Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Connecting the Dots to Prevent Youth ViolenceA training and outreach guide for physicians and other health professionals.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

NameDateInstitutionHealth Professional Training

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

The ProblemThe United States has the highest youth homicide and suicide rate among the wealthiest developed nations (Task Force on Violence, 1999).

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Impact of violence on healthHomicide is second leading cause of death

for youth ages 15-19 ( Cohen And Potter, 1999).

Medical costs just for firearm injuries are estimated to be $2.3 Billion a year (Cook et al, 1999).

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Impact on health

Recent research shows changes to the brain structure and chemistry following exposure to extreme violence (Niehoff, 1999).

The bright regions in these scans (at left, a top-down view of the brain; at right, a view of the brain from the back of the head) indicate greater hippocampus activity in healthy children during memory recall than in children with PTSD symptoms. (Credit: Copyright 2009: Journal of Pediatric Psychology)

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

The public health approachLike polio and other public health threats,

violence can be prevented.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

The causes of youth violence Risk Factors are personal characteristics or environmental conditions

scientifically established to increase the likelihood of problem behavior.

Protective Factors are characteristics or conditions that interact with risk factors to reduce their influence on violent behavior and may or may not have a direct effect on violence. Protective factors may exert positive effects in direct opposition to the negative effects of risk factors or by buffering individuals against the negative effects of risk factors.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Violence is learned by being victimizedApproximately 772,000 children were victims of maltreatment in 2008 (US DHHS).

Experiencing child abuse and neglect increases the likelihood of arrest as a juvenile by 53% and of committing violent crimes by 38% (Widom, 1992).

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

The 3.3 million children who witness domestic abuse each year are 15 times more likely to become victims or perpetrators of violence (Carlson, 1994; Horn, 2000).

They are also more likely to be victimized in intimate relationships as well as to become a perpetrator or victim of violence on the streets (Widom, 1992).

Violence is Learned

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Violence is learned by exposure to violent media

Studies suggest that children confronted incessantly by violent images may become immune to the horror of violence and may come to accept violence as a way to solve problems.

By the age 18, a child has seen 200,000 acts of violence on TV and other media.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Alcohol and drugs are risk factors50% of youth homicide victims have elevated blood alcohol levels. (Mann, et al, 1998; Adams et al, 1992; Prothrow-Stith, 1992).

50% of youth who commit homicide have elevated blood alcohol levels.(Mann, et al, 1998; Adams et al, 1992; Prothrow-Stith, 1992).

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

FirearmsTeenage boys are more likely to die from gunshot wounds than from all natural causes combined.

Family and friends are the primary source of guns for young people.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

A combination of factorsViolence is not the result of a single factor.

Violence is the result of the interaction of multiple individual, situational, contextual and society influences (National Youth Violence Prevention Resource Center, 2001).

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

What health care professionals can do:• Educate youth about ways to reduce risk and

increase protection.• Screen youth for risk and exposure.• Refer them to comprehensive support programs.• (Brandt, 1997; Sege et al, 2001; Cohn, 2001)

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Three Phases of the Haddon MatrixPre- Injury

Injury

Post-Injury

Prenatal careRoutine preventive careAcute care unrelated to injury from

violence.

AcuteUrgentEmergency care related to injury

from violence.(National Committee for Injury Prevention and Control, 1989)

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Post-Injury: EducateEducate parents on methods to help child avoid re-injury, and to cope with emotional trauma.

Educate young people on the same topics.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Post-Injury: AssessDocument injuries and surrounding events.Seek further psychiatric evaluation.Risk factors for re-injury:

Is conflict settled? Does person feel safe leaving health setting? Is He/she thinking about revenge? Is there a safe place to go while things cool

off?

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Post-Injury: Refer•Refer young people and families to mental health and crisis services.•Refer to long-term comprehensive services.•Notify authorities in case of abuse/ neglect or when plans for revenge warrant.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

“Invisible victims” of violenceChild witnesses to domestic violence are

victims - we often forget them.In a “cycle of violence,” many young

perpetrators have also been witness to and victims of violence.(Widom, 1992).

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Post-Injury: “invisible injuries”

Educate caregivers on emotional impact of witnessing violence and methods to help child cope.

Screen young people for exposure.Refer to comprehensive programs with

mental health services.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Three Phases of the Haddon MatrixPre- Injury

Injury

Post-Injury

Prenatal careRoutine preventive careAcute care unrelated to injury from

violence.

AcuteUrgentEmergency care related to injury

from violence.(National Committee for Injury Prevention and Control, 1989)

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Pre-Injury: EducateEducate parents on strategies to build

protective socio-emotional competencies.

Educate on the effects of media violence and ways to reduce exposure.

Educate on firearms and ways to reduce risk such as safe storage procedures.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Pre-Injury: ScreenAge-appropriate screening for risk factors

throughout child’s development.

Examples of tools for use with adolescents - FISTS:Fighting InjuriesSexThreatsSelf Defense

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Pre-Injury: ReferConnect young people who show risk and their

families to comprehensive and effective prevention programs.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Effective ProgramsEarly StartLong TermIntenseStrong Connection with Supportive AdultInvolves Many Sectors:

HEALTH CARE SCHOOLS POLICE COMMUNITY BUSINESS

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

GALVESTON TEXAS-ISLAND YOUTH PROGRAMS

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Beyond the clinicWork with schoolsWork with the community coalitions.Advocate for effective policy.

Choose Peace/Stop Violence is a community movement of concerned Broward County residents and agencies dedicated to creating safe, healthy and thriving environments for our children and families.

Discussion and ClosingSome years ago, a wise person wrote, “In violence we forget who we are.”

The tragedy of youth violence is that so many young people, who either caused violence or were themselves the victims, lost the chance to find out who they really were.

Thank you!