National Academic Centers of Excellence in Youth Violence Prevention:Working with Communities to Prevent Youth Violence

National Center for Injury Prevention and Control Division of Violence Prevention

2

Youth Violence in the United StatesViolencedisproportionatelyaffectsyouthsbetweentheagesof10and24intheUnitedStates.Youngpeoplecanbevictims,offendersorwitnessestoviolence.Homicideisthesecondleadingcauseofdeathinthisagegroup.Eachyearmorethan5,000youngpeoplebetweenages10and24aremurdered--anaverageofmorethan14perday.1

Deathsresultingfromyouthviolenceareonlypartoftheproblem.Youthviolenceincludesseriousviolentanddelinquentactssuchasaggravatedassault,robbery,rape,andhomicideandlessserious,butstillaggressivebehaviorssuchasverbalabuse,bullying,orfighting.Manyyoung

peopleseekmedicalcareforviolence-relatedinjuries.In2010738,000peopleages10to24weretreatedinU.S.emergencydepartmentsforassault-relatedinjuries.2Thesebehaviorscanhavemajoremotionalconsequencesevenwhentheydonotresultinseriousinjuryordeath.

Youthviolencecanalsoaffectthehealthofentirecommunities.Itcanincreasehealthcarecosts,decreasepropertyvalues,anddisruptsocialservices.Thelifetimecostsassociatedwithmedicalcare,lostwork,andhouseholdproductivityresultingfrommedicallytreatedyouthviolenceexceed$14billioneachyear.3

National Academic Centers of Excellence in Youth Violence PreventionIn2000,CongressionallegislationwasintroducedthatultimatelyformedtheNationalAcademicCentersofExcellenceinYouthViolencePrevention(ACEs).Between2000and2005,thegoalsoftheACEsweretobuildthescientificinfrastructurenecessarytosupportthedevelopmentandapplicationofevidence-basedinterventions,promoteinterdisciplinaryresearchstrategiestoaddresstheproblemofyouthviolence,fostercollaborationbetweenacademicresearchersandcommunities,andempowercommunitiestoaddresstheproblemofyouthviolence.Beginningin2005,theACEsalsofocusedtheireffortsonpartneringwithcommunitieswithhighratesofyouthviolence,integratingefficacyandeffectivenessresearch,andimplementinganddisseminatingresearchfindings.TheACEProgramfundedfournewcentersin2010andtwoadditionalcentersin2011.ThecurrentACEProgramsetsoutaboldnewpathinbringingsciencetobearonyouthviolenceincommunities.

Overthecourseofadecadeoffunding,theobjectivesoftheACEProgramhaveprogressedtowardsincreasedemphasisonimpactandintegration.Thisnewemphasismeansthat

ACEsmustmeasureandevaluatethepublichealthimpactofcomprehensiveyouthviolencepreventioneffortswhileworkingwithmultiplesectorsinthecommunity.Theprimarygoalofthe2010-2015ACEProgramistopartnerwithhigh-riskcommunitiesandtheirlocalhealthdepartmentstoimplementandevaluatecomprehensivestrategiestopreventyouthviolence.Thesestrategiesrelyonthebestscientificevidenceabouteffectiveviolencepreventionprograms.TheACEshavethreecorefeatures:

• Acoreadministrativeinfrastructuretosupportimplementationandevaluationactivities,tofosternecessarycollaborations,andtoworktogetherasanACE Youth Violence Prevention Network;

• Integratedimplementationandevaluationactivitiesfocusedonacomprehensive,evidence-basedapproachtoyouthviolenceprevention;and

• IntegratedtrainingactivitiesforjuniorandfutureresearchersinyouthviolencepreventiontocomplementtheimplementationandevaluationactivitiesoftheCenter.

Accomplishments 2000–2010• Developedmultidisciplinaryandcommunitypartnerships• Establishedlocalsurveillancesystemstomonitorandtracktrendsinyouthviolence• Builtcommunitycapacitytoworkcollaborativelytopreventviolence• Conductedresearchonriskandprotectivefactorsforyouthviolence• Trainedthecurrentandfutureworkforceonyouthviolenceprevention• Developedandevaluatedyouthviolencepreventionprograms• Disseminatedknowledgeonyouthviolencepreventiontothecommunityandresearchfieldwithover500presenta-

tionsandjournalpublications• Informedlocalpolicyeffortsfocusedonbuildingyouthviolencepreventioncapacity

3

Currently Funded Academic Centers of Excellence• JohnsHopkinsUniversity

• UniversityofChicago

• UniversityofColorado,Boulder

• UniversityofMichigan

• UniversityofNorthCarolina,ChapelHill

• VirginiaCommonwealthUniversity

Highlights of the Academic Centers of Excellence in Youth Violence Prevention

High-Risk Communities

ThegoalofeachACEistoreduceyouthviolenceinadefinedhigh-riskcommunity,definedas“individualsresidinginageographicalarea,suchasacatchmentareaorneighborhood,wheremultipleriskfactorsforyouthviolencearepresent.”

ResearchersattheUniversityofNorthCarolina,ChapelHill(NorthCarolinaAcademicCenterofExcellenceorNC-ACE)andtheUniversityofMichigan(MichiganYouthViolencePreventionCenterorMi-YVPC)areworkingwithtwoveryuniquecommunities.TheNC-ACEispartneringwithRobesonCounty,wheretheLumbeetribemakesupmorethanathirdofthepopulation.Althoughthiscountyhasarichculturalheritage,ithasalsoexperiencedsevereeconomicstressors.RobesonCountyisranked1stamongallNorthCarolinacountiesinjuvenilearrests.Mi-YVPC’seffortshavebeenfocusedinFlint,Michigan.ThecityofFlintisuniqueinthatithasseenbotheconomicprosperityandmisfortuneovertheyears.Inthe1960s,Flintwashometohigh-payingmanufacturingjobsatseveralGeneralMotors(GM)factories.However,sincethe1970sFlinthaslostover70,000autoindustryjobsduetothedepartureofmanyoftheGMfactories.Basedonsocio-economicindicators,FlintisnowoneofthemostdistressedcitiesinMichigan;withunemploymentratesthatconsistentlyexceedthestateaverageandviolentcrimeratesthatexceedthenationalaverage.

Implementation

TheACEsareintegratingcomprehensivestrategiestopreventviolencethroughpartnershipswithpublichealthdepartmentsandmulti-sectorcollaborations.Thestrategiesincludeeffortstoworkwithallyouthinthecommunityaswellaseffortstopreventviolenceamongyouthathighriskforviolence.Thecomprehensivepreventionstrategiesareputinplacethroughcoordinationandcollaborationwithcommunitypartners.TheACEs’strategiestargetriskfactorsattheindividual(e.g.,delinquency,substanceabuse,lackofsocialskills);relationship(e.g.,inadequateparentalmonitoring,supervision,discipline;

peernormssupportingviolence);andcommunity(e.g.,socialdisorganization,lackofcohesion,lackofeconomicorsupervisedrecreationalactivitiesforyouth)levels.Theseevidence-basedstrategieshavebeenshowntoeffectivelypreventorreduceyouthviolenceanditsassociatedriskfactors.

TheChicagoCenterforYouthViolencePrevention(CCYVP)approachesthecomplexproblemofyouthviolencebyimplementingpreventionprogramstargetedatchildrenandfamiliesatdifferentdevelopmentalagesandwithyouthatvaryinglevelsofrisk.Oneaspectofthisapproachfocusesonimplementingprogramswithfamilies,includingSAFEChildren,whichfocusesonchildren’stransitionintoelementaryschoolandisdesignedtoaidinmaintainingparentalinvolvementinschoolandhelpingchildrengetagoodstartinschool.AnadaptationofSAFEChildrenwillalsobeimplementedwith6thgradestudents.Anothercharacteristicofthisdevelopmentalapproachincludesfocusingeffortsonhighschoolstudentsandthoselivinginthecommunity.CCYVPissupportingimplementationofCeaseFire,aprogramthatprovidescommunityeducationandmobilizationstrategiesdesignedtoaffectneighborhoodnormsregardingaggressionandviolence.CeaseFireoutreachworkersfocuseffortsonhigh-riskindividualstomediateeventswherethereisahighlikelihoodofviolence.

Additionally,theDenverCollaborativetoReduceYouthViolence(DenverACE)isimplementingCommunitiesThatCare(CTC)intheMontbellocommunityinDenver,Colorado.CTCisastrategicplanningmechanismthatbuildsuponaconceptoffirstidentifyingandthentargetingeachcommunity’sspecificneeds,riskfactors,andassets,anddevelopingatailored,comprehensivepreventionstrategybasedonthoseneedsandresources.CTCreliesonadata-informedprocessforleveragingacommunity’sassetsandresources,andensuresthattheevidence-basedpreventionstrategiesmatchthespecificneedsandcharacteristicsthatareuniquetoeachcommunity.CTCalsousesdatatoassesspreventionneedsandtesttheeffectivenessofpreventionprograms.

4

Evaluation of Comprehensive Strategy

Inordertounderstandifthecomprehensivestrategiesimplementedincommunitiesareworkingtoreduceandpreventyouthviolence,ACEsareconductingrigorousevaluationstoassessyouthviolenceoutcomesoverthespanoffiveyears.Theseevaluationswilldetectthecommunity-wideimpactofthepreventionstrategiesonthetargetedhigh-riskcommunitiescomparedtomatchedcontrolcommunities.

ResearchersatVirginiaCommonwealthUniversity(Clark-HillInstituteforPositiveYouthDevelopment)andJohnsHopkinsCenterforthePreventionofYouthViolence(JHCPYV)areusingrigorousandinnovativedesignstoevaluatetheirstrategies.Clark-HillInstituteisutilizinganinnovativequasi-experimentalapproachcalledthemultiplebaselinedesign.Thisdesignallowstheresearchteamtostaggerimplementationamongthreecommunitiesoverthecourseoffiveyears.Theyarealsocollectingdataonratesofviolence,including:homicides,injuriesduetoviolence,emergencydepartmentvisits,schooldisciplinerecords,andyouths’ownreportsoffightingandviolence,aswellasfactorsreflectingtheirpositivedevelopment.

Usingadifferentapproach,JHCPYVisusingacomparativeinterruptedtime-seriesdesign.Thisapproachestimatesprogramimpactsusingmultipleresearchmethodsanddatasourcesincludingpolicedata(e.g.,homicides,shootings,crime),schooldata(e.g.,suspensionsforfighting),schoolclimate,andcommunitysurveystocontrastchangesinyouthviolenceduringtheinterventionperiodacrossthreeneighborhoods–onethatimplementscommunityandschoolstrategies,onethatimplementstheschoolinterventiononly,andathirdthatreceivesnointervention.

Integration and Collaboration

SeveralkeycomponentsoftheACEProgramincludepartneringwithlocalorstatepublichealthdepartments,collaboratingacrossACEs,andintegratingtrainingactivities.Inaddition,ACEsareassistingwithotherCDCyouthviolencepreventioninitiatives,includingStrivingtoReduceYouthViolenceEverywhere(STRYVE)andUrbanNetworkstoIncreaseThrivingYouth(UNITY).

ACEscollaboratewitheachotherthroughtheACENetwork,madeupofACEPIs,co-investigators,andCDCscientificcollaborators.FourACENetworkWorkgroups,includinganEvaluationandIndicatorsWorkgroup,ImplementationandFidelityWorkgroup,TrainingWorkgroup,andPolicy,Communications,andPartnershipsWorkgroupwereestablishedin2011.ThegoalsoftheworkgroupsaretoprovidesharedresourcesandsupportfortheworkofeachACE.TheTrainingWorkgroup,forinstance,bringsattentiontoandconnectstheworkbeingdonetotrainjuniorscientistsattheACEs.Thisworkgroupfocusesonsharinginformationandresourcesabouthowvarioustrainingactivitiescanbeconnectedtoworkincommunities(e.g.,byusingwebinarsorothertechnologytomaketrainingactivitiesavailabletoabroadaudience).Forexample,JHCPYVisworkingwithmembersoftheTrainingWorkgrouptodevelopaSummerInstituteforjuniorscientistsworkinginyouthviolence.TheSummerInstitutewillbeusedtotrainpostdoctoralscientistsinthefieldofviolencepreventionandhelpthemtodevelopstrongrelationshipswithkeyleadersinthefield.

Future DirectionsCDCcontinuestoworkwiththeACEsandotherrelevantpart-nersinbuildingcommunities’capacitytoputsciencetoactiontopreventyouthviolence.University-communitypartner-shipsprovideauniqueandimportantopportunitytosupportcommunities’effortstopreventviolencebyusingstrategiesinformedbythebestavailableresearchevidence.Theevalua-tionresearchthatiscentraltotheACEProgramwillmakeatre-mendouscontributiontopreventingviolenceincommunitiesbyidentifyingstrategiesthatareeffectiveatreducingviolenceandcreatingsafer,healthiercommunities.

Reducingyouthviolenceisnotaneasytask.Itinvolvesgivingcommunitiestheresourcesandtechnicalexpertisetocreate,implement,andmonitoracomprehensiveyouthviolencepreventionstrategy.TheACEProgramisdesignedtohelpcommunitiesbenefitfromscientificadvancesandresearchaboutwhatworkstopromotethrivingyouthandcreatesaferenvironments.Theemphasisonevaluationensuresthatwecontinuetolearnfromourviolencepreventioneffortsandbuildtheknowledgeneededtoaddressthepublichealthchal-lengesofyouthviolence.

1. CentersforDiseaseControlandPrevention.(2012).Web-basedInjuryStatisticsQueryandReportingSystem(WISQARS)[Datafile].Retrievedfromhttp://www.cdc.gov/injury/wisqars/fatal.html

2. CentersforDiseaseControlandPrevention.(2012).Web-basedInjuryStatisticsQueryandReportingSystem(WISQARS)[Datafile].Retrievedfromhttp://www.cdc.gov/injury/wisqars/nonfatal.html

3. Corso,P.S.,Mercy,J.A.,Simon,T.R.,Finkelstein,E.A.,&Miller,T.R.(2007).MedicalCostsandProductivityLossesDuetoInterpersonalViolenceandSelf-DirectedViolence.AmericanJournalofPreventiveMedicine,32,474-482.

Visitwww.cdc.gov/violenceprevention/ACEformoreinformationabouttheACEProgramanditshistory.Visitwww.cdc.gov/violencepreventiontolearnmoreaboutCDCandyouthviolenceprevention.