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The Prevention of Youth Violence: U.S. Department of Health and Human Services, Centers for Disease Control, National Center for Environmental Health and Injury Control Division of Injury Control, Office of the Assistant Director for Minority Health, Atlanta, GA Publication date: 01/01/1992
ForewordViolence has become common in the United States of America. Every day we see, hear, or experience some form of violence. Murder, sexual assault, child abuse, injuries from fighting, riots at sporting or entertainment events, and other violent occurrences directly affect many Americans. These acts of violence are uniformly condemned by our society, and we are upset and frustrated by their persistence and frequency. Although most of this violence is obvious and unacceptable, a good deal of it is subtle and even condoned. Indirectly, we are exposed to violence daily on television, radio, and in the newspapers. Modern technology brings on-the-scene coverage of gun-battles, sniper attacks, riots, and other physical violence directly into our homes from our own cities and towns and from around the world. Movies and television entertain us with realistic and bloody dramatizations of murders, beatings, and tortures. Warlike video games have become a popular part of our culture, and our children routinely watch cartoons that depict violent events. Sadly, the constant exposure to physical violence, some of which we do not even recognize as violent, dulls our natural distaste for this behavior. Violence has become so common that not only do we expect and accept it, but we have begun to view it as appropriate behavior. Frustrated by unemployment, difficult economic times, interpersonal or marital difficulties, racism, and other stresses of modern life, we sometimes respond in a variety of hostile and destructive ways. Traditionally, our society has taught us that violence often equals courage and strength. We must unlearn this tragic lesson. If we are to survive as healthy, responsible, and caring people, we must teach ourselves and our children that violence does not solve problems. This manual, which gives a framework for community action, is but one part of an increased effort by the U.S. Department of Health and Human Services to reduce the number of injuries and deaths produced by violence. Much needs to be done to understand our needs and reactions to the many ways violence robs us of our lives, health, potential security, and peace. We do not claim that the strategies and programs described in this manual provide all the answers to this complex problem. They focus on ways to prevent and discourage physical violence only. The suggested activities are designed to draw upon and empower the creative energies of local communities. As a nation, we must make this task a personal priority. We can reduce the violence. We can change our lives. We can make our world a safer place for our children, our elderly, and ourselves, making it easier for each member of our society to achieve her or his full potential.
IntroductionBackgroundViolence is a large and important health problem in the United States. More than 20,000 people die from homicide every year and more than 2,000,000 people suffer injuries received in violent conflicts. The emotional toll is immense. Violence and violence-related injuries and deaths are particularly common among young people, and have escalated in recent years. In December 1990, the Centers for Disease Control (CDC) and the Minority Health Professions Foundation responded to the growing concern of African- American and other minority communities about violence among youth by convening a conference entitled Forum on Youth Holence in Minority Communities: Setting the Agenda for Prevention. The purpose of this forum was to review what is known about programs designed to prevent youth violence. This framework for community action originated from the discussions in that forum. It has grown and developed through subsequent discussions and meetings with many concerned individuals throughout the country. As this manual progressed, the complex distribution of violence across the United States became clear. Some communities of color are severely affected by violence. Others are not. Some white communities have high rates of violence while others do not. However, the potential for violence exists everywhere. Therefore, this manual can be used by any community dealing with present or potential problems of violence. Each community must assess its own needs and adapt the framework to its own characteristics. The underlying causes of violence vary from community to community. Urban, suburban, and rural communities differ; each community is unique. Experts provide no simple explanations of the causes of violent injuries and deaths. Deeply imbedded cultural problems such as racism, sexism, poverty, drug and alcohol abuse, drug trafficking, and frequent exposure to violence are but a few of the important pieces of this complicated puzzle. Efforts to reduce these problems and to increase educational and economic opportunities are needed. However, the presence of these large and stubborn problems should not make us forget that we can do something
American society has traditionally looked to the crirmnal justice system for protection from violence. Criminal justice measures have been useful. However, they have not enabled us to satisfactorily reduce the burden of violence upon society. One important reason is that much of the violence does not begin in a criminal setting but arises instead between companions involved in arguments, sometimes over trivial matters. In fact, more than 40 percent of all homicides occur between friends and acquaintances. Throughout the country, community organizations are addressing the problem of violence at the local level. These organizations are starting activities based on their understanding of local problems and local conditions. Conflict resolution training is provided in a number of schools. Schools are seeking ways to reduce the number of weapons brought on campus. In several cities, programs are redirecting the energies of young people in gangs from violent confrontations to more peaceful pursuits. In preparing this manual, we were aware that a great deal of evaluation needs to be done to determine which of the many activities that have been tried or proposed actually do prevent youth violence. However, the seriousness of the problem of violence demands immediate action.
The Purpose of this ManualMany concerned individuals and community-based organizations want to reduce violence and prevent injuries and deaths from violence among youths in their community. This manual is designed to help. It includes a menu of specific activities for communities to undertake plus a framework for putting those activities effectively into place. The manual is based on the principles of effective, community-based health promotion programs that have been successfully used to address a variety of chronic diseases as well as problems of youth, such as sexually transmitted diseases and teenage pregnancy. The manual is divided into two major sections -- "Activities To Prevent Youth Violence" describes the target groups, settings, and strategies for the prevention of youth violence. The chapter takes into account:
"Program Management" covers basic principles of effective community-based health promotion programs. This section describes the processes of:
Activities to Prevent Youth ViolenceTo prevent violent injury and death, we need to weaken or break the chain of events that leads to violence. Often we do not know exactly why people behave violently, why one adolescent will react violently in a given situation while another who has a similar background will not. We need to learn much more about the causes of violence in American society. Yet even with imperfect knowledge, helpful action can be taken. We can teach, we can enact and enforce regulations, we can change the environment. Youth can be taught skills to help them deal with violent situations. They can be helped to develop the self-esteem needed to solve differences without violence. Young people can be taught about the situations or actions that are likely to result in violence or violent injuries, such as associating with violent peers, using alcohol or drugs, and possessing a firearm or other weapon. They can be provided with mentors, or special teachers, who can serve as role models. Laws and regulations can be developed specifically to reduce injuries and deaths, such as stronger laws governing the use, ownership, and sale of guns. Teenage parents, abused children, or bored or wayward teenagers can be provided with training, support, and recreation. In selecting the activities for any commumty, you should consider the following general principles:
Target GroupsA target group is the group of people whom the program or activity is designed to influence. Depending on the activity, the target group may be broad or specific. For example, some activities may address adolescents who are out of school or who have a history of violent or criminal behavior. Other activities may address all young children. Still others may address parents, teachers, employers, or others who interact directly or indirectly with youth. Activities suitable for one group may be inappropriate for another because groups and individuals vary in terms of culture, values, knowledge, attitudes, skills, behaviors, experience, and other attributes. The selection of target groups should take into account the specific nature of the problem being addressed, the major goals and objectives of the program, and community characteristics. For example, members of youth gangs would not be an appropriate target group if gangs are not a problem in the community. Successful programs will have activities that address many target groups. However, this takes time, and a decision must be made about which target groups to address first. There are a few broad categories of target groups (Table 1) that are useful to consider: The General Population of Youth -- Many activities designed to reduce injuries from youth violence can be applied to all youth (or to the environment that affects them). An example of such an effort is teaching conflict resolution skills to high school students. In this instance, the purpose of the intervention is to affect the manner in which all students resolve conflicts, not just those students who are thought to be most likely to engage in violent behavior. Programs with activities directed toward the general population of youth, if successful, are likely to produce early and possibly substantial reductions in violent injuries and deaths. However, to be successful they must reach large numbers of youths. Youth Who Engage in High-Risk Behaviors -- Youth with high-risk behaviors are those most likely to be injured, those most likely to engage in violent behavior that injures others, or both. These groups include young people who consistently engage in physical fights to resolve problems, those with a criminal record or a history of inflicting or receiving a violent injury, drug users, gang members, or those who have failed or dropped out of school. Other youth who may be at risk for fighting are relocated youth. This group includes immigrants and migrants, and can also include youth who live in communities that are highly mobile. One other group that may be prone to fighting are those with emotional or mental deficiencies who may not have the personal skills to settle disputes nonviolently. If successful, activities directed toward this group of youth may show early and possibly substantial reductions if these groups account for much of the violent injuries and deaths among youth in the community. Special efforts are often necessary to locate and contact youth with high- risk behaviors. Outreach workers may help. They can meet youths on street corners, parks, fast-food restaurants, or other places where they gather. They work to establish trust. Once trust is established, outreach workers may be able to refer or guide adolescents with high-risk behaviors into helpful activities. Outreach is important in making contact with youth who engage in high-risk behavior, but it is only a part of a program. Other activities are also necessary. The Commumty Youth Gang Services (CYGS) of Los Angeles, California, is a good example of a program that has a strong outreach component with a number of other program activities. This program is described later in the document. Young Children (10 Years Old or Less) -- Violence is a learned behavior. The basic values, attitudes, and interpersonal skills acquired early in life are likely to be pivotal in developing predispositions for violent behavior later in life. Therefore, activities for young children that promote nonviolent values, attitudes, and interpersonal skills are important to consider. Also, any long-term strategy to prevent violence may also want to include children who are abused or witness violence and activities that lessen the consequences of exposures to violence. If successful, these interventions may show substantial reductions in violent injuries and deaths when these children become adolescents. Other Target Groups -- The above three categories of target groups--the general population of youth, youth with high-risk behaviors, and young children--may be considered direct target groups because activities are intended to reduce violent injuries and deaths among those groups or caused by those groups. Programs focusing on these groups will also need activities for indirect target groups--those people who have a particular relationship with the primary target group. Examples of indirect target groups are family members, adult role models, or the general population. Family members -- Family experiences play a critical role in causing, promoting, or reinforcing violent behavior among youth. Consequently, the family is an important target for activities to prevent youth violence. Activities that target families can focus on parents, siblings, or the entire family unit. Typically, these activities reinforce health promotion or prevention messages, support the parents in raising and managing children and youth, or provide help in coping and responding to family crises. Special groups of adults -- Teachers, coaches, clergy, health proressionals, counselors, athletes, entertainers, and other adults often have special relationships with children and youth. They may be important role models. They may also recognize or decide which children and youth need or receive special services. Adult role models are an important target for youth violence- prevention activities because they are very influential in the lives of children and youth, frequently serving as confidants. As such, they can reinforce health promotion and prevention messages, including those pertaining to violence. General population -- The general population is an important target group for several reasons. First, people need to be educated about the role of society as a whole in promoting violent behavior. Second, activities such as modifying or passing gun control legislation may affect wide segments of the population. For such activities to be successful, we must address the entire population.
SettingsThe setting is the location where a prevention activity occurs. There are four important considerations involved in selecting settings for a prevention activity (Table 2):
Settings in which the general population of youth may be reached include schools, churches, streets, playgrounds, youth activity sites, and homes. Additional settings where certain groups with high-risk behaviors may be found include juvenile justice facilities, mental health facilities, social service facilities, and the medical care facilities. Young children may also be reached in child care settings (e.g., Head Start locations).
StrategiesActivities to prevent youth violence typically employ one of three general prevention strategies: education, legal and regulatory change, and environmental modification. Each of these general strategies has a role in a comprehensive youth violence prevention program (Table 3).
EducationEducation provides information and teaches skills. New knowledge and new skills change or reinforce a person's attitude and behavior thus reducing the chances that the person will behave violently or become a victim of violence. Educational efforts can be directed toward a wide variety of target groups to help convey knowledge and skills. Face-to-face teaching may occur in the classroom, in worksite or recreational settings, or through special teachers, such as nurses on home visits. Knowledge and skills are a crucial part of the process, but they are often insufficient by themselves. The acquisition of knowledge is usually not followed immediately by the adoption of new behaviors. Behavioral change requires time and repeated effort and is more likely to occur if the physical and social environment support and encourage it. The following are examples of types of educational strategies. With each example are several brief descriptions of the strategy as it is being implemented in a U.S. community. Adult Mentoring -- Mentors are special adults who provide a positive, caring influence and standard of conduct for young people. Mentors provide models for young people who have none, or they offer alternatives to negative role models. Mentors may reinforce positive attitudes or behaviors that children are trying to express. Adult role models may be teachers, counselors, friends, and confidants, or simply members of the community. Mentoring activities can be conducted in almost any setting, such as schools, churches, businesses, or other community locations. The attention and interest bestowed on the youngsters by people who care enhance the youth's self-esteem and strengthen his or her ability to choose nonviolent methods to resolve conflict. Baltimore, Maryland, Project RAISE (410)685-8316: In 1988, Project RAISE recruited mentors for more than 400 sixth grade students. The mentors contact the students at least weekly and meet with them face to face at least every other week. The mentors serve as role models, provide academic support, and strive to boost the youths' self-confidence. The mentors are recruited from two churches, two businesses, and two colleges that serve as sponsors of the project. A Project RAISE staff member coordinates the project with the schools, matching mentors with students after informal contacts and information exchanges with mentors ancJ students. A private foundation is funding the project. Atlanta, Georgia, Go to High School, Go to College (404)766-5744: The Atlanta "Go to High School, Go to College" project has paired 100 successful older men with adolescent African-American males at four Atlanta area high schools and one middle school. Each mentor meets twice a week with a student who is struggling academically, has discipline problems, or is at risk of dropping out of school. The mentors are provided with a 40-page curriculum of instructions and ideas. Mentors strive to increase the students' self-esteem and improve their grades. A local fraternity chapter provides scholarships to students who qualify and want to attend college. Conflict Resolution Education -- Classes in conflict resolution are designed to provide students with the opportunity to develop empathy with others, learn ways to control impulses, develop problem-solving skills, and manage their anger. Usually this curriculum is delivered in the classroom setting, although other settings, such as churches, multi-service centers, boys and girls clubs, recreation centers, housing developments, juvenile detention centers, and neighborhood health centers may be appropriate also. Courses in conflict resolution have been developed for students in both elementary and high schools. The methods used to teach conflict resolution usually include roleplaying conflict situations and analyzing the responses to, and consequences of, violence. Generally, students are trained for 15 or 20 hours, after which they may work in pairs mediating conflicts that occur in the classroom or cafeteria, on the playground, or elsewhere. These conflicts cover a wide range of situations, including bullying, stealing, and spreading rumors. Teaching materials can be designed to meet individual needs of different groups of students. Boston, Massachusetts, The Boston Conflict Resolution Program (617)492-8820: The Boston Conflict Resolution Program (BCRP) is a violence prevention program that helps elementary school teachers and students understand and deal with conflicts frequently encountered in schools. These conflicts often result from prejudice, competition, miscommunication, an inability to constructively express feelings, and a lack of respect and concern for others. Teachers participate in an intensive training program in conflict resolution, cooperation, and communication skills, dealing with cross-cultural conflict, anger management, and encouraging caring and empathy. They then receive in class support from a multiethnic team of trained staff developers who help them implement what they have learned in the training. In addition, the BCRP staff provide teacher training, implement peer mediation programs, and develop curricula and instructional resources. San Francisco, California, The School Initiatives Program (415)552-1250: The School Initiatives Program in San Francisco grew out of a community program that began in 1977 to train community residents to help their neighbors resolve disputes peacefully. In 1982, this program expanded to the schools because of growing conflict and violence in that setting. This program has two components: classroom curricula and a conflict secondary school students. These materials help students acquire self- esteem and the skills needed to resolve conflict and build a stronger sense of cooperation and community at school. To become conflict managers, students at the middle and high-school level participate in 15 hours of training over two and one-half days. They learn communication, leadership, problem-solving, and assertiveness. Once trained, these students help their fellow students to express and resolve their conflicts nonviolently. Training in Social Skills -- Teaching young people social skills provides them with the ability to interact with others in positive and friendly ways. Training in social skills includes many things that help students successfully interact with others. Aspects of social-skills training include maintaining self- control, building communication skills, forming friendships, resisting peer pressure, being appropriately assertive, and forming good relationships with adults. Nonviolent conflict resolution training may be included with these other social skills. Acquiring these skills provides students with appropriate standards of behavior, a sense of control over their behavior, and improved self-esteem. They may be less likely to resort to violence or become victims of violence. These educational activities can be conducted in schools, day-care settings, after-school programs, and youth organizations. New Haven, Connecticut, The New Haven Social Development Program (203)432-4530: Since 1983 the Yale University Psychology Department has collaborated with the New Haven public school system to provide training in social skills in the middle schools of the district. The major components of this activity are classroom activities for sixth and seventh graders that teach social development, and modeling of socially competent behavior by school staff. The curriculum emphasizes self-control, stress management, problem-solving, decision making, and communication skills. Once students have learned a general problem-solving framework, they apply their critical-thinking skills to specific issues, such as substance use. The emphasis is on providing accurate information about the topic and focusing on realistic situations. Finally, school, family, and community resources are identified that are available to help students cope with personal or family difficulties. Methods used are role-playing, videotaping, and live modeling; classroom presentations; smallgroup discussion; and competitive and cooperative games. Classroom teachers undergo training that includes practice modeling and review of techniques for dialogue, discussion of students' reactions to the lessons, and adaptation of the lessons to the special needs of their students. Education To Prevent Injuries from Firearms -- The meaning of education to prevent injuries from firearms varies from community to community. For some, this means avoiding firearms altogether and for others it means the proper handling of firearms. Activities providing education about firearm safety can be conducted in school settings and in the community. A number of educational techniques have been developed, including the use of audiovisual materials and curricula that deal with situations that involve firearms. Dade County Florida, Kids + Guns = A Deadly Equation (305)995-1986: A program designed to teach students from kindergarten age through high school about the dangers of playing with or carrying guns was developed jointly by the Dade County Public Schools, the Center to Prevent Handgun Violence, and Youth Crime Watch of Dade. Kids + Guns = A Deadly Equation includes classroom instruction and schoolwide activities that center on helping students recognize unsafe situations, react appropriately when encountering guns, resist peer pressure to play with or carry guns, and distinguish between real-life and media violence. The curriculum includes a video program for students in grades 7 through 12; a component for parents includes a brochure and video program. Parenting Centers -- Improving parenting skills through specially designed classes for parents can improve how the parent and child interact. The improvement in this relationship may reduce the risk of childhood behavior problems and subsequent antisocial behavior that may predispose an individual to violence in later life. Programs targeted toward parents must address the psychological needs of the parents, especially their sense of being competent parents; the parental behaviors that influence the physical and social development of their children; and the stresses and social supports that can either help or hinder parents' ability to adapt to their children's needs. Minneapolis, Minnesota, Project STEEP (612)624-0210: Project STEEP (Steps Toward Effective, Enjoyable Parenting) serves low-income, first-time parents. Most parents are single and have no more than a high-school education. The program includes both group sessions and home visits. It begins during the second trimester and continues until the baby is at least one year old. Prenatal visits focus on the mother's feelings about pregnancy and preparation for parenting. After the baby is born, transportation to the group sessions is provided by the project. The focus of demonstration and interactive sessions is on child-care skills, infant development, and infant-mother communication. Interactions between mother and infant are videotaped, reviewed, and discussed with the parent. State of Missouri, Parents as Teachers (PAT) (314)553-5738 Parents as Teachers is a home/school partnership that serves all parents, including single parents, teenage mothers, and two-parent families. PAT parent educators, trained in child development, go to homes of participating parents to help them understand each stage of their child's development and learn ways to encourage that development. The program also conducts group meetings for parents to get together to gain new insights and to share their experiences, common concerns, and successes. They conduct periodic screening of overrall development, language, hearing, and vision to detect potential problems, and refer families to special services. Peer Education -- Programs that use students to teach their peers about violence prevention are a powerful force among adolescents and can be used effectively to help shape norms and behaviors in this group. Research on peer education for other health issues such as alcohol, cigarette, and drug use, has had positive results and shows promise for violence prevention programs. Ferguson, Missouri, RAPP (Resolve All Problems Peacefully) (314)521-5792: RAPP was begun to reduce the number of physical fights among students. Students selected by teachers and other students are trained in mediation skills. Students found in conflict are given the choice of going to mediation or going to the office. Those who choose mediation meet with one of the trained mediators who works with them to peacefully resolve the conflict. During the first semester of the project, the number of fights was less than half the average for the same semester over the previous three years. Oakland, California, Teens on Target (510)635-8600, Ext. 415: Teens on Target is a peer education and mentoring group that was formed by the Oakland Safety Task Force in California after two junior high students were shot in the schools by other students. The task force, made up of a coalition of elected officials, parents, and school and community agency representatives, felt that students would do a better job of dealing with the youth violence problem than adults. Selected high school students are trained in an intensive summer program to be violence prevention advocates, particularly in the areas of guns, drugs (including alcohol), and family violence. These students become peer educators to other high school students and mentors to younger students in the middle and elementary schools. Teachers provide ongoing guidance and supervision to the teen educators. Public Information and Education Campaigns -- Public information campaigns reach a broad audience. They draw attention to an issue and help establish acceptable behavior for a community. They also convey a limited amount of information, which by itself is rarely enough to change behaviors. Therefore, activities that provide general information to the public are most effective when combined with other activities in a violence prevention program. There are a number of ways to inform the public through media. Some examples are public service announcements, educational video programs, appearances on public talk shows, posters, brochures, and other print materials. Charlotte, North Carolina, The Police Executive Research Forum and the Center to Prevent Handgun Violence (202) 289-7319: The Center to Prevent Handgun Violence in conjunction with Police Executive Research Forum developed and ran a public awareness campaign in Chadotte, North Carolina, that attempted to change people's knowledge, attitudes, and behaviors concerning the protection they believed firearms offered. Together these two groups developed guidelines, produced print and broadcast media messages, distributed brochures, made community presentations, and conducted safety demonstrations. The messages developed through this awareness campaign included safe storage of firearms, instructing children about handgun safety, and checking firearms before cleaning. Baltimore, Maryland, The Baltimore County Police Department and the Center to Prevent Handgun Violence (202) 289-7319: The Center to Prevent Handgun Violence has also helped the Baltimore County Police Department develop advertisements, public service announcements, pamphlets, brochures, and police presentations for both gun owners and people who do not own guns. The materials cover the dangers of misusing firearms, how to childproof handguns,legal issues including liability, and the psychological and practical issues of ownership.
Legal and Regulatory ChangeLaws or rules may lower the risk of violent behavior or victimization. Some regulations that would help reduce injuries and deaths from violence have already been enacted, but many are neither widely known nor well enforced. In many cases, it is easier to enforce existing laws than it is to enact new laws. In other cases, existing regulations are inadequate and new ones are needed. You can find out your state laws by contacting your state attorney general's office. You can find out your local laws by contacting your local police agency. The success of making or enforcing rules depends on the willingness of the population to support and obey the rules and the ability of regulatory agencies, such as the police, to enforce them. Examples of laws or regulations intended to reduce injuries and deaths from violence include laws prohibiting the carrying of firearms in public and rules prohibiting the wearing of gang colors in schools. Regulations Concerning the Use of and Access to Weapons -- Guns, knives, and other dangerous weapons may not actually cause violence, but they can convert an argument with no associated injuries into one with severe injuries or even death. A variety of strategies have been used to reduce the likelihood that weapons will be used. Many communities already have existing laws and regulations concerning the sale, ownership, use, or carrying of guns or other weapons.
Massachusetts Bartley-Fox Act (1975): This law mandated prison terms for anyone carrying an unlicensed firearm. In the two-year period following passage of this law and the accompanying publicity, the incidence of assaults with guns was reduced by 13.5 percent.
Washington, D.C., Prohibition of Handgun Ownership: ln 1976, the District of Columbia banned the purchase, sale, transfer, or possession of handguns by civilians. Although homicide rates remain high in Washington, D.C. "indicating other actions are still necessary" a comparison of homicide rates in the District with rates in the surrounding counties show that the handgun ban had an effect. The homicide rate in the District dropped about 25% promptly after the ban went into effect and has remained lower than expected on the basis of previous rates. An estimated 40 homicides per year have been prevented by the ban on handguns.
Regulation of the Use of and Access to Alcohol -- Alcohol consumption appears to play an important role in many violent situations. Youth who have been drinking are more likely to become involved in physical fights. In all 50 states and the District of Columbia, the minimum drinking age is now 21 years. Laws prohibit the sale or public possession of alcoholic beverages by anyone under the age of 21.
Oregon, Alcohol Server Education Program (503) 653-3030: Since 1987, Oregon law has required servers, managers, and owners of establishments that serve alcohol for on-premise consumption to pass a server education course. Participants are taught about the effects of alcohol on the body and its interaction with other drugs. They also learn about their responsibility to prevent irresponsible drinking. They learn to estimate the drinking capacity of customers, to look for signs of intoxication, to cut off people who have had too much to drink without causing an argument, and to identify minors. Courses include a minimum of 4.5 hours of instruction and participation. The Oregon Liquor Control Commission monitors the classes to assure their quality. The servers, managers, and owners must take the course every 5 years. Other Types of Laws and Regulations -- In addition to regulations concerning weapons and alcohol, other types of regulations may also reduce youth violence. For example, prohibiting corporal punishment and enforcing some dress codes in schools may be helpful.
Los Angeles, California, Challengers Boys Club (213) 971-6141: This club, which offers a wide range of activities for youth who are 6 to 17 years of age, requires that members adhere to strict rules, including restrictions against wearing gang-related clothing. The absence of gang-related clothing helps prevent the group from dividing into pre-established hostile clusters.
Environmental ModificationEnvironmental modification includes changes in both the social and the physical environments. Modification of the Social Environment -- Methods of changing the social environment of children and adolescents who may be at risk for being violent or for becoming a victim of violence include such activities as providing preschool education and appropriate or therapeutic day care programs for abused children. For older children and adolescents, this includes providing constructive, alternative activities, such as recreational opportunities and employment. Small, personal after-school programs that offer contact with caring adults, counseling, help with homework, and recreation can create a safe, constructive alternative to violent street cultures. Home Visitation -- Home visitation is an activity that provides services in the home either for an individual or the entire family. Home visitation programs performed during the prenatal and infancy years of the child focus on preventing health and developmental problems in children born to mothers who are teenagers, unmarried, or of low socioeconomic status. These activities have been found effective in preventing child abuse. Because research shows that abused children are more likely to be violent or be victims of violence as adults, prenatal and infancy home visitation programs may be an effective long-term strategy for preventing youth violence. These programs are typically designed to meet the needs of parents for information, emotional support, stress management, and other factors that undermine parents' health habits and the care of their children. Elmira, New York, The Prenatal/Early Infancy Project (716) 275-3738: This home visitation project was designed to prevent a wide range of health and developmental problems among children born to young, poor, or unmarried women. In this program, nurses visit pregnant women to provide information and support that encourage the mothers to adopt good health habits, learn the skills needed to care for their infant children, get access to needed community services, achieve educational or occupational goals, and prevent unwanted future pregnancies. Home visits begin in the early stages of pregnancy and continue through the second year of life of the child. Evaluation of this project showed that the health and social skills of participants had improved. In addition, there was a substantial reduction in verified oases of child abuse among the children of at-risk women who were visited at home by the nurses. Preschool Programs Such as Head Start -- Project Head Start is designed to help children of two-income families develop a greater degree of social competence through developing the child's intellectual skills, fostering emotional and social development, meeting the child's health and nutritional needs, and involving parents and the community in these efforts. A 1990 report of the Milton S. Eisenhower Foundation, which grew out of the bipartisan National Commission on the Causes and Prevention of Violence, reported that preschool programs like Head Start are among the most cost- effective inner-city crime and drug prevention strategies ever developed. Therapeutic Activities -- Therapeutic activities provide medical, psychological, or other treatment for children who have been abused, injured by violence, or witnessed an unusually violent event. The provision of medical, psychological, and nurturing services helps break the cycle of violence. In addition to child and family counseling, here are several special types of therapeutic services:
Dallas, Texas, Dallas Independent School District Crisis/Management Plan (214) 565-6700: The Dallas Independent School District Crisis Management Plan divides crises into three levels. The most severe level includes terrorist activities or a death at the school. This level also includes severe natural disasters and suicide clusters. For each level, there is a planned coordinated response. The plan includes methods of informing students, families, and the public about the event. It also includes the identification and provision of counseling services to students in need. Each school has a local crisis team. There is also a District crisis team consisting of psychological and social service experts. The District crisis team participates in the most stressful events, such as a death at the school. Recreational Activities -- Recreational activities offer young people opportunities to spend time in a structured and purposeful environment. Recreational interventions cannot be considered a sole answer to youth violence. However, activities that provide outlets for tension, stress, or anger and opportunities for social interactions and constructive problemsolving are important parts of a program with other violence prevention components. Many recreational activities are conducted with these goals across the nation in Boys and Girls Clubs, Girl Scouts and Boy Scouts, YMCAs and YWCAs, and local recreation departments. Columbia, South Carolina, Mid-night Hoops Program (803) 777-5709: The Mid-night Hoops Program is one part of the Five-Point Youth Violence Prevention Program. More than 200 youths, both boys and girls, 12-18 years of age, participate in evening and late night basketball leagues. Practices and games take place at 9 different sites. Officials are trained and employed by the city and county recreation departments. On Fridays, games are played between 10 p.m. and 1:30 a.m. Work/Academic Experiences -- Student work and volunteer activities that are supported by community organizations have a positive influence on youth. Structured job experiences and volunteer activities connect adolescents with supportive adults who act as role models, mentors, and counselors. All the parties involved benefit from this type of activity: schools, organizations, and students. School personnel learn about commumty resources, and community agency staff learn about the school system. Students learn what a community is and how a neighborhood functions while learning the roles they play in society. New York City, New York, Early Adolescent Helper Program (212)642-2947: This program places young adolescents (ages 10-15) in responsible and important work in their communities and schools. Students serve as interns, assistants, and helpers two or three times a week in early childhood and after-school child care programs, senior centers, community agencies, and other appropriate settings. They receive training and supervision in weekly seminars conducted at their school. Seminars place a strong emphasis on reflection and analysis of situations that arise from the work and volunteer placeme Modification of the Physical Environment -- The physical environment does not cause violence, but it may make violent events more or less likely to occur. Some environmental modifications by themselves may appear to merely displace the undesirable behavior to another location. Better lighting on a playground, for example, may move the undesirable activity to another location in a community. Sometimes, however, the new location is less conducive to violence, more difficult to reach, or easier for potential victims to avoid. In these cases, the overall amount of violence may decrease even though some violence has merely moved to a new location. Protective landscaping, changes in traffic flow, speed bumps, dress codes, visible identification cards, and closed- circuit television monitoring are other examples of enviornmental changes. Environmental change may be particularly effective when combined with educational and regulatory strategies. Ithaca, New York, Cornell University Blue Light System (607) 255-1111: The Blue Light system on the university campus has three components: an emergency phone system, a bus system, and an escort service. The Blue Light phone system has 61 emergency phones outdoors across the campus, placed so that at least one phone is easily visible to pedestrians. Additionally, there are 158 emergency phones in academic buildings and dormitory entrances. All phones are directly connected to the Public Safety Dispatch Office. When callers pick up the receiver or push a special button, they are automatically connected with the Public Safety office. The location of the phone is displayed and recorded automatically. A patrol unit is sent to all calls for assistance and to all hang-up calls. The Blue Light bus system is a free transportation system that operates every day from 6:00 p.m. to 1:30 a.m. The system operates throughout the campus and fringe areas. Buses have radio contact with Public Safety and Blue Light escorts. The escorts are paid student teams who are available to escort other students on campus between 8:30 p.m. and 1:30 p.m. People can request escorts by calling Public Safety or by using a Blue Light phone. Crime Prevention Through Environmental Design (CPTED) is a concept that is attracting interest in many police departments. Although its purpose is to prevent crime, the CPTED principle probably will help prevent violence also. CPTED relies primarily on increasing visibility and encouraging a sense of ownership. Undesirable acts are less likely to occur in places where they will be observed, and people naturally use and protect things they own.
Los Angeles, California, Community Youth Gang Services (213) 266-4264: Community Youth Gang Services is a program with many components, but some of the most innovative involve reclaiming the community that has been taken by gangs. One aspect of the program carefully plots on maps the physical areas of the community that are affected by gangs. These areas are targeted for reclaiming, and community residents are mobilized to do that through such activities as a Saturday in the Park, in which a particular day is designated for clean-up of the park and family activities. Another activity of this program is the removal of graffiti. Community Youth Gang Services staff have the professional staff and equipment to eradicate graffiti without damaging surfaces. Staff hires and supervises local youth and selected youth on probation to do this task.
Combining Activities for an Effective ProgramThe activities listed in this manual are presented individually so that the reader can investigate the different types of activities available to communities. In reality, activities are rarely conducted independently. Effective programs combine a number of activities to render the maximum impact on the problem and reach as many young people as possible. There are a number of examples of programs that combine three, four, or five strategies that have been discussed. Philadelphia, Pennsylvania, House of Umoja Boystown (215) 473-5893: The House of Umoja Boystown is a home for African-American boys in Philadelphia, an area with high numbers of youth in gangs. In addition to providing a home with food and shelter, the program offers extensive services that offer emotional and spiritual support. These services cover a number of the types of activities described earlier in these guidelines, such as outreach, educational activities, recreational opportunities, and work/academic opportunities. Some of the program activities of the House of Umoja Boystown include remedial education in subjects such as reading and mathematics, preparation for taking graduate equivalency examinations, vocational education, life skills training, job training and placement, planning for reintegration into the community, training in stress and aggression control, values clarification, problem-solving, communication, and conflict resolution. The program has organized many recreational opportunities, including the Black Youth Olympics in which the youth of Philadelphia competed with youth from other cities. Boston, Massachusetts, The Violence Prevention Project (617) 534-5196: The Violence Prevention Project in Boston, Massachusetts, is a multi- institutional, community-based program designed to reduce the incidence of interpersonal violence among adolescents, along with associated medical and social hazards. The major activity used in this program is a violence prevention curriculum that focuses on conflict resolution. However, in the initial phases of development, it became apparent that a school-based activity was not enough and activities in the community were added to reinforce nonviolent options learned in the classroom. Staff from the program train providers in diverse community settings in the use of the curriculum's strategies. They also help providers find ways to incorporate these strategies into the delivery of services to adolescents and encourage consensus from the community that supports the prevention of violence. As a result, educational materials are available in waiting areas of health centers, and staff at these centers offer violence prevention counseling. This program also includes activities at Boston City Hospital. Adolescents are screened in the emergency room to identify those at high risk of violence, and a special violence prevention clinic at the hospital offers services to these adolescents. Services include comprehensive assessment, educational interventions, counseling, therapy, and referral to other community services. Chicago, Illinois, African-American Male Education Network (AMEN) (708) 720-0235: The African-American Male Education Network centers its activities on Rites of Passage programs,which foster self-esteem and pride in one's cultural heritage and provides guidance for youth as they move from one stage of life to another. The program provides the guidance and support to overcome the confusion and frustration that lead to youth choosing destructive alternatives and alternatives such as violence, gangs, and substance abuse. The program accomplishes these goals through education, teaching life and social skills, and mentoring. Los Angeles, California, Community Youth Gang Services (213) 266-4264 The Community Youth Gang Services (CYGS) of Los Angeles is a program with many activities. CYGS has crisis intervention teams that negotiate disputes among gangs in the target area and try to convince youth not to join gangs. The program also has activities to reclaim areas of the community from gangs, areas such as parks or playgrounds that were not considered safe because of gang activity. Volunteers work with program staff and local agencies and community groups to develop cultural, recreational, and other activities that are alternatives to gang involvement. Educational programs in the schools are complemented with parent education and teacher education. In the June 17, 1993job development section of the program, staff work with youth to prepare them for employment and also encourage local employers to hire youth. One other active part of the program is the removal of graffiti from community landmarks. Staff hire youth in the community to do this task under professional supervision. This program has an aggressive outreach effort that works continually in the community to discourage gang membership and direct youth already in gangs to other activities.
Program ManagementCertain steps are necessary in building a successful community program to prevent youth violence. These steps, which are essentially the same for all community-action activities, are based on two principles:
Community OwnershipA united community can produce powerful changes. Even large and complicated problems like violence can be reduced by the creative energy of a community. One necessary ingredient is the participation of many residents. Community-based health promotion programs in other areas have been effective because they combined the efforts of many different organizations and individuals. In these programs, diverse organizations and individuals recognize their common interest and work together for a common purpose. A single individual or organization may provide the initial stimulus or the ongoing leadership, but sustained and effective community-wide action depends upon the coordinated efforts of many individuals and groups. In the process of building a community effort, you should do the following:
Throughout the life of the program, one of the major challenges will be to maintain a productive working relationship among all individuals and organizations interested in working to prevent youth violence.
Defining the ProblemAn accurate description of the problem of violence among youth in the community will help you:
As members of the community, you have good insight into what information will best describe the problem of youth violence in your community. There is no "scientific" formula for collecting this information -- it mostly requires patience and work. Providing training to community people who seek this information will help ensure its quality. People who participate in this process will be interested in the results; therefore, it is important to share the results of the process with community members at open meetings. There are several types of information that help describe the nature and extent of the problem in a community. There is factual information from statistical records and opinions about the nature of the problem from people in the community (Table 5).
Factual InformationFactual information can describe: The outcome of violent events, such as those that cause injuries and deaths. This information can be obtained from the vital statistics division of the state or local health departments, medical examiner records, hospital or emergency room records, outpatient records from public or private clinics, emergency medical service (ambulance) records, and school nurse records. Once you have these statistics, it may be helpful to compare them with state and national data, if possible, to see how your community compares with other areas. When possible, collect information specific to the neighborhood -- for example, incident reports from local schools.
It is usually best to begin with statistics on the number of violence related injuries and deaths. When these are described as well as possible, then look for information about the times, places, and circumstances of the events.
Opinions from Members of the CommunityYou must learn what your community members see as a problem and what they think is causing the problem. You can find this out through surveys of residents and discussions with community leaders, school personnel, legal and police personnel, health workers, and parents. For example, ask school principals and guidance counselors about the violence they see in the schools and listen to their ideas for reducing it. It is also important to talk to children and adolescents themselves, particularly those who might be in trouble or at risk for trouble (for example, those who are expelled from school). Contact youth and their parents in as many community sites as possible, including supermarkets and shopping areas, basketball courts and other recreational areas, churches, schools, and homes. Local schools and universities may be able to help with opinion surveys.
Community Background InformationOther types of information on such topics as racism, poverty, unemployment, and other social, cultural, or economic factors provide helpful background information about the community and the problem of violence. Some of this information can be obtained through the U.S. Census (available through your local library), the Department of Labor employment statistics, and from the Department of Housing and Urban Development. When approaching an organization, ask for information specifically related to the institution. For example, ask schools about attendance, truancy, suspensions, expulsions, and failures. The information you acquire from opinion surveys of local leaders and citizens is valuable and may not be available anywhere else. Academic institutions or university research organizations in the community may be able to help you obtain and assemble this type of information.
Data PresentationStatistics from public sources are usually set up for the needs of the particular agency or organization. They may not be tabulated, explained, or displayed in ways that you need. You can ask, but do not expect the people or the organizations from whom you get data to modify it for your use. You may find it useful to include people in your effort who have the data or who know how to organize, interpret, and use it. The causes of violent behavior are multiple and complex. The combination of statistics and opinions is important when you are deciding what you want to do. Statistics will suggest several possible areas for activities. However, the opinions from the community may identify information not provided by the statistics and could indicate the areas that should be addressed first. In addition, information about the community is a powerful tool to convince law-makers and other decision-makers about the importance of the problem and the need to address it. (Table 5) Sources of Information to Describe the Problem.
Goals and ObjectivesEffective community programs have both goals and objectives. A goal is a broad, general statement about what the program is designed to accomplish. Goals determine the direction of the program. Objectives are statements of specific things to be achieved by a specific time, and they determine what activities the community will do. Example: Goal--Reduce violent behavior in the schools. Objective--In the 1994-95 school year, 100 eighth grade students will study the curriculum on nonviolent conflict resolution. An objective should tell who should achieve how much of what, where, and by when.
As you develop goals and objectives, the following guidelines should be helpful:
(Table 6) shows how objectives flow from a goal. Objectives are important because they clarify the tasks that need to be done, call attention to areas of needed effort, and document the progress of the program and its activities. (Table 6) is a possible final objective, Often several intermediate objectives (steps) must be achieved first to ultimately meet the final objective. Objectives:
Who: Principals
Who: School
administrators
Who:
High school students As you can see from this example, an objective:
Locating Resources for your ProgramYou will need many resources to run a community violence prevention program. The greatest resource you can have is the time and efforts of community people. There are also a number of resources, such as office space, equipment, and supplies, that may be donated by organizations that cannot contribute money to a program. All these resources cost real dollars if they are not donated. Therefore, their contribution is very important. Although having funds will allow you to conduct more activities and reach more people, money does not assure success. There are two major sources of funds for community programs: public and private (Table 7). Public funds come from federal, state, or local governments. Particularly in tight financial times, government funds often go to support existing programs. In addition, because people administering public funds are held accountable to the public for their management, government agencies usually retain a great deal of control over how the money is spent. Private funds come from a number of private organizations, such as foundations, corporations and other businesses, voluntary organizations, charitable institutions, churches, and a wide variety of local concerns. Usually private organizations are more flexible than public agencies in the types of programs they fund and in the management of the program. Your own program can also raise funds by sponsoring events that bring attention to the program and also raise money. For example, you can conduct walk-a-thons or community road races, solicit pledges through media programs, conduct bake sales, or conduct contests or raffles with prizes donated by local businesses. Although the amount of money raised in this manner varies, the community's willingness to participate and to take on responsibility provides your program a good record when you approach private or public organizations to request funding. In fact, some granting organizations require that a percentage of the program's costs be provided by the community or other sources.
Private OrganizationsCommunity Organization -- Many organizations within local communities want to help worthy causes, often because of their sense of "corporate citizenship." You should consider the following types of organizations as possible sources of funding:
Some organizations may not have funds to contribute, but may donate facilities, equipment, or labor. Because these resources would probably cost a program real dollars to acquire, their donation is as good as money. Community organizations may not require formal grant proposals or extensive written requests. However, you must convince the person making decisions that the project is good for the community. Also, these organizations are not easily located. One of the best ways to find them is to talk with people who are likely to know about different kinds of community organizations and their leaders. You can also contact people with authority in organizations that have donated to local activities in the past. Foundations -- The sole purpose of foundations is philanthropic giving. One major advantage to grants from foundations is that it is usually easier to request money from foundations than from public agencies. Foundations also have the reputation for funding programs with good ideas but little experience. They are more likely to take a chance on a new organization. Because foundations may support only specific types of projects or projects in certain geographic areas, it is important to find out what foundations support violence prevention projects. The Foundation Center is an authoritative guide to foundations and provides detailed information on the interests and restrictions of individual foundations and on the money they have granted. The Foundation Center has four main offices as well as libraries in all 50 states. To locate the nearest library, call 1-800-424-9836. You can also find listings of foundations and information on what they support in your local library. After identifying a potential foundation funding source, write a letter to the foundation that briefly states what you want to do in the community and ask whether the foundation is interested in this type of project. Through this inquiry, you will also find out how to submit a grant proposal. Corporations -- Large business and nonprofit organizations in the United States donate a great deal of money each year. You may find a large company with facilities in your community, such as a factory or major distribution office, that is interested in donating money to your program.
Public AgenciesLocal Agencies-- Local agencies are potential sources for funding. These agencies include:
State Agencies -- State funding sources are often difficult to locate. Few states publish a directory of available funds. However, you may find funding sources through personal contacts, such as local elected officials. The Public Health Foundation compiles information on what program areas are funded in each state. You can reach the Foundation at (202) 898-5600. In addition, each state receives Federal funds in the form of block grants. These block grants are divided into four areas: preventive health; maternal and child health; alcohol, drug abuse, and mental health; and primary care. For information about these block grants, you can contact the appropriate administrative agency:
Federal Agencies -- As discussed under state agencies, Federal funds in the form of block grants are distributed through the states. However, there are additional grants and contracts distributed through individual Federal agencies. There are several sources for finding these federal agencies. Agencies solicit proposals and grant applications in the Federal Register and the Commerce Business Daily. Expect to devote considerable time to researching this information. Subscriptions to the Federal Register and the Commerce Business Daily can be ordered from the Government Printing Office by calling (202) 783-3238. (Stock number for this document is 941-001-00005-0.) However, these subscriptions are expensive. You may find it more practical to review these publications in your local library. The Catalog of Federal Domestic Assistance is an annual publication that describes major Federal grants and contracts. This publication includes eligibility requirements, criteria for selection, financial information, and contacts. Because this information could become outdated quickly, you should contact the agencies involved before submitting a proposal. The Catalog of Federal Domestic Assistance can be obtained by calling the Government Printing Office at (202) 783-3238. (Stock number for this document is 941-001-00005-0.) Other Federal agencies and organizations that have an interest in violence programs are listed here. These programs may not provide grant money or may have very restrictive qualifications for grantees. You should write the agency or talk with someone there to determine whether they are interested in your program.
Monitoring the Progress of Your ProgramProgram monitoring or evaluation is essential. It helps you adjust your program to meet unanticipated circumstances. We monitor things daily, which is how we improve things. Monitoring also enables the workers, the funding agencies, and, most importantly, the community members to know whether the program is making progress. Monitoring includes the collection of both objective data (e.g., the number of children who took a conflict resolution class) and subjective data (e.g., the number of students who say they are less likely to get into a fight). Monitoring should indicate whether your activities are on track and whether the intended outcomes are being achieved. Here are some of the questions that should be answered:
One of the major difficulties in violence prevention is that very few activities have been proven to work. Although some appear promising, thorough scientific evaluations of these programs are badly needed. However, such evaluations are complicated, expensive, and often too difficult for a community to do alone. Communities with a local university have a good opportunity to develop a community/academic partnership. In this type of relationship, the university could help design and carry out detailed evaluation of the community's violence prevention program. Even communities with limited resources must monitor and evaluate their progress. The specific evaluation activities undertaken and data collected are determined by the goals and objectives of the program. At the very least, community-based programs should do the following to monitor their progress:
ConclusionEffective community programs must do two general things:
The descriptions of the strategies provide a "menu" of violence prevention activities that may be appropriate for your community. Few of these activities are scientifically proven, but they appear promising. Many can be adapted to the specific needs of most communities. The chapter on "Program Management" provides suggestions about how to define the problem, select activities, get them started, and see them through to success. In general, one should strive to do the following:
To be successful, a program also requires attention day by day. Here are a few suggestions:
Other Useful Things To ReadBrown CR. The art of coalition building: A guide for community leaders. New York: The American Jewish Committee, 1984. Dyal WW. Program management: A guide for improving program decisions. Atlanta: Centers for Disease Control, Public Health Program Office. Green LW, Kreuter MW. Health promotion planning: An educational and environmental approach. Mountain View, CA: Mayfield Publishing Co., 1991. Milton S. Eisenhower Foundation. Youth investment and community reconstruction: Street lessons on drugs and crime for the nineties. Washington, D.C.: Milton S. Eisenhower Foundation, 1990. National Crime Prevention Council. Preventing Violence: Program ideas and examples. Order from the National Crime Prevention Council, 1700 K Street, NW, Second Floor, Washington, D.C. 20006-3817 The National Youth Gang Suppression and Intervention Program in cooperation with the U.S. Justice Department has developed a number of reports on youth gangs, how cities have responded to the problem of gangs, and community mobilization. You can order these reports by contacting: Administrative Assistant Newman O. Defensible space: Crime prevention through urban design. New York: Macmillan, 1972. Office of Disease Prevention and Health Promotion. Locating funds for health promotion projects. ODPHP National Health Information Center, P.O. Box 1133, Washington, D.C. 20013-1133. Wilson-Brewer R, Cohen S, O'Donnell LO, Goodman IF. Violence prevention for young adolescents: A survey of the state of the art. Working papers from the Carnegie Council on Adolescent Development. Carnegie Corporation, 2400 N Street NW, Washington, D.C. 20037-1153 (202) 429-7979
Appendix: Activities in the United States To Prevent Youth ViolenceThe following lists of community programs designed to prevent youth violence will help other communities that want to start activities locate programs that are of interest and talk to the people involved. Several points to keep in mind:
Tables that identify each Program(Table
8) - Mentoring If you want to list your violence prevention program, please fill out the following form and send to:
Name of the program: We would appreciate your helping us improve subsequent versions of this manual by taking a few minutes to answer the following questions: What did you find about the manual that was most helpful? POINT OF CONTACT FOR THIS DOCUMENT:To request a copy of this document or for questions concerning this document, please contact the person or office listed below. If requesting a document, please specify the complete name of the document as well as the address to which you would like it mailed. Note that if a name is listed with the address below, you may wish to contact this person via CDC WONDER/PC e-mail. MARY A FENLEY CDC Prevention Guidelines is presented as part of CDC
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