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What You Need to Know About Youth Violence Prevention

Promoting Healthy, Nonviolent Children: What Works and What Doesn't?

• Why take the public health and development approaches?
  
• What are best practices to prevent youth violence?
  
• How do large-scale prevention programs work best?
  
• Is prevention cost-effective?
  
• Violence prevention programs by best practices category

WHY TAKE THE PUBLIC HEALTH AND DEVELOPMENTAL APPROACHES?

• The most common reaction to youth violence has been to "get tough" on violent offenders and to focus on punishment. The public health approach focuses more on the prevention of violence than on punishment or rehabilitation.
• The public health model looks at factors that put young people "at risk" for violent behavior. Practical, goal-oriented, community-based strategies that address these risks can help reduce injuries and deaths caused by violence—just as the public health approach already has reduced traffic fatalities and deaths attributed to tobacco use.
• Patterns of behavior change over the course of a person's life. A developmental approach permits primary prevention researchers to design violence prevention programs that can be put in place at just the right time to be most effective in the life of a child or young person. Preventive interventions must be developmentally appropriate to be effective.


The U.S. Surgeon General's report suggests the following approaches to address youth violence:
• Prevention and intervention programs must reflect the different patterns of violence typical of early and later onset.
• Early childhood programs that target at-risk children and their families are important to prevent the onset of a chronic violent career.
• Programs must be developed to identify patterns, causes, and prevention strategies for late-onset violence.
• A comprehensive community prevention strategy must address both early- and late-onset patterns and determine their causes and risk factors.
• Serious violence is an element of a lifestyle that includes drugs, guns, early sex, and other risky behaviors. Successful interventions must focus on the risky lifestyle of the young person.

The most highly effective preventive intervention programs combine approaches that address both individual risks and environmental conditions. Building individual skills and competencies, providing parent effectiveness training, improving a school's social climate, and changing young people's type and level of involvement in peer groups, combined, are particularly effective.

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WHAT ARE BEST PRACTICES TO PREVENT YOUTH VIOLENCE?

The Surgeon General describes three categories of preventive interventions: primary, secondary, and tertiary.

• Primary preventive interventions are designed for general populations of youth, such as all students in a school. Most of these young people have not yet become involved in violence or encountered specific risk factors for violence.
• Secondary preventive interventions are designed to reduce the risk of violence among young people who display one or more risk factors for violence (high-risk youth).
• Tertiary interventions are designed to prevent further violence or escalation of violence among young people already involved in violent behavior.

The U. S. Surgeon General's report identifies prevention strategies found to be effective and ineffective for specific populations. Table 3 lists those findings.

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HOW DO LARGE-SCALE PREVENTION PROGRAMS WORK BEST?

Limited research shows that the successful implementation of a large-scale program depends as much on effective implementation as it does on the program's content and characteristics. Important factors for success in implementing a national program in a local community are:

• Focus on a distinct problem;
• Appropriate program for the specific target population, participant, and family;
• Staff buy-in to the program;
• Motivated and effective project leadership;
• Effective program director;
• Well-trained and motivated staff;
• Plentiful resources; and
• Implementation of the program with fidelity to its design.

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IS PREVENTION COST-EFFECTIVE?

Sometimes cost savings due to prevention and intervention programs are not obvious because of the time lag between the implementation of a program and the appearance of its effects. However, in the United States, where criminal justice focuses on get-tough laws and incarceration for serious violent criminals, hundreds of billions of dollars are spent each year on the criminal justice system, security, and the treatment of victims, or are lost due to lower productivity and quality of life.

Crime prevention, on the other hand, avoids incurring not only the costs of incarceration, but also some short- and long-term costs to victims, including material losses and medical costs. Other benefits may be difficult to quantify, but in addition to reduced medical costs, the indirect benefits of preventing serious or violent offenses include increased worker productivity, increased tax collection, and even reduced welfare costs.

It is important to match the intervention to the target population. This link has a critical effect on both the cost effectiveness and the overall effectiveness of an intervention. For more details about the cost effectiveness of youth violence prevention programs, see Youth Violence: A Report of the Surgeon General, chapter 5.

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VIOLENCE PREVENTION PROGRAMS BY BEST PRACTICES CATEGORY

The Surgeon General's report identifies strategies and programs that work, that are promising, and that do not work to prevent youth violence. If a program is not identified in the Surgeon General's report as "model" or "promising," it does not mean it is ineffective. In most cases, it means only that it has not yet been rigorously evaluated or that its evaluation was not complete. The scientific standards that were used in the analysis of programs for the Surgeon General's report are given here.

Model

• Rigorous experimental design (experimental or quasi-experimental)
• Significant deterrent effects on:
• Violence or serious delinquency
• Any risk factor for violence with a large effect size (.30 or greater)
• Replication with demonstrated effects
• Sustainability of effects

Promising

• Rigorous experimental design (experimental or quasi-experimental)
• Significant deterrent effects on:
• Violence or serious delinquency
• Any risk factor for violence with an effect size of .10 or greater
• Either replication or sustainability of effects

Does not work

• Rigorous experimental design (experimental or quasi-experimental)
• Significant evidence of null or negative effects on violence or known risk factors for violence
• Replication, with the preponderance of evidence suggesting that the program is ineffective or harmful

Twenty-seven model and promising programs and two programs that do not work are presented in the U.S. Surgeon General's report. Some are school-based and some are community-based. They present a wide variety of approaches for dealing with problems ranging from poor parenting to bullying, drug abuse, and gang involvement. Table 4 lists these programs. Descriptions of the programs are included in the appendix of this pamphlet and in the U.S. Surgeon General's report, pages 133-151.

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