Multipronged intervention works to reduce youth violence and injury

A comprehensive prevention approach in one Michigan city has reduced youth violence and injury as a result of an intervention involving a combination of existing programs, researchers at the University of Michigan report.

The Michigan Youth Violence Prevention Center at the U-M School of Public Health, in partnership with Flint, Mich., community organizations, found that following a two-and-a-half-year effort employing six community programs, young people in a selected intervention area were 25 percent less likely to be victims of a violent assault than those in a comparison area.

This was accompanied by a 38-percent decrease in youth assault-related injuries from those in the selected area seeking treatment in the local emergency room.

"We see promise in strengths-based approaches to violence prevention, where building social cohesion, social trust and collective efficacy in neighborhoods can help communities overcome blighted areas, in which 'broken windows' signal less ownership and more opportunity for crime," said Justin Heinze, lead author and research assistant professor of health behavior and health education.

"Rather, interventions that can help empower communities to create vibrant, safe spaces will promote healthy futures for all residents."

The intervention began in 2011 and concluded in 2015. The two neighborhoods, both a little more than a square mile, were similar in racial/ethnic makeup, economics and other demographics.

To get a picture of youth violence in Flint, researchers collected data from 2005 to 2013 to find an average number of assaults over the period. Assault injury data came from the Hurley Medical Center Emergency Department, the only Level 1 trauma center in the region and the only public ED in the community, from January 2010 through December 2013.

The researchers said it was the combination of programs that made the difference.

"We have learned a few things about youth violence prevention," said Marc Zimmerman, center director and professor of health behavior and health education and final author. "First, no one approach may work. Rather, we need to think ecologically and address multiple levels of intervention. Second, it is pretty clear from our work that success depends on collaborations across disciplines and with community partners.

"By focusing on individual skill development, family relations and environmental change, we had a better chance of reducing youth violence than if we focused on just one of those."

Partners included the Genesee County Health Department, Flint Police Department, Hurley Medical Center, faith-based organizations, neighborhood groups, Boys and Girls Club of Greater Flint, Michigan State University School of Criminal Justice, Mott Children's Health Center and Genesee County Land Bank.

The six programs include: Youth Empowerment Solutions and Project Sync (both with an individual focus); Fathers and Sons and Targeted Outreach Mentoring (relationship focus); and Community Policing Mobilization and Clean and Green (community focus).

Youth violence is the second-leading cause of death for adolescents and young adults ages 15-24. Research shows 700,000 young people visit the emergency department each year due to assault. To put a dollar figure on it, the Centers for Disease Control and Prevention estimates that youth violence costs the U.S. about $16 billion in loss of future work and medical costs every year.

Heinze said these statistics show that Flint is not alone in its experience of youth violence and this sort of intervention could be relevant elsewhere.

"Many of the resources that helped these programs to be effective were already present in the intervention community and would likely be available in communities all over Michigan and the U.S.," he said. "It tells me that Flint and cities like it already have the capacity to begin to change youth violence outcomes.

"Public health practitioners can use similar approaches (multiple programs focusing on multiple levels) to empower youth and adults in their own communities to reduce community violence, which is becoming an ever greater health risk for youth under 25."