understanding of the results obtained, each quadrant of the map will be presented separately below. In terms of SECURITY, the administrators of all schools classified the students' security as internal and external security, the first provided by the school in its internal environment, and the second provided by the military police in patrol activities near the school. External security was considered fragile by the heads of schools A, B, C and D, significant by the heads of school E, and nonexistent by the heads of school F. The predominance of fragile links showed that there was no homogeneity in the provision of this type of service to the schools analyzed in this study.

The links with RELIGION were classified as nonexistent by the heads of schools A, C, D and F, and as fragile by the heads of the other schools. The heads of all six schools reported that the institutions did not provide religious education because they considered the school a secular institution; they also reported they did not have the help of religious groups from the local community. Despite this direct evaluation of the links with religiosity, the heads reported the presence of students whose families had religious values and noticed that these students had a different ethical behavior, acting more respectfully, even when the family's contact with religion was minor.

The results obtained for LEISURE, SPORTS and CULTURE were similar, as mentioned above. Only two of the evaluated schools reported partnerships with external cultural projects. The other schools developed only internal cultural projects, without the help of other institutions. Sports activities were limited to physical education classes, and leisure activities were limited to some tours promoted by the schools. The heads of school A reported that the institution opened on Saturdays for the "Family School" project and the work of the "Solidary Health" NGO, whereas the other schools did not have any support from external sports and leisure projects. The heads of all six schools did not mention receiving support from the municipal government to their internal or external projects.

In relation to SOCIAL CARE, the only body mentioned by the heads of the schools was the Guardianship Council, and all links were considered fragile or nonexistent. In cases of violence involving students, the heads of all six schools participating in this study reported that they first informed the student's parents and/or guardians of the event and requested their presence. When the resources used by the school were not effective, the heads contacted the Guardianship Council. In general, dissatisfaction was reported in relation to the service provided by this body, as indicated by the excerpts below:

Very slow... very slow... leaving much to be desired. (school A, 2014)

[...] we contacted the Guardianship Council.... in fact, I went there in person to present the cases. (school A, 2014)

Regarding SOCIAL CARE, the heads of the schools were dissatisfied because they were obliged to receive students who had committed serious acts of violence. In particular, they claimed the professionals working in the schools were not prepared to deal with these students, and that they were not informed in advance by the judge that they would receive such students in their units.

[...] totally. Very far from the school. When we see a social worker here it's because the judge has sent a student back to school. He doesn't even give a notice to the school. He doesn't ask how the student's learning is going, about scores... nothing. We have no feedback here. (school C, 2014)

Regarding the LEGAL area, the heads of all schools considered the links were nonexistent or fragile. The main complaint was the lack of dialog of the prosecution with the heads of the schools. In some cases, the students returned to school after a court order, but without the prosecution's prior contact with the head of the school or supervision of the situation.

The heads of schools A, B, D and E reported significant links with the HEALTH services provided by basic health units or projects developed by public and private universities located in the municipality:

Health becomes significant because of these projects... which I guess bring a lot of information about health to them [...] information that they don't have in classes... and as it comes in the form of conversation, focused, I think it is very significant. (school B, 2014)

Schools C and F reported fragile links with the health services, characterized by non-continuity of the actions performed and lack of professionals in the area, considered essential aspects in the evaluated context:

[...] I would say the relation with health care is fragile. (...) that health in school, I guess, the whole school (...) should have a psychologist, a nurse... in the school. (school C, 2014)

This study showed the schools had partnerships with UNIVERSITIES in health-related projects, particularly in the areas of nursing, nutrition and psychology. The links varied, with prevalence of fragile links, as the participants reported temporary presence of the university in the school, short-term projects, and that the themes addressed were distant from the school's reality:

[...] very distant. There are few projects here. Sometimes there are health trainees who want to develop projects, but these are distant from the school's reality. They seem to live in a totally different world. And I think that the research developed in the university is very distant from the reality, really distant. (school C, 2014)

The heads of schools A, C, D, E and F classified the link with FAMILY as fragile, and the heads of school B classified it as nonexistent. The reports of participants highlighted these issues:

[...] it doesn't enhance the student's education, it doesn't enhance the student's wellbeing, it doesn't contribute to the student's wellbeing... (school D, 2014)

The heads of all schools repeated the information above, each using one's own particularities and different words, and concluded that the distance from the family increased with the student's age. Total absence of family participation was reported in some cases where the parents or guardians did not show up when required due to acts involving the court:

We've had some cases in which you call the father and say: "Your son was in a fight, he's giving us a hard time at school...", and the father says: "I don't care... call the police!...", and he hangs up. (school D, 2014)

Another aspect indicated in this study is that new students that came from neighborhoods with recently inaugurated housing developments near school D had greater social problems and difficult relationship with classmates.


Historically and in social terms, schools are designed to fully train individuals on scientific, cultural, technical, personal and citizenship knowledge. School is one's first social group, besides the family, and in this environment the concepts of citizenship, group experience, feeling of belonging and living with differences and frustrations will be developed.3,9 Given the current contexts and experiences of children and adolescents, which is not the scope of this study, school violence has become a relevant problem in the agenda of education, health and other sectors of child and adolescent protection.

The analysis of the minimum maps of social institutional external network of schools A to F showed low density of school networks, with many fragile links and few significant links. Regarding distribution and composition, the most significant links were in health relations, and important gaps were identified, due to fragile links or absence of concrete institutional links in other sectors, especially in family links. Although the links with the sports/leisure and culture sectors were significant in some schools, the interviews indicated only punctual actions, performed only by the school, without an effective partnership with other services in these areas.

The high dispersion of the links on the maps indicated that the geographical distance between the schools and other sectors/institutions generated very fragile links. Finally, the maps showed a homogeneous network, focused on significant links with few sectors, not allowing a dialog with other institutions and sectors that are required to cope with complex phenomena, such as school violence.

The complex phenomenon of violence requires constant attention, permanent work, involvement of various social sectors and the support of the State. To make it happen, it is important to consider a polyocular view of this phenomenon, that is, a view that contextualizes, gathers, encompasses and globalizes the information to build relevant and complex knowledge of the reality. For this purpose, it is necessary to consider an object of study in its context. However, it is important to point out that the proposed contextualization is not juxtaposition, but the unveiling of the numerous relationships that constitute and allow to work in a network and perceive "the mutual relations and the reciprocal influences between the parts and the whole in a complex world".10 Based on these concepts, the links and relationships expressed by the participants will be discussed in order to understand the gaps or possibilities to cope with school violence.

Security-related actions should be developed through public policies. It is understood that security, represented symbolically by the civil and military police, is part of a network to cope with school violence, but not the only one. Media vehicles usually support this conception of using police and penitentiary policies as a response to school violence issues, disregarding the investments in social rights and the absence of the State in this context.11

Although schools were conceived as secular environments, the heads of schools confirmed that the presence of religious values in the family environment has a positive impact on the student's behavior at school; the literature reinforces that religion is a social network that supports the families of adolescents, improving even parental involvement.12

As discussed above, school violence has its factors associated with broader contexts. According to the literature, the sectors of culture, sports and leisure are effective means to fight violence. Through strategies and actions in these areas focused on a culture of peace and more positive aspects of human relations, students can build knowledge and skills as citizens who are aware of their rights and duties.5,13 One way to fight school violence is to keep a dialog between teachers and students, aiming to involve them in discussion groups, identify sources of violence, and build a friendly and trustworthy relationship among school heads, teachers and students. Hence, students will be given a voice, making part of the construction of a more affectionate and less violent environment, with the insertion of the concepts of citizenship, coexistence and culture.5,14 The literature reports that young adolescents value the rules of coexistence, request the discussion of topics related to school violence, and claim for more monitoring, more teachers in schools and stronger dialog with teachers.15

The fragility of the network when coping with school violence is evident in the area of social care. A recent Australian study highlighted that although child protection services and domestic violence care services address common situations, they had fragmented and segregated philosophies and operationalization.16 The heads interviewed in this study reported a weak relationship between the school and the Guardianship Council, confirming the findings in the literature.17 A recent study shows that this relationship is reciprocal: guardianship counselors did not mention the joint work with health and education services, sectors considered as pillars of public policies focused on children and adolescents.18 The lack of follow-up and referral of situations of vulnerability experienced by this population reinforces the distance from the legal area.17

Schools are strategic institutions for the development of joint actions with the health sector, especially for the health of children and adolescents. This relationship has been empowered by specific programs and the literature, for easy perception of the health needs of children, adolescents and their families. In Brazil, the School Health Program (PSE, as per its acronym in Portuguese), created in 2007, aims to be an intersectoral policy between health and education services at the federal, state and municipal government levels. However, this coordination is still a great challenge, despite the potential of these environments and this link; there is still a conception that the health professional should be in loco in the school area, without interdisciplinary and interinstitutional actions connecting them. A recent study that analyzed the perception of school heads on the intersectoral actions in the PSE, showed that despite having knowledge of the intersectoral work, in practice the students and the school do not participate in the prioritization and planning of the actions.19 The school context becomes a privileged environment to promote health through actions that encourage self-care and social and community participation to discuss health, illnesses and care.5

The literature is comprehensive when addressing the benefits of programs and projects focused on school health, developed in partnership with universities; this partnership represents one of the main areas for several graduate courses to be included in the university curriculum.20 However, the insertion has occurred in a fragmented way, by professional area, making it difficult to identify gaps and possible strategies to eliminate problems that are similar to those described by participants in this study, such as non-continuity of actions.

The increasing absence of the family in the school environment has been associated with the growth of school violence.21 The family environment is one of the main factors that influence the behavior of students, and the more welcoming and protective the family environment, the less frequent the expressions of violence in school.22 In addition, the physical space and geographical location of the school have a direct influence on violence rates. The likelihood of episodes of violence in the school is greater when the area surrounding the school has a violent environment, for instance, with drug trafficking, gangs, robberies and enticement of children and adolescents.3


This study showed important fragility in the institutional links between the studied schools and the other sectors to cope with school violence. This aspect is aggravated by the weak or non-existent link between the school and the family, which represents the immediate context of insertion of adolescents. Despite the limitations mainly related to the non-generalization of data, this study methodologically addresses the current scientific guidelines identified to cope with contemporaneous phenomena, such as the perspective in network, and the results obtained are in agreement with the literature of this field.

In addition, this study has important contributions to nursing, for its important role in management, care, teaching and research, and for the interdisciplinary team, taking into consideration the current demands of adolescent health: (1) development of joint actions with schools in an interdisciplinary and intersectoral perspective, based on concepts of primary care and the PSE; (2) development of strategies to bring the family closer to the life context of adolescents, especially in the school environment; (3) development of programs with other sectors to promote adolescent health, with "extramural" actions, involving prevention of or coping with experienced situations of violence, and the promotion of a culture of peace. Further studies are recommended for an in-depth analysis of this theme in the perspective of other actors, such as adolescents and their families, using participatory methodologies.


The authors thank the National Council for Technological and Scientific Development (CNPq) for the scientific initiation scholarship provided for the period of Jan. 1, 2014 to Dec. 31, 2014.


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Received: November 29, 2016; Accepted: April 19, 2017

Corresponding author: Diene Monique Carlos. E-mail:

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