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.

Public Health Relevance

The goal of the proposed research is to implement and evaluate the impact of a comprehensive community-level youth violence prevention strategy that integrates the Communities That Care prevention system and the Walker Talker community outreach and capacity building approach (CTC PLUS) in three high-risk urban communities. Findings may inform youth violence prevention strategies in other communities for broader national impact.

National Institute of Health (NIH)
National Center for Injury Prevention and Control (NCIPC)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZCE1)
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Virginia Commonwealth University
Family Medicine
Schools of Medicine
United States
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