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

项目摘要/摘要 青少年暴力是对美国青少年健康和福祉的主要威胁。我们的项目重点是 弗吉尼亚州里士满，一个遭受暴力和贫困蹂躏的中等城市。2014年，凶杀率 年轻人中的这一比例几乎是全国平均水平的四倍。尽管预防科学已经显示出在 确定着眼于个人、家庭或学校层面的有前途的青少年暴力预防计划， 在社区一级的干预措施方面取得的进展很少。我们的项目涉及实施一个 采用社区护理预防系统(CTC)的社区一级方法，通过 沃克-泰克(WT)社区外展计划(CTC PLUS)。当反恐委员会建立和培育社会 通过建立联盟以及确定和实施循证青年暴力来获得资本 WT模式将提高社区的能力和意识，以充分利用这些资源。 该项目的总体目标是实施和评估CTC+在社区层面的影响 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对初级青少年暴力结果(例如青少年杀人和故意伤害)的有效性 比率)，b)确定四氯化碳加成在多大程度上导致近期结果，包括减少 社区混乱，越来越多的年轻人受到高质量的循证暴力的服务 预防方案，减少与青年有关的风险和增加保护/促进因素 暴力，以及c)了解CTC+对邻里和社区能力的影响 与预防青少年暴力有关。三个可比较的社区将随机分配到 在不同的实施开始日期接收干预。干预将在第一个月开始 随机选择的社区(社区A)，而其他两个社区(社区B和C)提供服务 作为对照。第二年，第二个随机选择的社区(社区B)将开始 干预(与第一个干预社区一起)，而第三个社区作为对照。在……里面 第四年和第五年，社区A和B将继续实施干预措施。这一设计将提供 有足够的时间(即3-4年)使社区A和B产生干预效果。 社区(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，代表无干预控制社区 在这一供资期间)。设计的多个元素的这种随机化(即，按照 社区接受干预和时机)大大加强了这种设计，因为它 增加可能的任务数量，同时保持干预的系统交错 引言。这为执行参数分析和替代分析策略提供了基础 减少对数据的假设。如果被证明有效，这种创新的干预措施将推动 预防青少年暴力的科学和实践，具有重大的公共卫生意义。

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.