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Community violence intervention

 

Key points

 

Introduction

Community violence intervention (CVI) reduces firearm injuries and deaths by addressing the root causes of violence and engaging with affected individuals and communities. CVI focuses on those who are at the highest risk of becoming victims of or engaging in violence. As defined by the CVI Ecosystem, CVI involves a comprehensive set of strategies that address the underlying factors contributing to violence and focus on interrupting cycles of violence, preventing retaliatory acts, and promoting positive community change.  Collaboration between public health agencies, community organizations, law enforcement, and hospitals is essential for effective CVI implementation. This CVI ecosystem combines prevention and intervention partnerships engaged in the work at the community and policy levels.

Are community violence interventions effective?

Evaluations of CVIs are limited; however, findings are promising, demonstrating that the programs result in increased access to needed services and reduced trauma. For more information  regarding single-site hospital-based violence intervention programs (HVIPs): 

Ongoing research and evaluation are underway nationwide to study their contribution to reducing incidents of firearm injury and deaths, core components of programs (both hospital-based and community-based), and ways in which the CVI ecosystem and efforts to empower community members can contribute to program success.

Community violence intervention strategies

Hospital-based violence intervention programs (HVIPs) work with individuals treated for firearm injuries, engaging them during their hospital stay. These programs offer trauma-informed care, counseling, and social support that address individuals' social, emotional, and economic needs, reducing the likelihood of future injury.6-9

Community-based programs work with individuals treated for firearm injuries, engaging them during their hospital stay. These programs offer trauma-informed care, counseling, and social support that address individuals' social, emotional, and economic needs, reducing the likelihood of future injury. Some additional resources for information about community-based programs include:

Community-based programs often use: 
  • Trained outreach workers to build relationships with individuals at risk of engaging in or being affected by violence. These outreach workers are credible messengers who possess personal experience, knowledge, and understanding that enable them to effectively communicate and engage with others, particularly those at risk or involved in violence. By providing support, mentorship, and access to resources, outreach workers connect individuals to appropriate services and resources to support physical and mental well-being, employment and education, and assistance with legal, housing, and transportation challenges. 
  • CVI specialists who respond to the scene of a shooting or incident of community violence to de-escalate the situation and provide resources to affected individuals, friends, and family.
  • Community empowerment to promote community resilience and empower individuals to create safer environments. By involving community members in decision-making, trust, and cooperation is fostered. Some additional resources for information about community empowerment include:

By proactively addressing and interrupting violence in communities, CVI strategies can help prevent injuries and deaths among communities most burdened by firearm harms. 

  • Several CVI programs in Colorado have been implemented to address firearm-related harm and promote community safety. These programs provide support and resources to at-risk youth and young adults. There are many notable community-based violence intervention programs in the state, many of which are listed in the Colorado Firearm Injury Prevention Directory. 
  • At-Risk Intervention and Mentoring (AIM) is an HVIP in partnership with the Gang Rescue and Support Project (GRASP). The AIM program began at Denver Health Medical Center in 2010 and is under the Health Alliance for Violence Intervention (HAVI) national network. The AIM program expanded to include the UCHealth AIM Program at the University of Colorado Hospital in 2020 and recently expanded to include Children’s Hospital Colorado. 
  • AIM programs:
    • Support youth and young adults who arrive at the emergency department after experiencing a traumatic, violent injury. 
    • Engage with patients at the hospital bedside and offer personalized support over a period of several months to 18 months, though essential services continue as needed. 
    • Provide a range of services, including mentorship, mental health support, substance use services, family support, medical follow-up assistance, education and job training programs, life skills training, tattoo removal, financial assistance, legal support, and prosocial activities. 
    • Focus on building long-term strategies to increase access to prosocial community resources to reduce individual-level risk and prevent future violence.
    • Use best practices, trauma-informed care, and a public health approach to care for survivors of violent injury.
    • Colorado's community violence intervention programs play a crucial role in providing support, resources, and mentorship to at-risk youth and young adults, aiming to prevent future violence and promote healing and recovery.

  1. Bureau of Justice assistance. Community-based violence intervention and prevention initiative implementation checklist. U.S. Department of Justice; 2022:1-8. https://bja.ojp.gov/doc/cvi-implementation-checklist.pdf
  2. CVI Ecosystem. The Coalition to Advance Public Safety. https://www.cviecosystem.org 
  3. James TL, Bibi S, Langlois BK, Dugan E, Mitchell PM. Boston violence intervention advocacy program: a qualitative study of client experiences and perceived effect. Acad Emerg Med. 2014;21(7):742–51
  4. Juillard C, Cooperman L, Allen I, et al. A decade of hospital-based violence intervention: benefits and shortcomings. J Trauma Acute Care Surg. 2016;81(6):1156–61
  5. Smith R, Dobbins S, Evans A, Balhotra K, Dicker RA. Hospital-based violence intervention: risk reduction resources that are essential for success. J Trauma Acute Care Surg. 2013;74(4):976–82.
  6. David-Ferdon C, Vivolo-Kantor A, Dahlberg L, Marshall K, Rainford N, Hall J. A Comprehensive Technical Package for the Prevention of Youth Violence and Associated Risk Behaviors. Centers for Disease Control, Violence Prevention; 2016:1-64. https://www.cdc.gov/violenceprevention/pdf/yv-technicalpackage.pdf
  7. Dawson MK, Ivey A, Buggs S. Relationships, resources, and political empowerment: community violence intervention strategies that contest the logics of policing and incarceration. Front Public Health. 2023;11:1143516. Published 2023 Apr 17. doi:10.3389/fpubh.2023.1143516
  8. Sanchez JA, Pyrooz DC. Gang intervention during COVID-19: A qualitative study of multidisciplinary teams and street outreach in Denver. J Crim Justice. 2023;84:102030. doi:10.1016/j.jcrimjus.2023.102030
  9. Wang EA, Riley C, Wood G, et al. Building community resilience to prevent and mitigate community impact of gun violence: conceptual framework and intervention design. BMJ Open. 2020;10(10):e040277. Published 2020 Oct 10. doi:10.1136/bmjopen-2020-040277.
  10. The Credible Messenger Approach. Credible Messenger Justice Center. https://cmjcenter.org/approach/. 
  11. The Health Alliance for Violence Intervention. NNHVIP Policy White Paper: Hospital-based Violence Intervention: Practices and Policies to End the Cycle of Violence. In: The National Network of Hospital-Based Violence Intervention Programs. The National Network of Hospital-based Violence Intervention Programs;1-16.
  12. Hall, J. E., Simon, T. R., Mercy, J. A., Loeber, R., Farrington, D. P., & Lee, R. D. (2012). Centers for Disease Control and Prevention’s expert panel on protective factors for youth violence perpetration: Background and overview. American Journal of Preventive Medicine, 43(2), S1–S7.
  13. Kim, B. E., Gilman, A. B., Hill, K. G., & Hawkins, J. D. (2016). Examining protective factors against violence among high-risk youth: Findings from the Seattle Social Development Project. Journal of Criminal Justice, 45, 19-25.