Healthy Communities for Youth

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

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.