Background:
Violence is a contagious disease that has long term effects on health. The disease has become an epidemic across the country, which has affected the African-American community at a disproportionate rate. Violence represents a major health, criminal justice, human rights, and development challenge. This multi-city project aims to educate community members from Ferguson, MO, and Chicago, IL, on the long-term effects of exposure to violence. The target population in Chicago is the community of Austin. Ferguson is a small community; however, it is recognized nationally for the demonstrations and unrest that erupted after the August 9, 2014 shooting death of 18-year-old Michael Brown. Being healthy is not a silo-based activity. Effective interventions that reduce violence require collaboration, education, and involvement of many individuals on many levels.
Studies describe many of the various risk factors that have been shown to contribute to community violence. Individual risk factors include a personal history of victimization of violence, high emotional stress, and exposure to violence and conflict. Family risk factors include low parental education, low income, poor family functioning and low parental involvement. Community risk factors include diminished economic opportunities, high concentration of poor residents, and socially disorganized neighborhoods. All which are prevalent in violent communities.
Wicked Problem Description:
This multi-city project aims to join in the search for effective intervention models to break the cycle of violence. This project is predicated on the presumption of a societal moral responsibility to seek to provide community members education that will promote healthier lifestyles, coping mechanisms, support systems, and early detection and monitoring. This education would provide immediate benefits for the target communities and provide an effective national model that will mitigate and alleviate the escalating incidence and prevalence of community violence in our nation for generations to come.
Violence is a health equity issue. Scientific literature has shown violence impacts the physical and mental health. While violence is a reality in the world that we live in, some communities and groups, however, are more exposed to social conditions that create a medium for violence and can make violence a normal part of life. Inequities in violence-related outcomes are related to various systemic issues. In order to achieve health equity and transform communities, violence must be addressed. Improving healthful social conditions for all will ensure all benefit from the same basic rights, security, and opportunities. If we strive to promote the best social and physical conditions for all, then we will increase health equity and reduce health disparities. The World Health Organization (WHO) views violence as “one of the leading public health issues of our time. Violence is preventable. Preventing violence has a tremendous value, not just saving lives, but it also promotes health equity and strengthen communities.”
Project Strategies:
Building partnerships in both Ferguson and Chicago. This multi-city violence intervention project will promote awareness by educating community members on the effects of violence on the health. As leaders, the Clinical Scholars, Lachell Wardell and Tonita Smith, will reach out to community-based organizations, schools, faith-based organizations, healthcare providers, and after school programs to promote the vision of good health for these communities that have been impacted by violence.
Outcomes:
Continue to empower educators, parents, and clergy in both cities through education on the effects that violence has on health.
Ferguson:
- Educate community members on the importance of clinical screenings for youth.
- Advocate for policies that extend protective factors to at risk community members.
Chicago:
- Develop a trauma informed care program at the after school program, By The Hand Club for Kids, that embeds the theory of trauma in the organization’s five after school sites; thereby improving health outcomes for families and increasing staff wellbeing and retention.
Year One and Two Outcomes
A multi-city advisory board was developed that included both Clinical Scholars. Several meetings were held to strategize on ways to approach community leaders regarding violence prevention.
Ferguson:
- Anti-Violence Awareness video was created featuring youth from Ferguson Missouri. This video was used to create a social media campaign that is featured on Facebook and YouTube.
- A mentorship pilot curriculum program was developed and implemented in South Korea while Clinical Scholar (Tonita Smith, Public Health Nurse/Missouri) was deployed during year two of the project.
- Staff and students at three Korean based schools were surveyed on the benefits of mentoring in youth to improve overall health outcomes; results are in the final phase.
- The development of a curriculum with emphasis on trauma informed care, mental health and effects of violence on mental health is in the development phase targeting youth in the Ferguson area.
- Our partnership with a local community organization resulted in a total of eleven outreach and speaking engagements in St. Louis area schools and one community-wide health fair to raise awareness of the effects of violence on health and the importance of health screenings.
Chicago:
- IRB was established through Creighton University.
- Invitation was extended to join St. Louis ReCAST Coalition of Stakeholders after engaging St. Louis Public Health Department.
- A curriculum which infuses mental health and resilience aspects into how violence affects health was developed.
- Presentation in Chicago to educate faith based community members on the impact of trauma on health.
- Parents were surveyed in Chicago on the effects of violence on health.
- By The Hand Club for Kids collaborated with PCC Community Wellness.
- Staff at By The Hand Club for Kids received a half-day training conducted by RWJF Culture of Health Leaders Fellow, Dr. Isaiah Pickens, from The National Child Traumatic Stress Network.
- Parents of youth at By The Hand Club for Kids were educated on the link between trauma and poor health outcomes.
- A pilot program that offers clinical screenings for 4th and 5th grade youth at By The Hand Club for Kids.
- A referral system has been developed between PCC Community Wellness and By The Hand Club for kids.
- Youth who tested positive for Post-Traumatic Stress Disorder (PTSD) were offered behavior health services at PCC.
Timeline:
Ferguson: Provide educational awareness on the importance of health screenings and early interventions to achieve optimal health outcomes. Surveys will be conducted with parents and educators to evaluate their perception of behavioral health services.
Chicago: Promoting awareness on the link between trauma and health outcomes. Focus groups will be conducted with community members to evaluate their perceptions of counseling.
Partnerships:
Ferguson: Believers Temple Word Fellowship, Urban Initiatives, DREAM Success, Inc.
Chicago: PCC Community Wellness, By the Hand Organization, Emmanuel Health and Social Services, and UIC Miles Square/OCEANHP School Health Center.
Evaluation Strategies:
- Promotion of awareness of the effects of violence through education in the community
- The effectiveness of outreach efforts to promote a vision for good health among community-based organizations, schools, faith-based organization, healthcare providers, and after school programs where the population has been impacted by violence
- Evidence of engagement of participants in focus groups
- Effectiveness on the empowerment of educators, parents, and clergy through education on the effects that violence has on health
- Educate community members on the importance of clinical screenings
- Effectiveness of advocacy for policies that extend protective factors to at risk community members
