Evaluation of a Comprehensive Community-Level Approach to Youth Violence Prevention

项目总结/摘要 青少年暴力是对美国青少年健康和福祉的主要威胁。 弗吉尼亚州的里士满，一个饱受暴力和贫困蹂躏的中等城市。2014年， 年轻人的死亡率几乎是全国平均水平的四倍。尽管预防科学已经取得了进展， 确定有希望的预防青少年暴力方案，重点放在个人、家庭或学校层面， 社区一级的干预措施进展甚微。我们的项目包括实施一个 社区一级的方法，采用社区护理预防系统（CTC），加强与 步行者-谈话者（WT）社区外展计划（CTC PLUS）。在CTC建立和培养社会 通过建立联盟以及查明和实施循证青年暴力， WT模式将提高社区充分利用这些资源的能力和意识。 该项目的总体目标是实施和评估社区一级CTC PLUS的影响 在多基线设计背景下的战略。我们的具体目标包括：a）确定 CTC PLUS对主要青少年暴力结果的有效性（例如，青少年杀人和故意伤害 率），B）确定CTC PLUS导致近端结局的程度，包括降低 邻里组织混乱，越来越多的青年受到高质量的循证暴力的服务 预防计划，降低风险，增加与青年相关的保护/促进因素 c）了解CTC PLUS对邻里和社区能力方面的影响 与预防青少年暴力有关。三个可比较的社区将被随机分配到 在不同的实施开始日期接受干预。干预将在第一个开始 随机选择的社区（社区A），而其他两个社区（社区B和C） 作为对照次年，第二个随机选择的社区（社区B）将开始 干预（沿着第一干预社区），而第三社区作为对照。在 第4年和第5年，社区A和B将继续实施干预措施。该设计将提供 足够的时间（即，3-4年）的干预效果出现在社区A和B。第三 社区C将接受实施干预措施的培训和技术支持 在第5年的最后一波数据收集之后（即，代表一个无干预控制社区 在此期间，）。设计的多个元素的这种随机化（即，这两个顺序 社区接受干预和时机）大大加强了这一设计，因为它 增加了可能的分配数量，同时保持干预的系统交错 导论.这为进行参数分析和替代分析策略提供了基础， 对数据做更少的假设。如果证明有效，这种创新的干预措施将推动 预防青年暴力的科学和实践，并具有重大的公共卫生影响。

Project Summary/Abstract Youth violence is a major threat to the health and wellbeing of youths in the U.S. Our project focuses on Richmond, Virginia, a medium-sized city that is ravaged by violence and poverty. In 2014, the rate of homicide among youths was nearly four times the national average. Although prevention science has shown progress in identifying promising youth violence prevention programs that focus on the individual-, family-, or school-levels, progress on community-level interventions has been scarce. Our project involves the implementation of a community level approach employing the Communities That Care prevention system (CTC), enhanced with the Walker-Talker (WT) community outreach program (CTC PLUS). While the CTC builds and cultivates social capital through coalition building and identification and implementation of evidence-based youth violence programs, the WT model will increase community capacity and awareness to make full use of these resources. The overall goal of this project is to implement and evaluate the community-level impact of the CTC PLUS strategy within the context of a multiple-baseline design. Our specific objectives include: a) determine the effectiveness of CTC PLUS on primary youth violence outcomes (e.g., youth homicides and intentional injury rates), b) determine the extent to which CTC PLUS leads to proximal outcomes including decreased neighborhood disorganization, increased numbers of youth served by high quality, evidence-based violence prevention programs, and decreased risk and increased protective/promotive factors associated with youth violence, and c) understand the impact of CTC PLUS on aspects of neighborhood and community capacity associated with youth violence prevention. Three comparable communities will be randomly assigned to receive the intervention at different implementation starting dates. The intervention will begin in the first randomly selected community (Community A), while the other two communities (Communities B and C) serve as controls. The following year, the second randomly selected community (Community B) will begin the intervention (along with the first intervention community), while the third community serves as a control. In years 4 and 5, communities A and B will continue implementing the intervention. This design will provide adequate time (i.e., 3-4 years) for the intervention effect to emerge in Communities A and B. The third community (Community C) will receive training and technical support for implementing the intervention following the last wave of data collection in Year 5 (i.e., representing a no-intervention control community during this funding period). This randomization of multiple elements of the design (i.e., both the order in which the communities receive the intervention and the timing) strengthens this design considerably because it increases the number of possible assignments while maintaining the systematic staggering of the intervention introduction. This provides a basis for conducting parametric analyses and alternative analytic strategies that make fewer assumptions about the data. If proven effective, this innovative intervention will advance the science and practice of youth violence prevention and have significant public health implication.