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Journal Article

Citation

Schleimer JP, Lyons V, Smith D, Ali F, Averett L, Baugh M, Benson L, Colon J, Cook J, Davis D, Diandy M, Fox A, Gonzalez E, Johnson A, Lowe AB, Marshall M, Maryman B, McLaurin V, Nehra D, Orozco A, Palmer K, Serrano R, Shrader Z, Thurston C, Watlington E, Waskewitz L, Westlake E, Jones K, Rowhani-Rahbar A. J. Trauma Acute Care Surg. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000004277

PMID

38509040

Abstract

BACKGROUND: Community-based violence intervention (CVI) programs are considered important strategies for preventing community violence and promoting health and safety. Mixed and inconclusive results from some prior CVI evaluations-and our general lack of understanding about the reasons for such varied findings-may be explained in part by misalignment of program theories of change and evaluation measures. Further, most prior evaluations have focused solely on deficit-based outcomes; this narrow focus is inconsistent with the premise of CVI and may fail to capture improvements in health and wellbeing that are on the hypothesized pathway from intervention to violence reduction.

METHODS: This paper describes the process and results of co-developing a theory of change for community-based youth firearm violence intervention and prevention programs in Washington state through a community-researcher partnership. We followed a multi-step iterative process, involving 1) CVI program documentation review, 2) individual meetings, and 3) a day-long workshop.

RESULTS: The theory of change included 6 key domains: 1) root causes, 2) promotive factors, 3) activities, 4) inter-mediate outcomes, 5) longer-term outcomes, and 6) multi-level context (youth/family, staff/organizational, community, and societal). Root causes were social and structural drivers of community violence. Promotive factors were assets and resources among the community, youth/their families, and community organizations that promote health and safety. Activities were supports and services the program provided to youth and their families, staff, and potentially the broader community. Inter-mediate and longer-term outcomes were the changes among youth, their families, staff, and the community that resulted from program activities. Inter-mediate outcomes may be felt within 6 months to 1 year and longer-term outcomes may be felt after 1-2 years and beyond.

CONCLUSIONS: The theory of change we co-developed provides a common lens to conceptualize, compare, and evaluate CVI programs in Washington state and may support more rigorous and equity-centered evaluations.Study type: original investigation. LEVEL OF EVIDENCE: N/A.


Language: en

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