A Model for Effective Community-Academic Partnerships for Youth Violence Prevention

"This program is literally saving lives": A participatory qualitative study of youth outcomes in a community-based music program to interrupt violence

INTRODUCTION

Despite urgent need for evidence-based violence prevention solutions, demonstrating the impact of community-based violence prevention programs, which are primed to be culturally relevant and community-tailored, remains difficult. Thus, our community-academic research team, conducted a participatory evaluation to identify proximal outcomes of Beyond the Bars (BTB), an urban United States-based music enrichment program seeking to empower young people and facilitate community healing from cycles of disinvestment and violence.

METHODS

We explored perceived BTB outcomes on student participants through semi-structured qualitative interviews with 16 adolescent students (Mage=17.31 years, 69% male), 4 adult instructors (75% male), and 6 adult community partners (50% male). We coded interview transcripts and then iteratively analyzed relevant coded text to identify salient themes within and across interest holder groups.

RESULTS

Interviewees identified similar programmatic impacts on students, which we consolidated into five themes: (1) access to safe, creative spaces (2), musical and technical skill development (3), personal growth (4), relational and interpersonal growth, and (5) growth mindset and future orientation. They described outcomes as progressive, with students' gaining musical, social, and creative skills and access to a safe and supportive community being foundational to enhancements in self-efficacy and future orientation and budding efforts to advocate within their communities.

CONCLUSIONS

Our findings demonstrate integration of strengths-based approaches in youth violence prevention programming to support holistic wellbeing beyond risk reduction. Further, our work underscores need to develop evidence for and elevate community-generated solutions to rebuild and heal communities.

Using Community Engagement to Move Upstream to Address Social Determinants of Health

ABSTRACT

Given its role as a safety net institution, the University of Florida Health (UF Health) Jacksonville has responded to the community's needs through partnerships with the community for decades. Such academic-community partnerships have a broad emphasis on population health and primary care that expands the model of care to include community engagement, which allows such partnerships to promote health and well-being and reduce health inequalities by addressing social determinants of health (SDOH).This report describes the UF Health Jacksonville and University of Florida College of Medicine-Jacksonville's creation of the Urban Health Alliance (UHA) in June 2019 due to continued poor health outcomes and inequities within the community. The mission of the UHA is to improve community health using community-focused, self-sustainable strategies and solutions to impact SDOH (i.e., more upstream interventions). Using the tenets of the collective impact model, the UHA acts as a backbone organization to achieve these objectives by empowering community partners to affect changes in policy, systems, and other structures necessary for the optimal health of the community. The UHA's work is divided across 4 pillars: services, research, education, and policy. These pillars reflect the traditional missions of academic medical centers-clinical care, research, and education-and the need to address structural changes to improve community health-namely, policy. By addressing the issues that most impact the patients and community of UF Health Jacksonville, the UHA can serve as an example of how an academic medical center can use the traditional missions to improve the community's health and move toward health equity.

The ACHIEVE Program: Bringing Chicago Youth and Community Organizations Together to Impact Local Disparities

To evaluate the Advancing Community Health and Individual leadership through a noVel Educational (ACHIEVE) program uniting Chicago high school and undergraduate students (scholars) and community organizations to empower youth to meaningfully impact communities while enhancing organizational capacity. Between 2020 and 2022, the ACHIEVE program engaged cohorts of youth in classroom-based learning and community-based projects targeting health and education disparities. Pre and post-program surveys were administered to scholars to assess knowledge about disparities, skills, and self-efficacy. Semi-structured interviews were conducted with community organization leaders to examine programmatic impact. Descriptive and thematic analyses were performed. Across four cohorts (March 2020; September 2020-May 2021; September-November 2021; March-May 2022), 85 students participated in the ACHIEVE program. Scholars supported 19 community-based projects that increased awareness of local issues and resources and evaluated programs. Scholars reported advancement in their knowledge and skills as well as interest in sustaining their community engagement. Leaders shared several benefits at the organizational and community levels from collaborating with scholars. The ACHIEVE program enabled bidirectional learning between scholars and organizations. It also demonstrated that youth can contribute positively to addressing disparities while supporting local organizations and communities.

The Impact of the Communities that Care Approach in Reducing Violence and Crime Within an Urban, High-Burden Community

Community violence and crime are significant public health problems with serious and lasting effects on young people, families, and communities. This violence and crime have significant ripple effects, affecting not just those who are directly physically injured, but also those who witness violent episodes, those who have friends or loved ones killed or injured, and those who must everyday navigate streets that they know have been frequent sites of serious violence and crime. The current study presents evidence of the impact that a data-driven, collective impact approach - the Communities that Care prevention system - can have on violence and crime outcomes within a large urban, high-burden community. Established as one of the national Youth Violence Prevention Centers (YVPC) funded by the Centers for Disease Control and Prevention, the Chicago Center for Youth Violence Prevention is among the first to implement the CTC approach in a large, urban community. The current study's findings show reductions in violence (i.e., aggravated assaults and robberies) in the Bronzeville community, compared to similar communities in Chicago.

Preparing Trainees for Public Health Advocacy Through Community Partnerships

This article reviews the existing literature related to medical training in public advocacy and provides the reader with several training examples to consider in a child and adolescent psychiatry fellowship or in combined training programs. Advocacy training embedded within community, forensic, integrated care, school, and many other experiences throughout training provides the skills and tools that the trainee will use in the future when they practice in any setting. This comprehensive training approach aligns with the evolving landscape of child and adolescent mental health where a deep commitment to public health and advocacy is increasingly essential.

Costs of Implementing Teen Dating Violence and Youth Violence Prevention Strategies: Evidence From 5 CDC-Funded Local Health Departments

OBJECTIVES

In 2016, the Centers for Disease Control and Prevention supported 5 local health departments (LHDs) to implement teen dating violence and youth violence primary prevention strategies across multiple levels of the social-ecological model and build capacity for the expansion of such prevention efforts at the local level. The objective of this study was to estimate the total cost of implementing primary prevention strategies for all LHDs across 3 years of program implementation.

METHODS

We used a microcosting analytic approach to identify resources and compute costs for all prevention strategies implemented by LHDs. We computed the total program cost, total and average cost per strategy by social-ecological model level, and average cost of implementation per participant served by the program. All costs were inflated via the monthly Consumer Price Index and reported in August 2020 dollars.

RESULTS

For 3 years of program implementation, the total estimated cost of implementing teen dating violence and youth violence primary prevention strategies was >$7.1 million across all 5 LHDs. The largest shares of program-related costs were program staff (55.9%-57.0%) and contracts (22.4%-25.5%). Among prevention strategies, the largest share of total costs was for strategies implemented at the community level of the social-ecological model (42.8%).

CONCLUSIONS

The findings from this analysis provide a first look at the total costs of implementing comprehensive teen dating violence and youth violence primary prevention strategies and serve as a foundation for investments in local violence prevention funding for young people.

Violence Prevention in Pediatrics: Advocacy and Legislation

Given the complexities of youth violence prevention and longstanding violence inequities, advocacy by pediatric clinicians provides a critical voice to represent youth at multiple levels to address the myriad contributors and effects of youth violence. Institutional, community, state, and federal programs, policies, and legislation are required to support a public health approach to the amelioration of youth violence. This article focuses on the role of pediatric clinicians in advocating for youth and families, promoting change within clinical and hospital systems, partnering with communities to advance evidence-informed prevention and intervention, and legislative advocacy to advance violence prevention policy, research, and practice.