Healthy Communities for Youth

Principal Investigators: Terri Sullivan, Ph.D., and Derek Chapman, Ph.D.

Co-Investigator: Fantasy Lozada, 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. 

2021-2026 Healthy Communities for Youth – II (HCFY-II)

This project uses a comprehensive, multi-level social-ecological approach to prevent youth violence. The Centers for Disease Control and Prevention (CDC) identified risk and protective factors for youth violence prevention at the individual, relationship, community, and societal levels (CDC, 2021). However, most youth violence prevention strategies focus solely on individual-level and relationship-level factors, which limits their ability to create and maintain reductions in community-levels of youth violence (Nation et al., 2021). Our comprehensive approach addresses this gap by incorporating universal prevention strategies that target social and structural factors associated with youth violence.

Two universal prevention strategies focus on developing school- and community-based actions to increase opportunities for positive youth development (PYD). A strong link exists between youth violence prevention and PYD opportunities. These opportunities include settings, resources, programs, and activities that promote youth skills, connect youth with positive relationships (e.g., with caring adults and prosocial peers), and create safe and healthy, youth-centric environments (David-Ferdon et al., 2016). At the community-level, limited youth services and experiential learning opportunities increase risk for violence exposure, while access to PYD opportunities (e.g., educational and experiential learning, sports, the arts, music, and recreation in school, after-school, and community settings) serves a protective role in decreasing the likelihood of youth violence (David-Ferdon et al., 2016). Thus, PYD opportunities can reduce violence exposure and increase protective processes (i.e., support, empowerment, and constructive use of time) and competencies (i.e., social competencies, positive values, and identity) related to youth violence prevention and healthy development (Benson, Scales, & Syvertsen, 2011; Smith, Witherspoon, & Wayne Osgood, 2017).

Participatory Action Research Strategies

1. The SEED Method is an evidence-based PAR approach developed by Dr. Emily Zimmerman that engages adult and youth participants in decision-making, in this case, to address opportunities for PYD. The SEED Method was developed in response to the need for evidence-based methods that incorporate best community-based practices, processes, and engagement models. It has been applied in various settings to assist stakeholders in examining health-related issues, identifying and prioritizing strategies to address them, and developing a community action plan to increase PYD.

Youths’ strategies

•   Increase out-of-school time programming at the local community center by providing multiple, interesting programs (e.g., dance, cooking, computers, art), increased staffing, increased safety (e.g., street lighting), and transportation assistance as needed.
•   Prioritize community unity – make it a place where the community can come together
•   Provide job opportunities for youth – on weekends and school breaks so they can build resumes and earn money.

Parents/Caregivers

•   Create structures that allow families to be heard and have real input on decisions.
•   Create a year-round mentoring program with consistent mentors for youth who are available and in it for the kids.

Community partners

•   Staff preparation and training – offer training for youth organizations addressing social-emotional learning and mentoring.
•   Ensure collaboration among youth-serving organizations and ensure that resources are allocated fairly and benefit grassroots programs.

2. Youth Voices is a curriculum developed by Dr. Fantasy Lozada that focuses on sociopolitical development (e.g., civic engagement) and teaches adolescents how to rely on their socioemotional competencies as they learn more about community- and societal-level factors that impact PYD opportunities.

•  Included 15 school-based sessions in the classroom or after-school with an emphasis on leadership skills, scientific inquiry, socioemotional competence, sociopolitical development, and community action
• Youth-selected project – Photovoice and Artificial Intelligence (AI)
  • 3 sessions dedicated to using photovoice to capture what youth see as barriers to PYD in their communities
  • 3 sessions dedicated to using image generator AI to demonstrate the future that youth hope to see in their communities.
  • 1 Photovoice Gallery Exhibit hosted at the Main Branch Library to showcase their work and speak to the action plan.

3. Emerging Leaders – is a prevention strategy developed by the Injury and Violence Prevention Project (IVPP) that focuses on a 16-session PYD workshop series. Emerging Leaders engages youth aged 10-24 years, delivering group workshops within their respective age groups. The workshop series was developed in accordance with the PYD framework to promote healthy youth development. The goal is to provide a curriculum that offers youth appropriate resources for their stage of development and provides youth with assets and environmental support.

• The workshop topics include the following:
• • Self-Discovery - self-identity, understanding emotions and emotion regulation, and goal setting
  • Trust and Relationships – building healthy relationships
  • Social Responsibility – community service and making positive community changes
  • Financial Responsibility – learning how to manage finances and access financial resources
  • Career Exploration and Readiness – exposure to career opportunities in the hospital, further education, and internship/apprentice opportunities
  • Self-Reflection of Growth and Accomplishments – review of progress and goals achieved

Healthy Communities for Youth – I (HCFY-I)

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. 

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Surveillance: Monitoring Youth Violence

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 in Richmond city residents under the age of 24 years. The surveillance entails continuous gathering, analysis, interpretation and dissemination of data. The data are intended to assist policy makers, program planners and researchers designing prevention programs. The surveillance system relies on administrative data gathered by agencies in the city and available for further research. Currently, the community surveillance system summarizes data from the VCU Health System’s emergency room, Department of Juvenile Justice, Richmond Ambulance Authority, Richmond Public Schools, and Office of the Chief Medical Examiner and Division of Vital Records at the Department of Health.

Data are summarized in the form of fact sheets and maps and are disseminated regularly. Maps geographically display youth violence rates in the city and present a visual representation of the spatial relationship between violence, neighborhoods and zip codes.