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Healthy Communities for Youth

Principal Investigators:
Saba Masho, M.D., M.P.H, Dr.PH., and
Terri Sullivan, Ph.D.

Youth violence is a major threat to the health and well-being of youths in the U.S. This project focuses on Richmond, Va., a medium-sized city that is ravaged by violence and poverty. In 2014, the rate of homicide among youths in Richmond 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 slower. This project seeks to advance progress in this area by evaluating the impact of a strategy that combines two complementary evidence-based community-level intervention approaches. 

The Communities That Care prevention system (CTC) builds and cultivates social capital through coalition building and identification and implementation of evidence-based youth violence programs. The Walker-Talker (WT) community outreach program complements CTC by increasing 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 combining these two strategies (i.e., CTC PLUS).

Specific objectives are to determine the impact of CTC PLUS on: 

a) primary youth violence outcomes (e.g., homicides and intentional injuries);
b) 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 and promotive factors associated with youth violence; and
c) aspects of neighborhood and community readiness and capacity associated with youth violence prevention.

CTC PLUS will be evaluated using a multiple baseline experimental design in which three high-risk communities will be randomly assigned to begin the intervention at different start dates (i.e., Year 2, Year 3, Year 5) with continuous assessment of outcomes through surveillance data, community surveys of youth and their caregivers, and observations. By including one or more replications, multiple baseline designs reduce a variety of threats to internal validity and provide a more rigorous test of interventions than designs in which an intervention is implemented within a single community. Additional tests of intervention effects will be conducted through spatial analysis of more than ten years of surveillance data that compare patterns of change in the three selected communities to concurrent changes observed in other communities in Richmond. 

The cost-effectiveness of the CTC PLUS models will be conducted to monitor and document implementation costs. If proven effective, this innovative intervention may reduce youth violence in our high-burden communities and help advance the science and practice of youth violence prevention. 

Additionally, the project monitors youth violence rates and characteristics in the city of Richmond via a community surveillance system.

The primary objective of the community surveillance system is to describe and monitor youth violence activities of Richmond city residents under age 24 through continuous gathering, analysis and interpretation of data. The surveillance system is also used to disseminate information to assist policy makers, program planners and researchers designing prevention programs. The surveillance system relies primarily on secondary data gathered by agencies in the City and available for further research. The community surveillance system currently obtains data from the following sources: VCU Health System’s emergency room; Medical Examiner; Vital Registry; Ambulance service; Richmond Public Schools; and the Department of Juvenile Justice in Richmond.

Analysis of these data is conducted regularly and used to develop fact sheets and maps to educate policy makers, program planners, researchers and the public. Maps geographically display youth violence activities in the city and present a visual representation of the spatial relationship between violence, neighborhoods and zip codes.

Data Sheets Available for Download:


This fact sheet focuses on ambulance pick-ups among 10-24 year-olds made by the Richmond Ambulance Authority, the franchise granted by the City of Richmond to provide emergency medical services. Trends, characteristics, rates and the geographic distribution of violent injury events are described.


The VCU Emergency Department (VCU ED) is the only level-one trauma center in Central Virginia and is estimated to serve approximately three-quarters of Richmond City’s trauma patients. Trends of intentional injury emergency room visits to the VCU ED among 10-24 year-old Richmond City residents are characterized and depicted in figures and maps.


Trends and characteristics of youth involved in crime incidents reported to the Richmond City Police Department are examined. This analysis includes youth between 10 and 24 years of age who were victims or perpetrators of violent incidents. This fact sheet describes Group A offenses (using the FBI Incident-Based Reporting classifications), as they are most serious and reported more frequently, and also specifically includes characteristics and trends of homicide, assault and sexual assault.


Publically available data for Richmond City public schools are obtained from the Virginia Department of Education and Richmond Public Schools. Information on truancy conferences of unique students, dropouts, discipline incidents and accreditation status are described.


This fact sheet describes youths who receive services from the Department of Justice Services. Data include youths who were formally processed by the Juvenile and Domestic Relations Court. Youth between the ages of 10 and 18 years are included in this analysis to describe characteristics and trends of violence-related offense referrals for services.


Describes trends of homicide and suicide related deaths captured in the Virginia Violent Death Reporting System (VVDRS). The VVDRS is a surveillance system that continually collects data on violence-related deaths. The Office of the Chief Medical Examiner, Virginia Department of Health conducts the VVDRS as part of the National Violent Death Reporting System funded by the Centers for Disease Control and Prevention. This report summarizes data from the VVDRS, inclusive of 10-24 year-old youths who reside or were injured in Richmond City.