Community Violence as a Population Health Issue Proceedings of a Workshop (2017) / Chapter Skim
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5 Lessons Learned: Evaluating Community- and Hospital-Based Models and Initiatives
5 Lessons Learned: Evaluating Community- and Hospital-Based Models and Initiatives
Pages 43-56
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From page 43... ...
Jeffrey Butts, director of the Research and Evaluation Center at John Jay College of Criminal Justice, then reviewed his research team's evaluation of New York's Cure Violence program, and Thea James, vice president of mission and associate chief medical officer at the Boston Medical Center, discussed the implementation and expansion of a hospital-based violence intervention advocacy program. Following the three presentations, Webster moderated an open discussion among the workshop participants.
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From page 44... ...
One of these neighborhoods, known as Cherry Hill, is geographically isolated from the rest of the city, noted Webster. More recently, the city introduced the program in a west Baltimore neighbor lic Health, director of the Johns Hopkins Center for Gun Policy and Research, and deputy director for research for the Johns Hopkins Center for the Prevention of Youth Violence.
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From page 45... ...
By May 2012, two of the neighborhoods experienced a drop in homicides, 21 percent in McElderry Park and 34 percent in Cherry Hill, but in one neighborhood, Madison East End, where the program had been running for only 18 months, the homicide rate rose by 200 percent. That is a relatively rare outcome, but that is what they found.
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From page 46... ...
The most impressive results, said Webster, occurred in the geographically isolated Cherry Hill neighborhood, where there was a 44 percent reduction in homicides and a 41 percent drop in non-fatal shootings over a 7-year span starting in November 2008 even though the resources allocated to that neighborhood were reduced. Two other neighborhoods, Lower Park Heights and McElderry Park, also saw a reduction in homicides, 38 percent and 23 percent, respectively, though the program's inability to reduce gun violence in the Mondawmin neighborhood is of great concern, said Webster.
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From page 47... ...
Police and public officials received low marks while fire and ambulance crews received more positive reviews. When it came to measuring violence, Butts said there is no such thing as data on the incidence of violence, but rather data on proxies of violence, such as injuries reported by hospitals.
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From page 48... ...
In fact, she said, when she and her colleagues created Boston Medical Center's Violence Intervention Advocacy Program (VIAP) ,3 which is part of the National Network of Hospital-Based Violence Intervention Programs,4 2 This section is the rapporteurs' synopsis of the presentation made by Thea James, vice president of mission and associate chief medical officer at Boston Medical Center, and the statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 49... ...
they created it to provide services for both the injured individuals and their families. Helping individuals to leverage their own personal strengths and assets can affect population health and even prevention when dealing with a young person who has children, said James.
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From page 50... ...
Once her team had formed alliances throughout the hospital, the program ran smoothly. Another early approach James and her colleagues used was to plot a four-stage path that these young individuals would
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From page 51... ...
The program now has three advocates serving as case managers as well as a family support coordinator, a data research manager, and an employment
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From page 52... ...
James and her colleagues also work in tandem with a behavioral health team called the Community Violence Response Team based in the hospital's trauma department. Every person on the hospital's "protected list," which restricts visitors to protect an injured person's safety, is assigned to one of VIAP's advocates and to a member of the Community Violence Response Team.
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From page 53... ...
In contrast, neighborhoods that did not have good outcomes were staffed by outreach workers who saw their job as merely a means to a paycheck. "I believe that this is a program model that is highly dependent on these credible messengers building trust.
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From page 54... ...
Butts said the hospital component can be an incredibly powerful part of a violence intervention program if done well, but the political and economic power of the health sector can easily overwhelm the neighborhood base of what a Cure Violence program is supposed to be. "You do not want to professionalize it too much, but somehow there has to be a linking mechanism that allows the neighborhood-oriented credible messengers to feel comfortable interacting with the health industry," Butts
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From page 55... ...
George Isham of HealthPartners wondered in relation to scaling and consistency if there is a need to bring in collaborators from business schools who could share what they know about creating consistent leadership and scaling interventions so that they are more reproducible across geographies and organizations. Webster thought that was an important point and said he is co-chair of a recently formed Safe Streets Baltimore advisory committee that includes people with just that expertise to help them think about program management.
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From page 56... ...
He recounted a conversation he had with a physician who said he could say exactly how many cases of hepatitis B there were in his community from year to year. Butts replied to this physician that he does not have a state legislature deciding what hepatitis B is, nor is hepatitis B a different disease in every state.
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