Preventing Youth Violence:

Opportunities for Action

TM

National Center for Injury Prevention and Control

Division of Violence Prevention
Preventing Youth Violence: Opportunities for Action is a publication of the National 

Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention

Thomas R. Frieden, MD, MPH, Director

National Center for Injury Prevention and Control

Daniel M. Sosin, MD, MPH, FACP, Acting Director

Division of Violence Prevention

Howard Spivak, MD, Director

Suggested citation: 

David-Ferdon C, Simon TR. Preventing Youth Violence: Opportunities for Action. Atlanta, 

GA: National Center for Injury Prevention and Control, Centers for Disease Control and 

Prevention, 2014.
Preventing Youth Violence: Opportunities for Action 1

Preventing Youth Violence:

Opportunities for Action

Developed By:

Corinne David-Ferdon, PhD

Thomas R. Simon, PhD

Copy Editing and Layout By:

Alida Knuth

June 2014

Centers for Disease Control and Prevention

National Center for Injury Prevention and Control

Divsion of Violence Prevention

Atlanta, Georgia

Preventing Youth Violence: Opportunities for Action 3

Table of Contents

Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Preventing Youth Violence: Opportunities for Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Focus on Youth Violence Prevention. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Youth Violence: A Leading Cause of Death and Physical Injury for Young People. . . . . . . . . . . . . . .7

Violence-related Behaviors Reported by Youth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Youth Violence Remains a Critical Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

The Impact of Youth Violence Is Not the Same for All Young People and Communities. . . . . . . . . 10

Youth Violence Is a Costly Problem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

There Is Not Just One Cause of Youth Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Early Prevention Is Important. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Importance of Broad Prevention Strategies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Evidence-based Youth Violence Prevention. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Key Prevention Strategies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Evidence-based Prevention Approaches and Programs, Policies, and Practices 

Are Available to Move Youth Violence Prevention Strategies Forward. . . . . . . . . . . . . . . . . . . . . . . . . 21

Evidence that Youth Violence Can Be Prevented. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

Prevention Can Save Money. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Partners and Leaders in Understanding and Preventing Youth Violence. . . . . . . . . . . . . . . . . . . . . . . 28

Role of CDC in Youth Violence Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Implementing Evidence-based Youth Violence Prevention Activities. . . . . . . . . . . . . . . . . . . . . . . . . .30

Opportunities for Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Seizing the Opportunity and Responsibility to Prevent Youth Violence . . . . . . . . . . . . . . . . . . . . . . . .42

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43

Acknowledgements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Appendix A. Development of Preventing Youth Violence: Opportunities for Action. . . . . . . . . . . . . . .50
4 Preventing Youth Violence: Opportunities for Action

Foreword

Every time a young person is harmed by violence, our nation’s future strength and 

growth are jeopardized. We are losing our next generation of young people—our 

future community builders and leaders—to homicide at an alarming rate. Beyond 

premature death, youth violence causes emotional, academic, and physical scars 

that limit young people’s potential independence, growth, and success. When the 

opportunities of our young people are curtailed by youth violence, we all suffer the 

negative and long-lasting consequences.

Research and experience in communities show it is possible to prevent youth 

violence. The Centers for Disease Control and Prevention’s (CDC) Preventing Youth 

Violence: Opportunities for Action and its companion guide will help communities 

use strategies that are known to work. We have the knowledge, experience, and 

scientifically supported strategies to take steps today that can make real and lasting 

differences in our communities. Part of what we have learned is that we can all be part 

of the solution. Suggested actions are provided for all members of a community who 

can help make neighborhoods safer and reduce youth violence.

Preventing youth violence has far reaching benefits for our health, safety, and 

prosperity. The prevention of youth violence can lower the risk for other youth-related 

problems, such as alcohol and substance abuse, obesity, and academic failure, and 

can result in cost savings for our justice, education, and health service systems. That is 

why it is so important for communities to take action to prevent youth violence. 

Youth violence is not just a law enforcement problem or an issue for schools to 

address. Youth violence is a public health problem. Public health professionals and 

other community leaders have critical roles to play in working across sectors to take 

action to prevent violence. Community members, youth, and adults who care for 

youth also have important roles to play in preventing violence, and their actions can 

contribute to the development of safe and supportive communities where young 

people can reach their full potential.

For the past two decades, CDC has worked to prevent youth violence before it starts. 

This resource that describes evidence-based actions for communities is an example 

of CDC’s work to share information so that communities can more effectively prevent 

youth violence. The evidence-based strategies and opportunities for action presented in 

this resource make me confident that we can all do our part to prevent youth violence.

Howard Spivak, MD, Director

Division of Violence Prevention

National Center for Injury Prevention and Control

Centers for Disease Control and Prevention

Howard Spivak, MD, Director

Division of Violence Prevention
Preventing Youth Violence: Opportunities for Action 5

Preventing Youth Violence:

Opportunities for Action

All forms of violence, including youth violence, suicidal behavior, child maltreatment, sexual violence, intimate partner 

violence, and elder abuse, negatively affect the health and well-being of our country. Youth violence, in particular, is a 

significant public health problem. Each and every day, approximately 13 young people in the United States are victims of 

homicide and an additional 1,642 visit our hospital emergency departments because of physical assault-related injuries.1

Among high school students, 1 in 4 report being in at least one physical fight and 1 in 5 report being bullied in the last 

year.2 Youth who are victims of violence also have a higher risk for many other poor physical and mental health problems, 

including smoking, obesity, high-risk sexual behavior, asthma, depression, academic problems, and suicide.3-6 Young people 

are frequently the ones hurting other youth and commit a significant proportion of the violence in communities—youth 

aged 10–24 years represented 40% of all arrests for violent crimes in 2012.7 The damage resulting from youth violence 

extends beyond the young perpetrators and victims. Each year, youth homicides and nonfatal assault injuries result in 

an estimated $17.5 billion in combined medical and lost productivity costs.1 Violence can increase health care costs for 

everyone, decrease property values, and disrupt social services.8

Many of our young people and communities view the grim facts about youth violence as unavoidable and have accepted 

youth violence as a societal reality. However, the truth is that youth violence is not inevitable. Youth violence is preventable. 

The past investment into monitoring, understanding, and preventing youth violence is paying off and proving that youth 

violence can be stopped before it occurs. We cannot continue to just respond to violence after it happens—the public 

health burden of youth violence is too high and our potential to prevent youth violence is too great.

Our understanding about youth violence and our ability to prevent it is based on decades of work by the Centers for 

Disease Control and Prevention (CDC) and the larger field of youth violence prevention researchers and practitioners. From 

systematic surveillance, rigorous research on modifiable factors that predict violence, evaluation of prevention strategies, 

and the strengthening of the capacity of communities to use approaches that work, we have learned a great deal about 

how to prevent youth violence. To help communities take advantage of the available knowledge, CDC has developed, 

Preventing Youth Violence: Opportunities for Action. This resource summarizes what we currently know about youth 

violence—the health consequences, trends, disparities, causes, costs, and prevention strategies. This resource outlines 

important strategies for youth violence prevention that are based on strong evidence and experience. It includes examples 

of specific programs and activities that have been found to be effective. These evidence-based youth violence prevention 

strategies focus on reducing the factors that put young people at risk for violence and bolstering the factors that strengthen 

their positive development and buffer against violence.

Everyone has a role to play in preventing youth violence. Preventing Youth Violence: Opportunities for Action provides 

information and action steps that can help public health and other community leaders work with partners to prevent youth 

violence. This resource also describes actions that young people, families, caregivers, adults who work with youth, and 

other community members can take to reduce youth violence. A companion document, titled Taking Action to Prevent Youth 

Violence, is available to help these groups better understand the steps they can take.
6 Preventing Youth Violence: Opportunities for Action

Focus on Youth Violence Prevention

The term youth violence used by the CDC and in this resource refers to when young people 

aged 10–24 years intentionally use physical force or power to threaten or harm others. The 

World Health Organization has described this behavior as “violence between individuals who 

are unrelated, and who may or may not know each other, generally taking place outside the 

home.”9 Youth violence typically involves youth perpetrating violence against other young 

people. A young person can be involved with youth violence as a victim, an offender, or 

a witness. Youth violence can take different forms, such as fighting, bullying, threats with 

weapons, and gang-related violence. These different forms of youth violence can vary in 

where and how often they occur and who is impacted. They can also vary in the harm that 

results and can include physical harm, such as injuries or death as well as psychological 

harm. However, the different forms of youth violence can be prevented. The evidence-based 

actions in this resource are appropriate for preventing all forms of youth violence. 

Preventing Youth Violence: Opportunities for Action focuses on youth violence because there is 

an enormous breadth and depth of knowledge about youth violence and how to effectively 

guide community action to prevent it. For youth violence, research has provided a strong 

understanding about the burden and trends, the factors that influence the likelihood it 

will occur, and a variety of effective prevention strategies.10,11 However, this same level of 

understanding is not yet available for other forms of violence that youth may experience, 

such as dating violence, sexual violence, and suicide. Research demonstrates that the causes 

of youth violence and other forms of violence often are similar, but knowledge is limited about 

whether the evidence-based youth violence prevention strategies and action steps discussed 

in this resource also lower the risk for other forms of violence. Other forms of violence might 

require unique preventive action, and a full discussion of the research that is the foundation for 

these different prevention approaches is beyond the scope of this resource. 

What is Youth 

Violence?

Youth violence is when 

young people aged 

10–24 years intentionally 

use physical force or 

power to threaten or 

harm others.

Why Focus on 

Youth Violence?

Opportunities for Action

focuses on preventing 

youth violence because 

the need for action to 

reduce youth violence is 

great and effective action 

is possible. Attention to 

all of the interrelated 

forms of violence that 

impact youth—child 

maltreatment, suicidal 

behavior, sexual 

assault, and teen dating 

violence—is beyond the 

scope of this resource 

and might require 

different prevention 

strategies. 

More youth die from 

homicide each year 

than from cancer, heart 

disease, birth defects, 

flu and pneumonia, 

respiratory diseases, 

stroke, and diabetes 

combined.
Youth Violence: A Leading Cause 

of Death and Physical Injury 

for Young People 

Youth homicide in the United States is a significant public health issue. 

In 2011, 4,708 (7.3 per 100,000) youth aged 10–24 years were victims of 

homicide. 1 Homicide is the third leading cause of death among young 

people aged 10–24 years, responsible for more deaths in this age group 

than the next seven leading causes of death combined (see Figure 1). For 

each young homicide victim, we lose an entire lifetime of contributions 

to families, potential employers, and communities. The number of youth 

who are physically harmed but do not die as the result of youth violence is 

significantly higher. In 2011, we saw that for every young homicide victim, 

there were approximately 142 youth with nonfatal physical assault-related 

injuries treated in U.S. emergency departments.1

 A total of 599,336 youth 

aged 10–24 years (928 per 100,000) were treated in U.S. emergency 

departments for nonfatal physical assault-related injuries in 2012.1

This means that each day approximately 13 young people are victims of 

homicide and an additional 1,642 are treated in emergency departments 

for physical assault-related injuries.

Violence-related Behaviors 

Reported by Youth

Official data from death certificates and emergency departments are 

critical to helping us understand and address youth violence, but they 

only tell part of the story. The full extent of the violence that youth 

perpetrate and experience as victims goes far beyond these data sources. 

The Youth Risk Behavior Survey conducted by CDC in 2013 indicates 

that 24.7% of high school students reported having been in at least one 

physical fight in the year before the survey.2 Nearly 18% of high school 

students reported they carried a weapon (e.g., gun, knife, or club), and 

5.5% reported they carried a gun at least one day in the month prior to 

being surveyed.2

Youth violence also occurs in schools and negatively impacts students’ 

ability to attend and to participate fully. In 2013, nearly 20% of high 

school students reported being bullied at school, and 6.9% said they had 

been threatened or injured with a weapon on school property in the past 

year.2

 Furthermore, 7.1% of high school students reported missing at least 

one day of school in the past 30 days because they felt unsafe either at 

school or on their way to or from school.2

Preventing Youth Violence: Opportunities for Action 7

Figure 1. More Youth Aged 

10–24 Die from Homicide 

Than from the Next Seven 

Leading Causes of Death 

Combined

Homicide

4,708

Cancer

2,030

Stroke**

233

Diabetes

192

Respiratory 

Diseases

242

Flu & Pneumonia

275

Birth Defects*

608

Heart Disease

1,109

*

Congenital Anomalies 

**Cerebrovascular Diseases 

Source: 2011 fatalities; Web-based Injury 

Statistics Query and Reporting 

System (WISQARS)1
8 Preventing Youth Violence: Opportunities for Action

Youth Violence Remains a Critical Problem 

Although the prevalence of several forms of youth violence has declined since the early 1990’s, the declines are inconsistent 

and the public health burden is still too high. For instance, examination of youth homicide trends show rates have declined 

over time, but these declines are stalling. The overall homicide rate among youth aged 10-24 years reached a peak in 1993 

at 15.9 per 100,000, and then from 1994 to 1999 declined 41% (15.2 per 100,000 in 1994 to 8.9 in 1999).12 This promising 

decline has slowed over the last decade. Between 2000 and 2010, youth homicide rates have declined approximately 1% 

per year.12 As illustrated in Figure 2, the youth homicide rate has remained between 7.3 and 9 homicides per 100,000 youth 

each year from 2000 to 2011 and has been substantially and consistently higher than the overall homicide rate for all ages.1

Additionally, the youth homicide rate in the United States is higher than the rate for other high income countries. For 

example, international research on adolescent and young adult males aged 15–24 has shown that the homicide rate in the 

United States is between 3 and 40 times higher than the homicide rate in other high income countries.13

Trends in other forms of youth violence also show declines over time. For instance, Figure 3 illustrates significant declines in 

high school students’ reports of being in a physical fight over the last decade. However, even with these declines, the levels of 

violence remain unacceptably high. The most recent data indicate that 1 in 4 high school students reported being in at least 

one physical fight, and 1 in 12 high school students reported fighting at least once on school property within the past year.2

The variability of the prevalence of youth violence over time is similar to shifts in violent crime rates.7 Although the causes 

for these patterns are uncertain, previous research suggests that changes in youth homicide and violent crime rates in the 

mid-1980s to early 1990s were related in part to the emergence of crack cocaine and the associated growth in drug use and 

drug-related crime, increased weapon carrying, and weak economic conditions.14 When youth violence started to decline 

in the mid-1990s, there were various community changes occurring, such as an increased emphasis on violence as a public 

health problem and the need to use evidence-based prevention approaches.

14,15 

National trends suggest that the prevention of youth violence is possible. But, even with promising reductions youth are still 

experiencing high levels of violence and youth violence persists as an important public health issue. Strategic, data-driven 

steps can be taken to reenergize declines in youth violence rates and to assure that downward trends are not reversed. 
Preventing Youth Violence: Opportunities for Action 9

Figure 2. Trends in Homicide Rates in the United States, 2000–2011*

*Homicide rates for all ages are age-adjusted to the standard 2000 population; rates for those age 10–24 years are age-specific.

Source: Web-based Injury Statistics Query and Reporting System (WISQARS)1

Figure 3. Prevalence of Physical Fighting among High School Students 

in the United States, 1991–2013*

*Percentage of high school students fighting on school property not available for 1991.

Source: Youth Online: High School YRBS2

Rate per 100,000 Percentage of high school students

Physical Fighting Physical Fighting on School Property

All Ages Youth 10–24 Years
10 Preventing Youth Violence: Opportunities for Action

The Impact of Youth Violence Is Not the Same 

for All Young People and Communities 

Youth violence is a significant problem that negatively impacts all young people in all communities whether they 

experience it as perpetrators, victims, or witnesses. The rates and types of youth violence, however, vary across communities 

and across subgroups of youth. These disparities can be attributed to different exposure to risk and protective factors. Some 

of these potential influences are discussed in a subsequent section of this resource (There is Not Just One Cause of Youth 

Violence). Although a complete description of all disparities in youth violence is beyond the scope of this document, some 

examples are provided below to show some of the variations that exist. Understanding that youth violence differs across 

neighborhoods and subgroups of youth can help communities plan and implement prevention approaches that have the 

greatest effects in reducing youth violence. 

•	 Disproportionate burden on ethnic and racial minority youth. The risk for some forms of youth violence varies 

significantly by racial and ethnic group. For instance, the homicide rate in 2011 for non-Hispanic African American 

youth (28.8 per 100,000) was 13.7 times higher than the rate for non-Hispanic white youth (2.1 per 100,000) and 

14.4 times higher than the rate for non-Hispanic Asian/Pacific Islander youth (2 per 100,000).1 The homicide rate for 

non-Hispanic African American youth was also 4.1 times higher than the rate for Hispanic youth (7.1 per 100,000) 

and 3.8 times higher than the rate for non-Hispanic American Indian/Alaska Native youth (7.5 per 100,000).1

Homicide is the leading cause of death for non-Hispanic African-American youth, the second leading cause of death 

for Hispanic youth, the third leading cause of death for non-Hispanic American Indian/Alaska Native, and the fourth 

leading cause of death among non-Hispanic White and Asian/Pacific Islander youth.1

Different patterns emerge when looking at various forms of youth violence (see Figure 4). For example, among 

high school students, a significantly higher percentage of non-Hispanic African American (35%) and Hispanic (28%) 

students than non-Hispanic White (21%) students reported that they have been in at least one physical fight in the 

last year.2

 In contrast, a significantly higher percentage of non-Hispanic White high school students (22%) reported 

experiencing bullying in school than Hispanic (18%) or non-Hispanic African American (13%) high school students.2

Figure 4. Physical Fighting and Bullying Among High School Students 

in the United States by Race/Ethnicity, 2013

Source: Youth Online: High School YRBS2

non-Hispanic Black

Hispanic

non-Hispanic White

Percentage of high school students

Physical Fight (unspecified location) Bullied at School
Preventing Youth Violence: Opportunities for Action 11

•	 Different patterns for males and females. The prevalence of some types of youth 

violence also varies by sex. For example, the youth homicide rate in 2011 was 6 

times higher among males (12.3 per 100,000) than females (2.1 per 100,000).1 The 

rate of youth who were treated in emergency departments for nonfatal physical 

assault-related injuries in 2012 was 1.6 times higher for males (1,141 per 100,000) 

than females (704 per 100,000).1 The prevalence of involvement in physical fights 

among high school students also was approximately 1.6 times higher for male (30%) 

compared to female students (19%).2 In contrast, female high school students (24%) 

were more likely than their male peers (16%) to report being a victim of bullying at 

school.2

Violence is clearly not just a problem among males. Data show violence is also a 

critical public health issue for young females. Among females aged 10–24 years, 

homicide is the fourth leading cause of death.1

 Additionally, over 221,900 female 

youth were treated in emergency departments for physical assault-related injuries 

in 2012.1 Young females are also at risk for perpetrating violence. In 2012, over 

30,830 females aged 10–24 years were arrested for violent crimes, including robbery, 

aggravated assault, and murder.7 Females represent 19% of all arrests for violent 

crime among those aged 10–24 years.7

•	 Disproportionate burden on sexual minority youth. Sexual minority youth—young 

people who identify as lesbian, gay, bisexual, or transgender or are questioning 

their sexual identity (LGBTQ)—have a heightened risk for violence.16 Relative to their 

heterosexual peers, LGBTQ youth report experiencing higher levels of verbal and 

physical violence and associated physical injury across multiple studies.16 Reports 

from high school students between 2001 to 2009 reflect that sexual minority 

students were more likely to report being in a physical fight at least once during the 

year before the survey (43% of bisexual students, 42% of gay or lesbian students, 

and 35% of questioning students) than heterosexual students (29%).17 Sexual 

minority students were also more likely to be injured in a physical fight (16% of gay 

or lesbian students, 10% of questioning students, and 9% of bisexual students) than 

heterosexual students (3%).17

Bullying and harassment of LGBTQ youth can happen in any community setting 

and at home, but violence experienced by LGBTQ youth at school has tended to 

get the most research attention. LGBTQ high school students are more likely than 

heterosexual students to report that on school property they have been threatened 

or injured with a weapon and have been in a physical fight.16,17 These experiences 

are associated with absenteeism, poor academic achievement, and higher rates of 

suicidal behavior.16 The prevalence of not going to school because of safety concerns 

is higher among gay or lesbian students (21%), students questioning their sexual 

identity (17%), and bisexual students (13%) than their heterosexual peers (5%).17

What Do We 

Know about 

Bullying?

Bullying is a form of 

youth violence that can 

be inflicted physically, 

verbally, relationally, or 

by damaging a young 

person’s property.18 It can 

harm a youth’s physical, 

emotional, and academic 

well-being as well as hurt 

peers, families, schools, 

and neighborhoods. 

Bullying can increase 

the potential for other 

forms of youth violence, 

like weapon carrying 

and physical fighting.19

Research on preventing 

bullying is still developing, 

and the benefits of many 

school-based programs 

are unknown. Some 

promising approaches are 

increased supervision of 

students, use of behavior 

management techniques, 

and having and 

enforcing whole school 

anti-bullying policies. 

For more information 

about bullying, visit 

Stopbullying.gov and 

CDC’s Division of Violence 

Prevention.
12 Preventing Youth Violence: Opportunities for Action

•	 Violence varies across communities, and no community is immune. Youth violence 

affects all communities—urban, suburban, and rural. However, communities vary in 

terms of the subgroups of young people at greatest risk, the factors that influence 

the likelihood of violence, the specific types of youth violence experienced, and the 

consequences. Some communities are disproportionately affected by violence, and 

the pressure for action is intensified. For example, law enforcement data indicate 

that the violent crime rate in 2012 was higher in cities (469 per 100,000 population) 

than in metropolitan counties (259 per 100,000) or suburban areas (252 per 100,000), 

and the largest cities generally had the highest rates of violence.7 Youth gang activity 

also is more prevalent in cities but can and does occur in all types of communities. 

For example, data from the 2011 National Youth Gang Survey of law enforcement 

agencies show that 85% of larger cities, 50% of suburban counties, 30% of smaller 

cities, and 14% of rural counties reported gang activity.20

The level of violence often varies considerably across neighborhoods within the 

same city. Youth in some neighborhoods are growing up exposed to relatively 

higher rates of crime, family violence, poverty, and failing schools and businesses. 

Under these circumstances, youth often are more likely to see violence and gangs as 

acceptable and as a way to enhance social status and reduce vulnerability.21

Some areas of the United States experience lower levels of one type of youth violence 

but higher levels of another. For example, in 2013 only 17% of high school students in 

Maine reported having been in a physical fight in the past 12 months (national average 

was 25%), but 24% of students reported being bullied at school (national average was 

20%).

2

 While the specific forms of youth violence might differ across communities, all 

communities face the challenge of how to prevent youth violence. 

What Do We 

Know about 

Gangs?

Nearly 1 in 5 students ages 

12–18 reported that gangs 

were present in their 

school in 2011.22 Although 

youth often report joining 

a gang for protection, they 

are more likely to be both 

victims and perpetrators 

of violence after joining 

a gang.23 Most youth join 

gangs before age 15, 

and many children start 

affiliating with gangs 

between 11 and 12 years 

old.24 In addition to efforts 

to intervene to reduce 

gang violence and to help 

youth leave gangs, we also 

need to prevent young 

people from joining 

gangs in the first place.25

Prevention activities that 

enhance problem-solving 

skills, school performance, 

family functioning, and 

school safety and that 

reduce exposure to 

violence in the home 

and community are 

promising approaches to 

reduce gang joining. For 

more information about 

gang joining prevention 

research and approaches 

visit CDC’s Division of 

Violence Prevention and 

the National Gang Center.
Preventing Youth Violence: Opportunities for Action 13

Youth Violence Is a Costly Problem

In addition to the physical, emotional, social and societal consequences of violence for youth, their families, schools, 

and communities, violence has a range of financial costs to society (see Figure 5). The full costs of youth violence are 

difficult to quantify, but there are known short-term as well as long-term impacts on the health, social, educational, 

employment and judicial systems. Even when looking at narrow descriptions of cost, a picture of the huge burden of 

youth violence begins to emerge. In 2010, the combined cost from just medical care and lost work due to homicide 

among youth aged 10–24 years was an estimated $9 billion.1 Nonfatal injuries among youth that result from physical 

assaults and are treated in hospitals and emergency departments were another $8.5 billion in medical and work loss 

costs.1 The combined total of $17.5 billion is an underestimate of the true toll of youth violence because it does not 

include the costs associated with the criminal justice system, including arrest, prosecution, incarceration, and reentry. It also does not include costs associated with addressing the psychological and social consequences for victims, 

perpetrators, and their families. These estimates also do not reflect the effects of youth violence on social service 

agencies, functioning of schools, and property values, which can be negatively impacted by the direct or indirect 

effects of youth violence.8

Financial losses and required expenditures to address youth violence reduce the resources that are available to 

support other community needs and goals. The cost of arresting, prosecuting, incarcerating, and rehabilitating 

offenders is the fastest growing part of most state budgets and runs into the billions of dollars per year.26 Also, there 

is strong evidence that exposure to violence contributes to a range of physical and mental health consequences, 

including smoking, high-risk sexual behavior, depression, obesity, asthma, post-traumatic stress disorder (PTSD) 

symptoms, and suicide.3-6,27,28 The financial toll associated with these consequences exponentially increases the costs 

associated with youth violence.

Figure 5. Examples of Direct and Indirect Costs of Youth Violence

Total Cost of Youth Violence

Direct Costs

• Medical and mental health care

• Law enforcement and incarceration

• Legal and social services

Indirect Costs

• Lost earnings

• Struggling schools

• Fear in communities

• Declining property values
What Is a 

Risk Factor?

A risk factor is 

a characteristic 

that increases the 

likelihood of a person 

becoming a victim 

or perpetrator of 

violence.

What Is a 

Protective 

Factor?

A protective factor 

is a characteristic 

that decreases the 

likelihood of a person 

becoming a victim 

or perpetrator of 

violence or buffers 

against the effects of 

risk factors.

14 Preventing Youth Violence: Opportunities for Action

There Is Not Just One Cause of Youth Violence 

Youth violence is not the result of one factor, so there is not one definitive way to prevent it 

from occurring. A growing body of research indicates that youth violence is influenced by 

the interplay of multiple individual, relationship, community, and societal risk and protective 

factors that affect youth over the course of their development from early childhood through 

young adulthood.29-31 These factors can interact to increase or reduce the likelihood that 

youth will become involved in violence. Some communities and subgroups of youth 

experience relatively more risks and fewer protective influences, which contributes to 

disparities in youth violence. The good news is that many of these factors are modifiable.

The field of youth violence prevention has come to recognize that attention needs to 

be given to both risk and protective factors in order to have bigger reductions in youth 

violence.32 Risk factors are complex, interactive, and cumulative over time, and not everyone 

exposed to risk factors will develop violent behaviors. Protective factors can directly reduce 

violence or they can buffer against risk factors. Research demonstrates that individuals 

with more protective factors and fewer risk factors are less likely to engage in violence and 

other high-risk behaviors.33-35 Protective factors have not been studied as extensively or 

rigorously as risk factors.36 The knowledge about protective factors is growing. Presented 

below and shown in Figure 6 are examples of risk and protective factors that influence the 

likelihood of youth violence. Because youth violence is influenced by multiple factors, our 

ability to prevent youth violence is stronger when multiple levels of risk and protection are 

understood and addressed by prevention strategies.

Figure 6. Examples of 

Contributing Factors 

by Level of Influence

Societal

Norms about violence, policies that 

influence job opportunities or that support 

prevention programming

Community

Sense of social connectedness, 

residential instability, gang activity 

Individual

Past exposure to violence, impulsiveness, 

poor school achievement

Relationship

Peer delinquency, parental conflict, 

monitoring and supervision
Preventing Youth Violence: Opportunities for Action 15

•	 Individual level. Individual youth have a unique set of experiences and traits that influence their likelihood of 

experiencing violence. Many individual level risk factors have been identified, including impulsiveness, substance 

abuse, antisocial or aggressive beliefs and attitudes, weak school achievement, and a prior history of exposure 

to violence or abuse.37-39 Unsupervised access to a firearm is also a contributing risk for lethal youth violence.40

Examples of youth violence protective factors include the development of healthy social, problem-solving, and 

emotional regulation skills, and a young person’s school readiness and academic achievement.34,38

•	 Relationship level. The nature and quality of the relationships young people have with friends, peers, parents, and 

other adults, such as teachers and community members, can influence their behavioral choices, opportunities for 

engaging in violence, and perceptions of what behavior is acceptable and appropriate. Young people who associate 

with peers who engage in violent or delinquent behavior or gang activity are at substantially greater risk for 

experiencing and perpetrating violence.38,39 Examples of family risk factors include parental conflict and violence, 

poor parental attachment and monitoring, lack of appropriate supervision, and the use of harsh or inconsistent 

discipline.37-39 Whether adults are supportive, encouraging of youth to use nonviolent ways to solve problems, and 

willing to intervene with conflicts also contribute to youth’s beliefs about the acceptability of violence and their 

likelihood to act violently.41 Youth’s well-being and behavioral choices can be strengthened through a positive and 

nurturing relationship with caring adults. The development of this relationship begins in infancy with responsive 

parenting and the building of strong parent-infant attachment.42 Positive and warm parent-youth relationships in 

which parents set consistent, developmentally-appropriate limits are associated with positive child and adolescent 

developmental outcomes and the prevention of violent behavior.36,38,43 Additional factors that have been found to 

positively influence adolescent adjustment and decrease aggressive behavior include stable connections to school 

and school personnel and feelings of connectedness to prosocial, nonviolent peers who are concerned about the 

well-being of others and demonstrate a willingness to help and cooperate with others.

36,41

•	 Community level. Individuals and relationships are embedded within settings, such as schools, businesses, and 

neighborhoods. The characteristics of these settings influence how people interact with each other and affect 

the likelihood that a person will become involved in violence. Community factors, such as residential instability, 

crowded housing, density of alcohol-related businesses, poor economic growth or stability, concentrated poverty, 

lack of positive relationships among residents, and views that violence is acceptable behavior are all associated with 

an increased risk for youth violence.38,39,44,45 High levels of crime, gang activity, unemployment, and drug use or sales 

are additional risk factors. We are only beginning to learn about the community-level factors that provide a buffer 

to violence, and existing research suggests that factors which enhance a sense of belonging, residents’ willingness 

to intervene to help others, and attachment to a community can lower the risk for youth violence.38 Physical 

environments of schools, parks, and business and residential areas that are regularly repaired and maintained and 

designed to increase visibility, control access, and promote positive interactions and appropriate use of public 

spaces provide additional buffers to violence.46-49 Policies related to the density of alcohol outlets and sales could 

contribute to lower rates of violence and injury.50,51 While research is mixed about whether youth employment 

or vocational training impact violence, economic growth of a community and job training and employment 

opportunities for community adults may be additional protective factors.52,53

•	 Societal level. Broad societal factors influence population-wide health and safety, including rates of youth violence. 

These factors include social and cultural norms about the acceptability of youth violence and the presence of broad 

determinants of health inequalities, such as poverty and social disadvantage.39,52 Societal influences, including 

media violence and policies related to health, education, and economic opportunities, can serve to increase or 

lower the risk for youth violence.9

 Societal factors can impact youth violence through a variety of mechanisms, 

including how the community formally and informally responds to youth violence, the availability and accessibility 

of prevention resources, the coordination of prevention activities, the use of evidence-based prevention strategies, 

and opportunities for education and employment. Societal factors can contribute to inequities in risks for violence 

and access to prevention resources.
16 Preventing Youth Violence: Opportunities for Action

Early Prevention Is Important 

Youth violence statistics tend to focus on youth aged 10–24 years. However, we should 

not wait until the teenage years to act to prevent youth violence. Changing behaviors 

after they are already established is harder than developing healthy behaviors from a 

young age. The emergence of risks that put young people on a path to violence often 

begins during early childhood. Research shows that physical aggression is common 

among toddlers, and most children learn alternatives to violence before starting 

elementary school.54 A subset of children continues to be aggressive, and if their 

behavior and other risk factors are not addressed their aggression can persist and 

increase.55

Effective prevention activities should begin early to address risks. CDC’s Essentials 

for Parenting Toddlers and Preschoolers is an example of a resource that offers videos, 

interactive activities and other tools to help parents build healthy relationships with 

their young children and to prevent violence. Prevention activities should continue 

throughout childhood, adolescence, and young adulthood, and these activities 

should be adapted to address varying risks at different stages of development. A lifecourse prevention approach includes promoting and establishing healthy problemsolving skills, relationships, and experiences during early childhood to prevent the 

establishment of violent beliefs and behaviors and to promote healthy development 

across the lifespan.56

Far too often, we wait until youth violence occurs before we act instead of working to 

prevent it before it starts. Medical, law enforcement, and justice responses to violence 

are important to minimize the physical and emotional consequences for victims, to 

hold perpetrators accountable, and to repair the harm caused by violence. Responses 

are critical, but they are not enough. 

Communities are increasingly including prevention strategies as part of their overall 

approach to addressing youth violence.57 By prioritizing prevention, communities 

can have greater reductions in youth violence and realize multiple economic and 

health benefits compared to communities that solely react to violence after it occurs.58

Additionally, because adolescent risk behaviors have common causes, youth violence 

prevention activities that address underlying risk factors may lower the occurrence 

of other problems, such as alcohol and substance abuse, gang membership, criminal 

behavior, and academic failure.59,60 These cross-cutting positive effects can contribute 

to significant cost savings for numerous service systems, including justice, education, 

and health care, and increase the availability of resources for other community 

priorities. Most importantly, they could preserve young people’s lives, protect their 

health, and promote their positive development.

Importance of Broad Prevention Strategies 

We often begin our prevention activities by identifying youth, families, and 

communities that are at relatively higher risk for youth violence and putting into 

place prevention approaches to address their needs. At-risk groups may include 

young people who have experienced abuse or behaved aggressively in childhood 

“We have to stop 

violence from starting 

because it gets worse 

over time and increases 

fear and the pressure 

to be violent in other 

people.”

Jacob, age 13
Preventing Youth Violence: Opportunities for Action 17

and families with high levels of conflict. At-risk settings may include schools and communities that have a relatively higher 

concentration of risk factors, such as poverty, crime, gang activity, school dropout, and unemployment. At-risk groups and 

settings often require more intensive prevention efforts that are longer in duration and utilize different types of strategies 

relative to those with less known risk.61,62 Because a small proportion of young people are responsible for the majority 

of serious violent incidents and some communities are disproportionately impacted by violence, including prevention 

activities for at-risk groups and communities is an important part of an effective prevention strategy.63 

Our success will be limited, though, if we only implement prevention activities that meet the needs of the more obvious 

at-risk groups. Broad prevention approaches that positively affect all youth, their relationships, and the environments in 

which they grow and learn are the most likely to be effective in eliminating youth violence and other adolescent health 

problems.30,64 Broad prevention strategies help all individuals or groups regardless of their level of risk and are important 

to achieving widespread and sustained reductions in youth violence. For example, universal youth violence prevention 

activities include providing information and skill development to all children in a school rather than only to students who 

have been aggressive or have other risk factors.65 Prevention approaches that can benefit all members of a community 

also include changing norms about the acceptability of violence and addressing the physical characteristics of housing, 

communities, and schools to improve perceived and actual safety, to reduce opportunities for crime and violence, and to 

promote positive behaviors and interactions.

Evidence-based Youth Violence Prevention 

Our research investment has resulted in knowledge about how to effectively prevent youth violence. This knowledge can be 

expressed as evidence-based prevention strategies, which communities can use to design their comprehensive prevention 

plan. These broad strategies, which are summarized in the next section, are based on consistent underpinnings of effective 

youth violence prevention activities as well as the growing understanding of modifiable youth violence risk and protective 

factors.8,10,11,32,66,67 These prevention strategies also reflect our understanding that effective and sustained prevention of youth 

violence comes from reaching beyond strengthening young people’s knowledge, skills and abilities to include working with 

families, schools, and entire communities to enhance the relationships and environments that impact youth. 

To make progress on their youth violence prevention strategies, communities can use multiple evidence-based prevention 

approaches (e.g., school-based approaches, parenting skill and family relationship approaches) and implement various 

specific programs, policies, and practices (see Figure 7). Many of the available prevention approaches and specific activities 

can be used to advance more than one prevention strategy. Examples of these approaches and programs, policies, and 

practices that communities can use to realize their youth violence prevention goals are presented in a subsequent section 

(Evidence-based Prevention Approaches and Programs, Policies, and Practices Are Available to Move Youth Violence 

Prevention Strategies Forward). This resource also concludes with a list of Opportunities for Action that can further help 

bridge the gap between our prevention knowledge and activities.

Figure 7. Evidence-based Youth Violence Prevention

Program

Approach Approach

Practice Policy Program Practice

Strategy

Approach

Policy
18 Preventing Youth Violence: Opportunities for Action

Key Prevention Strategies 

Evidence-based youth violence prevention strategies have become more evident as our research has grown. Rather than 

focusing on the problems that need to be reduced, these broad and overlapping strategies emphasize how the strengths 

within individuals, families, communities, and society can be enhanced. The implementation of a combination of these 

strategies is likely to result in stronger and more sustainable improvements in health and safety than the implementation of 

a single strategy.

•	 Build children’s and adolescents’ skills and competencies to choose nonviolent, safe behaviors. This strategy 

focuses on providing opportunities for young people to build their skills, knowledge, and motivation to choose 

nonviolent behaviors and conflict resolution approaches. By fostering the development of protective factors, such 

as effective problem-solving, communication, anger management, impulse control, and emotional regulation 

abilities, young people’s risk for violence decreases and their health and safety increases. The risk for violence can 

also be lowered by strengthening youth’s beliefs that violence is never an acceptable way to resolve conflicts, 

minimizing their unsupervised access to firearms, and helping them to avoid substance use, succeed in school, 

and cope effectively with past exposure to violence or abuse. For very young children, prevention activities may 

include helping them to understand and label emotions, control aggressive impulses, experience empathy, and 

nonviolently communicate and solve interpersonal problems. Prevention activities for older youth may seek to 

develop their skills for understanding the thoughts and feelings of others, managing anger, and feeling positive 

about the future, and being a leader. These opportunities can be provided in a variety of different formats and 

settings, including schools, after-school youth serving organizations, and faith-based institutions.

•	 Foster safe, stable, nurturing relationships between young people and their parents and caregivers. Parents 

and other caregivers (e.g., grandparents, foster parents) have a profound influence on young people’s beliefs and 

behaviors, and this influence extends from early childhood through late adolescence and beyond.68,69 The risk for 

youth violence is increased by elements of some caregiver-child relationships and home environments, such as 

family violence and abuse, lack of supervision, and inconsistent discipline. Other characteristics, such as parental 

monitoring of youth’s activities, strong parent-child connectedness, and good parent-child communication, can 

protect against the development of violent behavior, even when young people are exposed to violence in their 

communities. The risk of youth violence and other problem behaviors can be lowered by providing caregivers 

with support and knowledge about healthy child development, and by building caregivers’ skills related to 

strong communication, setting age-appropriate boundaries and rules, monitoring young people’s activities and 

relationships, and using consistent and nonviolent discipline.70,71 These skills and other activities can contribute to a 

supportive bond between caregivers and their children and to a conflict-free home, which lowers the risk for youth 

violence and other difficulties.

•	 Build and maintain positive relationships between young people and caring adults in their community. Young 

people’s risk for violence can also be buffered by healthy and safe relationships with adults who are not their 

primary caregivers.72 These adults include individuals who have formal and stable relationships with youth, such 

as mentors, teachers, and coaches. Youth are also influenced by other adults with whom they interact in more 

narrow ways including neighbors, academic tutors, and members of the faith-based institutions they attend. These 

individuals provide informal monitoring and guidance to youth and have the potential to lower the risk for youth 

violence. The prevention of youth violence can be strengthened by increasing the number of positive relationships 

that youth have with adults in their community. This relationship-focused strategy lowers young people’s risk for 

violence by promoting their feelings of connectedness to caring adults and their school and community, having 

adults available to reduce opportunities for violence, and increasing exposure to nonviolent and positive role 

models who demonstrate a willingness to help and cooperate with others.
•	 Develop and implement school-wide activities and policies to foster social 

connectedness and a positive environment. When students believe that adults 

in their school care about their individual well-being as well as their learning, they 

are more likely to succeed academically and engage in nonviolent behaviors.73

Communities can lower the risk for violence when they implement activities and 

develop and enforce school policies that promote a shared understanding that 

violence in any form is not acceptable at school and build the connectedness 

of their students, families, teachers, and other school personnel to their school 

environments. These policies can help all students to feel supported and safe 

at school. They can help students understand what behaviors are acceptable 

in the school environment and what are consequences for misbehavior. They 

may include specific policies and clubs to support at-risk groups, such as 

LGBTQ youth.

74,75 These activities also include strategies and policies related to 

professional development of school personnel (e.g., teachers, coaches, counselors, 

nurses, administrators), ongoing engagement of students in prevention activities, 

opportunities for meaningful student and family participation, and teachers’ 

classroom management practices. 

•	 Improve and sustain a safe physical environment in communities and create 

spaces to strengthen social relationships. The physical characteristics of the 

environments in which individuals interact influence safety, crime, and violence. 

Examples of these characteristics include lighting, availability of green spaces, and 

repair and upkeep of neighborhoods and schools.48 An important youth violence 

prevention strategy is the examination and potential modification of the physical 

characteristics of housing, schools, and community areas (e.g., parks, business areas, 

public transportation hubs) to improve perceived and actual safety and to reduce 

opportunities for crime and violence. By addressing the physical landscape of a 

community, residents may feel more comfortable accessing these areas, which can 

increase prosocial interactions between residents and supports for young people. 

•	 Build viable and stable communities by promoting economic opportunities and 

growth. The economic climate of a community is created by the presence of legal 

and prospering businesses, the income level of residents, and stable employment 

of residents. When a community has limited legal economic and occupational 

opportunities, many residents and businesses will leave the neighborhood and the 

concentration of low income residents increases. Because these factors increase 

the risk for youth violence, this prevention strategy increases the stability and 

potential growth of a community by enhancing the success of local businesses 

and the employment and training opportunities for adults in the community.52

By providing the infrastructure and incentives for businesses to expand their 

operations and invest in the community and the next generation of workers, a 

community can become more economically stable. Additionally, this stability 

can attract other families and businesses to the area and encourage the further 

investment of human and financial resources into improving the health, safety, 

and prosperity of the community.

Businesses 

Taking Action

The business community 

can help reduce youth 

violence through publicprivate partnerships that 

collect resources from 

businesses and invest 

them in local services and 

activities, such as street 

cleaning, security, and 

adding green spaces, to 

increase the appeal and 

use of the area. These 

approaches have different 

names. In Los Angeles 

they are called Business 

Improvement Districts 

(BIDs). An evaluation of 30 

BIDs found a 12% drop in 

robberies and an 8% drop 

in violent crime as well 

as substantial economic 

benefits.49

Preventing Youth Violence: Opportunities for Action 19
20 Preventing Youth Violence: Opportunities for Action

•	 Facilitate the social cohesion and collective efficacy of the community. When individuals, groups, and 

organizations within a community do not have meaningful and positive social interactions and are not 

collaborating to improve their community, the risk for youth violence increases.44,52 In contrast, when 

community residents are connected (i.e., strong social cohesion) and willing to help others (i.e., high collective 

efficacy), violence is less likely. Activities aligned with this prevention strategy seek to build the community’s 

connectedness by increasing opportunities for residents to form positive relationships with their neighbors 

and to actively participate and contribute to their community’s health, safety, and prosperity. Examples include 

the willingness to help neighbors, talk with parents about their child’s unsafe behavior, and volunteer with 

community activities. These activities can create an increased understanding and respect for differences, 

promote trust, support the development of a shared community vision, and engender a willingness to act 

in ways to achieve their community vision. The meaningful and appropriate engagement of youth in these 

activities is especially important since they represent the future of communities and are particularly vulnerable 

to experiencing negative health and safety outcomes associated with a disorganized community.

•	 Change societal norms about the acceptability of violence and willingness to intervene. Far too often, violence 

is viewed as normative and an acceptable way for young people to resolve conflicts.76 Some youth and adults 

believe carrying a weapon or instigating violence is necessary to protect themselves from becoming a victim.77

Additionally, some individuals believe it is appropriate for youth to use violence to settle disputes and that 

some experiences of violence, such as bullying, are simply rites of passage. This acceptance of youth violence 

and reluctance to intervene increase the likelihood that youth violence will occur and, in some instances, 

escalate.78 A part of a community’s prevention plan can focus on changing norms about youth violence from 

being an acceptable behavior to being an unacceptable behavior. This work may include changes to how social 

interactions and conflict resolution are discussed and portrayed in the media, movies, television, video games, 

and other forms of communication. Changing societal norms about violence requires time and multiple datadriven strategies, similar to how changes pertaining to normative beliefs about smoking tobacco required 

efforts to change pro-tobacco attitudes, policies to limit smoking and reduce minors’ access to cigarettes, and 

strategies to support cessation.79 Communities can also encourage the belief that individuals have the power and 

responsibility to prevent violence, and then help residents have the knowledge and skills necessary to intervene 

safely and appropriately.

•	 Change the social and structural conditions that affect youth violence and lead to health inequity. Deficits 

in education, limited access to health care, and concentrated poverty are associated with higher rates of youth 

violence.52 Youth violence in turn reinforces these gaps and health inequities. By altering the underlying social 

and structural conditions that affect youth violence and lead to health inequity, population-wide reductions in 

youth violence could occur. Activities may include improving early learning and educational opportunities (e.g., 

access to libraries, parenting support, pre-schools, tutoring), modifying housing policies, increasing access to 

high quality child care, enhancing high school graduation rates and workforce development, and supporting 

the provision of evidence-based mental health and social service supports to children, youth, and their families. 

Policies, including organizational and regulatory policies and laws or ordinances, have the potential to provide 

support to families and create positive environments for children.80
Preventing Youth Violence: Opportunities for Action 21

Evidence-based Prevention Approaches and 

Programs, Policies, and Practices Are Available to 

Move Youth Violence Prevention Strategies Forward

Most communities will need to identify a range of potential approaches and implement several specific activities in order to 

make progress on their prevention strategies and achieve local goals. Table 1 provides some examples, but it is not meant 

to be a comprehensive list of evidence-based approaches or an endorsement of any specific program, policy, or practice. 

Rather, the information is offered to help provide a concrete sense of how youth violence prevention strategies can be 

advanced through the selection and implementation of evidence-based approaches and activities. Detailed information 

about each example listed in Table 1 is available online, including a description of the program, the intended recipients, 

evidence for effectiveness, and how to acquire program materials. The next section of this document (Evidence that Youth 

Violence Can Be Prevented) describes some of the online resources that communities can use to learn more about particular 

evidence-based programs, policies, and practices, including the examples listed in Table 1 and many more that are not 

listed. The selection of specific programs, policies, and practices depends on the needs and resources of the community. The 

development of a strategic and data-driven plan for selecting and implementing these approaches is also described in a 

later section (Implementing Evidence-based Youth Violence Prevention Activities).
22 Preventing Youth Violence: Opportunities for Action

Table 1. Youth Violence Prevention Approaches Based on the Best Available Evidence*

Approach Description Examples of Programs, 

Policies, and Practices

Universal School-based 

Youth Violence Prevention

Provide students and school 

staff with information 

about violence, change 

how youth think and feel 

about violence, and teach 

nonviolent skills to resolve 

disputes.

Life Skills Training (LST) teaches anger management and 

conflict resolution. Evaluations of this program have 

shown significant reductions in fighting and delinquency, 

including a 26% reduction in high frequency fighting within 

one year.81

Other evidence-based universal school programs include: 

Good Behavior Game, Positive Action, Project Towards No 

Drug Abuse, and Promoting Alternative Thinking Strategies.

Parenting Skill and Family 

Relationship Approaches

Provide caregivers with 

support and teach 

communication, problemsolving, monitoring, and 

behavior management skills.

The Strengthening Families program teaches parents to 

use discipline, mange their emotions, and communicate 

with their child and teaches youth strategies to deal 

with peer pressure, manage stress, and solve problems. 

Evaluations of this program have shown significant 

reductions in aggression, hostility, and conduct problems 

and improvements in parent’s limit-setting, parent-child 

communication, and youth’s prosocial behavior.82,83

Other examples of evidence-based parenting and family 

programs include: the Incredible Years, Triple P (Positive 

Parenting Program), and Guiding Good Choices. 

Intensive Family-focused 

Approaches

Provide therapeutic services 

to high-risk, chronic youth 

offenders and their families 

to address individual, family, 

school, and community 

factors that contribute to 

violence and delinquency.

Multidimensional Treatment Foster Care is for youth who 

need out-of-home placements and includes extensive 

training of foster parents, family therapy for biological 

parents, skills training and support for youth, and schoolbased academic and behavioral supports. This program has 

been shown to significantly reduce delinquency, violence, 

and violent crime and sustain improvments over time.84, 85

Other examples of evidence-based intensive family-focused 

approaches include: Multisystemic Therapy and Functional 

Family Therapy. 

Policy, Environmental, and 

Structural Approaches

Involve changes to 

community environments 

that can enhance safety 

and affect youth violence 

and youth violence risk/

protective factors.

Business Improvement Districts (BIDs) are public-private 

partnerships that collect resources from businesses 

and invest in local services and activities. Significant 

reductions in violence have been documented in BIDs 

neighborhoods.49

Other examples include: policies to reduce youth access 

to alcohol and changes in the physical environment using 

principles of Crime Prevention Through Environmental 

Design (CPTED).
Preventing Youth Violence: Opportunities for Action 23

Approach Description Examples of Programs, 

Policies, and Practices

Street Outreach and 

Community Mobilization

Connects trained staff with 

at-risk youth to conduct 

conflict mediation, make 

service referrals, and 

change beliefs about the 

acceptability of violence.

Cure Violence (formally known as CeaseFire) works to 

interrupt violence, particularly shootings, and change 

norms about the acceptability and inevitability of violence. 

An evaluation found reduced shootings and killings and 

fewer retaliatory killings in most communities where the 

program was implemented.

86

Other examples include: Richmond Comprehensive 

Homicide Initiative, Operation Ceasefire, and Safe Streets.

Early Childhood Home 

Visitation

Provides information, 

caregiver support, and 

training about child health, 

development, and care to 

families in their homes.

Nurse-Family Partnership (NFP) provides training and 

support to mothers during pregnancy and two years after 

giving birth to support a healthy pregnancy and increase 

mothers’ knowledge and skills about child development 

and care. It has been shown to decrease risk factors for 

youth violence, such as child maltreatment and early 

behavior problems, and reduce adolescent arrests and 

delinquency.87-89

Another example includes: Triple P

Early Childhood Education Provides high-quality, early 

childhood education to 

disadvantaged children to 

build a strong foundation for 

future learning and healthy 

development.

The Highscope Perry Preschool Project provides small 

classroom instruction by staff trained to address the needs 

of disadvantaged children and their families. Evaluations 

have found beneficial outcomes, including better 

academic achievement and classroom behavior and lower 

delinquency and lifetime arrests for violent crimes.90-92

Other examples include: Early Risers Skills for Success and 

Raising Healthy Children Program

*More information about the specific programs, policies, and practices listed as examples can be found from online resources, 

such as CDC’s STRYVE Strategies Selector Tool and Blueprints for Healthy Youth Development. These resources also provide 

information about other programs, policies, and practices that have also been found to help prevent youth violence.
24 Preventing Youth Violence: Opportunities for Action

Evidence that Youth Violence Can Be Prevented

Over the last two decades, much has been learned about many of the specific prevention 

programs, policies, and practices that fall under the prevention approaches described in Table 

1. Linking this knowledge to community practice has been a challenge. Many communities 

are not aware of, or are unable to take advantage of, the approaches known to work to 

improve health and safety. This section highlights some online resources that provide in-depth 

information about effective youth violence prevention activities and describes a few of the 

specific prevention programs that are included in these resources. The resources listed vary in 

terms of the extent to which they focus on prevention versus responding to youth violence and 

the extent to which they focus exclusively on youth violence or include other outcomes, such 

as substance abuse and mental health. All include examples of evidence-based youth violence 

prevention programs, policies, and practices, but the resources differ in the level of scientific 

rigor necessary to be included in their materials.

Striving To Reduce Youth Violence Everywhere (STRYVE) Strategies Selector Tool. STRYVE, 

CDC’s national youth violence prevention initiative, is working to bridge the gap between 

what is known about effective youth violence prevention activities and what is happening 

in communities. As part of the many STRYVE Online resources that assist communities with 

developing and implementing comprehensive prevention plans, the STRYVE Strategies 

Selector Tool helps communities connect their unique risks and needs to specific evidencebased youth violence prevention programs, policies, and practices. Other online resources 

about prevention approaches, some of which are described below, include information about 

approaches for a wide range of health, social, and academic issues. These other resources 

also vary in how rigorously an approach has been evaluated before it is included. The STRYVE 

Strategies Selector Tool pulls together information from multiple sources to help communities 

connect specifically with youth violence prevention approaches that have been rigorously 

evaluated and shown to impact risk and protective factors for youth violence and/or lower 

the occurrence of youth violence. This tool combines rigorous evaluation science with the 

flexibility required for communities to devise a tailored approach to youth violence prevention. 

National Centers 

of Excellence in 

Youth Violence 

Prevention

CDC’s National Centers 

of Excellence in Youth 

Violence Prevention are 

an example of a federal 

investment in promoting 

partnerships to continue 

to build the evidence 

base for youth violence 

prevention. Starting in 

2000, the Centers have 

promoted collaboration 

between youth violence 

prevention researchers 

and communities. 

They have improved 

community capacity to 

work collaboratively on 

violence prevention, 

increased the evidence 

base for prevention 

approaches, and 

disseminated the results 

in numerous ways, 

including over 500 

presentations and journal 

articles. Their activities 

have led to reductions 

in youth violence and 

have also informed 

local policy efforts for 

enhancing youth violence 

prevention. For more 

information, visit CDC’s 

Division of Violence 

Prevention.
Preventing Youth Violence: Opportunities for Action 25

Blueprints for Healthy Youth Development. The University of Colorado’s Center for the 

Study and Prevention of Violence is one of several research consortiums that has sought to 

increase the use of evidence-based approaches by reviewing and summarizing the available 

scientific information. Their Blueprints for Healthy Youth Development project includes the 

review of more than 1,100 programs that address problem behavior (e.g., youth violence, 

crime, and drug abuse) and other adolescent health issues (e.g., education, emotional wellbeing, physical health, and positive relationships).10 To assist communities in identifying 

which programs have strong evidence of effectiveness, very strict criteria are applied to 

determine if a program can be deemed a “model” or “promising” approach based on the 

program’s evaluation quality, impact, specificity, and dissemination readiness. The Blueprints 

project has identified over 30 model or promising programs that reduce violence or key 

risk factors for violence, such as delinquency and substance abuse. Programs identified as 

effective in reducing the risk for youth violence include several school-based programs that are 

designed to promote the health and safety of all students (e.g., Life Skills Training), parenting 

and family programs that bolster caregivers’ skills and parent-youth relationships (e.g., The 

Incredible Years: Parent and Family Training), and intensive family and community-based 

treatment programs that address the skill development and social support needs of high-risk 

youth and their families (e.g., Functional Family Therapy, Multisystemic Therapy). With only 

a small number of the more than 1,100 programs examined meeting the Blueprints project 

criteria, this review demonstrates that most existing programs have not been adequately 

evaluated or have been evaluated and shown not to work. Some programs are known to 

even be harmful (see Task Force for Community Preventive Service description below). The 

Blueprints project helps connect communities to prevention approaches with the strongest 

evidence and illustrates more research about different prevention strategies is needed. 

Task Force for Community Preventive Services. Another source for guidance on what 

works to prevent youth violence is the Task Force for Community Preventive Services, a 

nonfederal group of experts in public health and prevention. The Task Force is appointed 

by CDC’s Director but functions independently to systematically review the research in an 

area of public health and to issue recommendations based on the strength of the evidence. 

The Task Force has examined several strategies related to youth violence, including firearms 

laws, therapeutic foster care, universal school-based violence prevention programs, and the 

transfer of juveniles to adult courts. Based on the availability of strong research evidence, the 

Task Force has issued recommendations for preventing youth violence with universal schoolbased programs and therapeutic foster care for chronically delinquent juveniles.66 Work 

by the Task Force also helps communities understand which prevention approaches are 

not effective or even harmful. For example, the Task Force’s review of policies that facilitate 

the transfer of juvenile offenders to the adult criminal system rather than maintaining 

them in the juvenile justice system demonstrates an increase in the risk of young people 

re-offending. The review found an increase of 34% in re-arrests for violent crimes among 

juveniles who had been transferred, suggesting this policy is an ineffective way of 

preventing future violence. The Task Force issued a recommendation against this approach.93

The Task Force has also evaluated the impacts of eight types of federal and state firearms 

laws on violence-related outcomes and has concluded that there is insufficient evidence 

to determine the evidence of effectiveness of the laws to prevent violence (see text box on 

page 26 for more information about reducing minors’ unsupervised access to firearms). 

Universal 

School-based 

Youth Violence 

Prevention 

Programs

Universal school-based 

violence prevention 

programs are designed 

to reach all students in 

a given school or grade. 

Many different programs 

have been developed, 

and their curricula vary. 

In general, they provide 

students with information 

about violence, change 

how youth think and 

feel about violence, and 

develop youth’s skills 

to avoid violence and 

resolve disputes through 

nonviolent means. 

When looking across 

evaluations, the Task 

Force for Community 

Preventive Services found 

these programs result in 

a 15% relative reduction 

in students’ violent 

behavior.65 It is important 

to recognize that not all 

school-based violence 

prevention programs are 

effective or achieve similar 

reductions.
26 Preventing Youth Violence: Opportunities for Action

Crime Solutions. The U.S. Department of Justice’s Office of Justice Programs 

established CrimeSolutions.gov to provide practitioners and policy makers with 

information about what works in criminal justice, juvenile justice, and crime victims’ 

services. Reviewers assess the quality, strength, and extent of the evidence for 

different programs. Programs are rated as “effective,” “promising,” or having “no 

effects.” Effective approaches have strong evidence to indicate that they achieve their 

intended outcomes when implemented with fidelity, and promising approaches 

are ones that have also been demonstrated to achieve their intended outcomes but 

have relatively less support. Programs listed as having no effects are ones that have 

strong evidence indicating that they had no effects or had harmful effects when 

implemented with fidelity. This resource currently includes 41 entries for violence 

with an evidence rating of “effective,” and these approaches address a number of 

outcomes, such as youth violence, dating violence, and child maltreatment.104 

National Registry of Evidence-based Programs and Practices (NREPP). The 

Substance Abuse and Mental Health Services Administration (SAMHSA) supports 

NREPP to help connect the public to information about evidence-based approaches 

that promote mental health, prevent substance abuse, and treat mental health and 

substance abuse. Approaches that address a number of outcomes are included (e.g., 

violence, mental health, homelessness, tobacco, drugs, education, and employment). 

The online registry includes over 300 interventions that have been reviewed for “quality 

of research” and “readiness for dissemination.”67 The quality of research rating is based 

on six criteria that reflect measurement, intervention fidelity, and appropriateness of 

the design and analysis. The readiness for implementation rating is based on three 

criteria reflecting availability of materials, training and support, and quality assurance 

procedures. The registry is searchable with a variety of fields, such as age, race/ethnicity, 

setting, geographic location, and outcome. The registry currently includes 48 entries 

that are listed with a focus on violence outcomes, including youth violence, dating 

violence, and suicide.67

Taken together, these resources demonstrate that evidence-based approaches 

exist and are available for communities to utilize. These easily accessible systematic 

reviews of prevention strategies help communities learn more about approaches 

that work. Beyond these resources, communities are also learning from each other 

and accessing other tools, training, and technical assistance to select and implement 

evidence-based approaches that address a community’s unique needs. CDC’s STRYVE 

Online provides some of these prevention supports and narratives of communities in 

action to share how some groups are using evidence-based approaches to prevent 

youth violence.

Unsupervised Access 

to Firearms

Over 80% of youth homicides 

are committed with a firearm.1

Young people can acquire a 

firearm from their own home 

or from a relative or friend or 

obtain it illegally.94-97 Identifying 

ways to reduce minors’ 

unsupervised access to firearms 

has been a challenge with very 

few tried and tested solutions. 

Schools and communities 

have implemented various 

approaches focused on curbing 

weapon-carrying and reducing 

violent behavior (e.g., metal 

detectors, neighborhood gun 

buy-back programs). The few 

studies that have examined 

the effectiveness of these 

measures find either mixed 

results or no effect.95,98 With 

the exception of safe storage 

interventions, which are 

associated with fewer firearm 

injuries and deaths of children 

and young people, most other 

measures, such as educational 

strategies for gun owners 

and technological changes, 

have not been adequately 

evaluated making it difficult to 

know which ones are the most 

effective in reducing lethal 

violence among youth.95,99-102

The Institute of Medicine, in 

collaboration with the National 

Research Council, has convened 

a committee of experts and 

developed a research agenda

to address firearm violence 

as a public health problem. 

This agenda includes a priority 

focused specifically on minors’ 

access, possessing, and carrying 

firearms.103
Preventing Youth Violence: Opportunities for Action 27

Prevention Can Save Money 

The evidence about the benefits of some youth violence prevention programs has grown considerably in recent years to 

include demonstrations of their substantial cost savings. Researchers are systematically assessing the benefits relative to 

costs of prevention programs for a range of outcomes including crime, educational attainment, substance abuse, child 

abuse and neglect, teen pregnancy, and public assistance, and they are finding that many prevention programs are cost 

effective.105 Table 2 lists the benefit-cost information for some programs that have been shown in one or more studies to 

have significant preventive effects on youth violence or key risk factors for youth violence and that have financial benefits 

that exceed costs. The benefits can be substantial, often with several dollars saved for each dollar spent.106

Table 2. Estimates of Benefits Relative to Costs of Selected Prevention Programs*

Evidence-based 

Program

Benefits per 

$1 of cost

Communities that Care $3.69

Functional Family Therapy $11.50

Good Behavior Game $84.63

Guiding Good Choices $8.93

Life Skills Training $28.19

Multidimensional Treatment Foster Care $4.86

Multisystemic Therapy $4.54

Nurse-Family Partnership $2.73

Parent-Child Interaction Therapy $3.28

Triple P–Positive Parenting Program $5.46

*Dollar estimates are 

specific to the state 

of Washington and 

likely vary across states 

and communities. 

The benefit-cost 

estimates are 

continually updated, 

and cost estimates 

presented are based on 

information published 

by Washington State 

Institute for Public 

Policy as of May 2014.106

The latest information 

is available online 

from the Washington 

State Institute for 

Public Policy. Example 

programs include those 

designated as model or 

promising by Blueprints 

for Healthy Youth 

Development and 

are included in CDC’s 

STRYVE Strategies 

Selector Tool.

Source: Washington State Institute for Public Policy.106
28 Preventing Youth Violence: Opportunities for Action

Collaborating 

to Address 

Youth Violence

The National Forum 

on Youth Violence 

Prevention is an example 

of coordinated partners at 

the national level working 

to increase multisector 

collaboration at the local 

level.57 The National 

Forum pulls together 

the unique expertise 

of multiple federal 

agencies, including the 

Departments of Justice, 

Education, Labor, Health 

and Human Services, 

and Housing and Urban 

Development. Through 

technical assistance and 

peer-to-peer learning, 

the national partners are 

increasing local capacity 

to build multisector 

collaboration, develop 

strategic plans with a 

prevention component, 

and implement datadriven approaches to 

address youth violence. 

For more information, visit 

Find Youth Info.

Partners and Leaders in Understanding 

and Preventing Youth Violence

Effective prevention of youth violence is possible and sustainable with coordinated 

action and solid leadership by partners. No single person, group, or organization can do 

everything needed to prevent youth violence. To achieve a community’s youth violence 

prevention goals, a wide range of governmental and non-governmental representatives 

need to collaborate on a strategic plan and the selection and implementation of multiple 

evidence-based prevention activities. President Obama’s initiative, My Brother’s Keeper, 

is an example of partners working together to help boys and young men of color reach 

their full potential. This initiative includes a focus on reducing violence and emphasizes 

the importance of public health approaches as part of an integrated strategy that includes 

federal, state, and local leadership in violence prevention.

The partners necessary to the success of local prevention activities will vary from 

community to community. Partners will generally include representatives from diverse 

sectors and systems, such as justice, education, labor, social services, medical and mental 

health, and public health and safety. Community partners, such as businesses, youth 

serving organizations, and faith institutions, also have unique strengths and resources to 

help reduce youth violence.

Additional critical partners to preventing youth violence include community residents. 

Parents, other caregivers, and supportive community adults are pivotal in creating safe 

and nurturing environments for youth to develop adaptive behaviors. Also, research 

on the benefits of involving youth themselves in prevention activities is growing. Early 

indications suggest that when youth are prevention partners, their risk behaviors can 

decline, young people and adults enhance their skills and connection to the community, 

organizations and researchers strengthen their ability to engage hard-to-reach youth, and 

communities have improvements in their programs and policies.107-110

Historically, the justice system and medical institutions have been the primary leaders 

in addressing youth violence. Based on their expertise, their approaches have typically 

emphasized law enforcement and medical and mental health responses to violent 

incidents after they occur. Law enforcement and medical responses are necessary to 

minimize and address consequences of violence. They also have the potential to deter 

future acts of violence. This work is critical, but these responses do not stop youth violence 

from occurring in the first place. These groups have increasingly encouraged communities 

to include prevention as part of their activities.15

Youth violence has a significant impact on learning, and the education sector has 

been another visible leader and partner in understanding, tracking, and addressing 

violence that occurs within school settings. A safe and healthy school environment can 

promote academic success and reduce the risk for many short- and long-term health and 

occupational difficulties. Guidelines and tools have been developed to increase the use of 

strategic planning and evidence-based approaches to promote the development of safe 

places for students to learn.111
Preventing Youth Violence: Opportunities for Action 29

The public health community is an often underutilized youth violence prevention leader and 

partner. The public health community includes local and state health departments, federal public 

health institutions, researchers, practitioners, and schools of public health. It brings a focus on 

prevention and the promotion of population-wide well-being that is essential to helping any 

community stop youth violence before it starts. The expertise of public health professionals to 

apply science to challenging health problems and to coordinate the actions of multiple partners 

can greatly strengthen youth violence prevention planning, implementation, and monitoring 

of prevention activities and effects. The public health community has a key role to play as a 

convener, partner, and leader in increasing the use of existing evidence-based strategies and 

in expanding surveillance and research for our youth violence prevention actions to be more 

effective and sustained. This work includes collecting and interpreting data on the subgroups 

most impacted by youth violence, conducting research on modifiable risk and protective 

factors, designing rigorous evaluations of innovative prevention strategies, and supporting the 

dissemination, implementation, and monitoring of the most promising prevention approaches.

Role of CDC in Youth Violence Prevention

CDC examines trends in violence, studies risk and protective factors, evaluates prevention 

strategies, and works with communities to use this information to implement and monitor the 

most promising approaches. CDC also actively disseminates the research knowledge gathered 

so that communities can better understand and prevent youth violence. This resource is one 

example of CDC’s prevention support to communities and draws upon CDC’s surveillance

systems, research investments, and programmatic activities as well as other sources for youth 

violence prevention. CDC’s focus on prevention complements the work of law enforcement 

agencies to hold perpetrators accountable and the efforts of healthcare agencies to provide 

services to victims. CDC’s work represents a pipeline of prevention activities that move from 

research to practice. Below are some examples of current activities along this pipeline. More 

information about each of these examples and other CDC activities that help prevent youth 

violence is available from CDC’s Division of Violence Prevention.

National Violent Death Reporting System (NVDRS). NVDRS combines data from death 

certificates, law enforcement reports, and coroner or medical examiner reports to provide rich 

information on the circumstances of violent deaths, including information on youth and gang 

homicides. NVDRS operates in 18 states (as of March 2014) and will be expanding to more states. 

School-Associated Violent Death Study (SAVD). Since 1992, CDC has been collecting data on 

each homicide or suicide that happens on school grounds, on the way to or from school, or at a 

school-sponsored event. The SAVD collects information about the victims, alleged perpetrators, 

and the lethal incident. 

Youth Risk Behavior Survey (YRBS). The YRBS has been conducted biennially since 1991 with 

a large, nationally representative sample of students in grades 9–12. The YRBS collects data on 

a range of health risk behaviors, including bullying, weapon carrying, and fighting on and off 

school property.

Crime Prevention Through Environmental Design (CPTED). CDC has developed a tool that uses 

CPTED principles to assess the physical environment in school settings. CDC is currently testing 

the extent to which scores on the tool are associated with students’ reports of fear and violence. 
30 Preventing Youth Violence: Opportunities for Action

National Centers of Excellence in Youth Violence Prevention. CDC currently supports six 

National Centers of Excellence in Youth Violence Prevention that connect academic and 

community partners to implement and evaluate a comprehensive youth violence prevention 

strategy in a high-risk community. The Centers are using approaches that have the best 

available research evidence and are assessing their impact on assault, homicide, and other 

youth violence outcomes. They are a catalyst for prevention efforts in the communities they 

serve and are models for other communities. 

Striving To Reduce Youth Violence Everywhere (STRYVE). STRYVE, CDC’s national youth 

violence prevention initiative, helps public health departments and community partners 

stay abreast of the latest information and implement evidence-based prevention strategies.11

Components of STRYVE, such as STYRVE Online, connect communities to tools that help 

them convene partners, use data to design local prevention approaches, select evidencebased strategies, and conduct evaluations to help ensure community youth violence 

prevention goals are being achieved. Additionally, training and technical assistance are 

provided directly to select local public health departments in order to build their leadership, 

infrastructure, and capacity to use evidence-based youth violence prevention approaches.

Youth Violence Prevention Training and Technical Assistance. To further build local 

capacity to prevent youth violence, CDC provides training and technical assistance to help 

communities better understand youth violence, evidence-based prevention approaches, 

and strategies to develop partnerships and comprehensive plans. Some of this guidance is 

found on CDC’s Violence Education Tools Online (Veto Violence). CDC also provides training 

and technical assistance to local health departments and their partners working in highrisk communities. This support is intended to build the infrastructure of local public health 

departments to plan and implement strategies based upon the best available evidence.

Implementing Evidence-based 

Youth Violence Prevention Activities

Communities around the country are making significant progress in using what is known 

about effective youth violence prevention. CDC’s STRYVE Online Communities in Action

and Veto Violence Success Stories provide examples of communities working to prevent 

violence. Communities have learned that there is not one program, practice, or policy that 

solves their youth violence problem. Rather, they have to examine their unique strengths 

and needs and design a comprehensive plan that puts in place multiple prevention activities 

that have the best available evidence. A systematic, data-driven approach increases the 

likelihood that implemented youth violence prevention activities will be effective. A strategic 

plan also aids in aligning resources with prioritized youth violence prevention goals and 

reduces redundancy in efforts. 

The success of a youth violence prevention strategic plan also rests on the community’s 

capacity to select evidence-based approaches that help achieve community goals and an 

infrastructure that enables the implementation and sustainability of effective approaches. 

Communities may need a youth violence prevention coordinator at the public health 

Data-Driven 

Strategic Action

Communities that Care 

(CTC) is an example of 

a prevention system 

that uses a data-driven 

strategic approach to 

prevent youth problem 

behaviors, such as 

violence, delinquency, 

school dropout, and 

substance abuse. With 

CTC, a coalition of 

community stakeholders 

assess local risk and 

protective factors 

and then selects and 

implements evidencebased prevention 

programs.64 An evaluation 

of the CTC prevention 

system in 24 communities 

found that between 5th 

and 7th grades youth in 

the CTC settings were 

27% less likely to initiate 

delinquent behavior 

(e.g., stealing, attacking 

someone) compared to 

their peers in non-CTC 

settings.112 The most 

recent wave of analyses 

indicates that these 

significant differences 

were sustained through 

10th grade.113 Cost 

benefit analyses of the 

effects through 8th 

grade estimate that the 

net benefit is $5,250 per 

youth. This equates to a 

return of about $5.30 for 

every $1.00 invested.114

For more information, visit 

Communities that Care.
department or other partner organization who can provide leadership and focused 

attention to building collaboration and identifying prevention strategies based on local 

data. Many communities may also need training and technical assistance to improve 

their capacity and infrastructure to take better advantage of what is known to work. 

Free tools and training available through such resources as CDC’s STRYVE Online can 

help communities learn how to forge partnerships, use local data to guide prevention 

planning, identify and implement multiple evidence-based prevention strategies, 

evaluate whether community goals are being met by prevention activities, and modify 

and expand prevention activities as necessary.

Population-wide reductions in youth violence are possible by expanding the 

implementation of evidence-based prevention strategies throughout a community 

to ensure that as many people who can benefit from the activity as possible are 

participating. Examples include reaching an entire county instead of just one 

neighborhood, impacting an entire school district rather than just one school, 

embedding a strategy within a state agency instead of just one organization, or 

adapting a school-based strategy for community settings. This expansion includes being 

strategic about the mix of prevention strategies used, building on existing capacity and 

infrastructures, addressing the needs of diverse groups, and ensuring the quality of

the implementation is maintained.115,116 Widespread adoption of an effective approach 

throughout an organization or a community or even across a city or state can occur 

with the appropriate infrastructure in place, support from leadership, and knowledge 

of community context and community experience of what strategies work, with whom 

(e.g., specific age groups, specific risk groups), and in what contexts (e.g., schools, 

community settings). 

Opportunities for Action

Youth violence can take many forms, including fighting, bullying, and gang violence. 

Regardless of the form, the consequences of youth involvement in violence are felt by 

everyone—young victims, families, neighbors, schools, and local organizations. Typically 

when we think about who should be working to reduce youth violence, we point to 

someone else instead of looking in the mirror. We think it is a law enforcement issue or 

a school problem or a family matter. Or, we naively believe youth violence happens to 

other people’s kids or in other communities and we are immune. 

The reality is that youth violence is a public health problem that touches us all, and each of 

us has a role to play in prevention. The research presented in this document demonstrates 

that there are strategies that can stop youth violence before it occurs. This knowledge 

helps us identify the actions community leaders and members, public health professionals, 

adults who care for or work with youth, and young people can take to reduce youth 

violence. Actions are presented below for each of these groups and summarized in Table 

3. People can be in multiple categories. For example, community leaders can also be 

caregivers. Consequently, individuals will likely see action steps in multiple categories that 

they can take. Each potential action step is supported by the research summarized in this 

document about modifiable youth violence risk and protective factors and youth violence 

prevention strategies that have been shown to be effective.

Preventing Youth Violence: Opportunities for Action 31
32 Preventing Youth Violence: Opportunities for Action

Table 3. Summary of Actions to Prevent Youth Violence Community Leaders and Members Public Health Professionals Families, Caregivers, and Other Adults Young People

Action 1. Enhance the skills and experiences of individual youth. 

•	 Serve as a mentor, tutor, or volunteer at schools and youth-serving organizations to support the healthy 

development of all young people.

•	 Provide meaningful and appropriate opportunities through businesses and social/civic groups for youth to 

develop their interests, skills, and talents. 

•	 Praise good behavior and take immediate action to stop youth violence when it occurs. 

Action 2. Use and promote youth violence prevention strategies that are based on evidence to benefit the 

entire community. 

•	 Support local action by joining or starting a youth violence prevention coalition that works across groups and 

sectors.

•	 Make prevention a community priority. 

•	 Insist on the use of data to make decisions and put in place evidence-based approaches. 

•	 Use a comprehensive set of approaches to support and strengthen youth, families, schools, and communities. 

•	 Seek out and use existing resources to learn about effective youth violence prevention activities and programs. 

•	 Share progress and successes to raise awareness that youth violence is a preventable public health problem.

Action 3. Help communities build their capacity to prevent youth violence. 

•	 Actively disseminate the latest information about what works.

•	 Join with partners to strategically plan and support widespread implementation of evidence-based youth 

violence prevention approaches.

•	 Expand and enhance data systems on youth violence and risk/protective factors and improve data integration 

and dissemination.

•	 Establish and maintain dedicated youth violence prevention staff. 

•	 Enhance public health leadership for youth violence prevention.

Action 4. Continue innovative research to address gaps. 

•	 Continue research about factors that protect youth, families, and neighborhoods from violence.

•	 Rigorously evaluate promising youth violence prevention strategies. 

•	 Study ways to strengthen communities’ ability to implement youth violence prevention strategies well.

Action 5. Reduce the risk for violence and promote the strengths of young people. 

•	 Be a consistent model for how to respond nonviolently to conflict, stress, and fear. 

•	 Pay attention when youth behave well and help them see the benefits that come from their good choices. 

•	 Build a connection with young people that allows them to feel comfortable discussing violence and related 

concerns. 

•	 Carefully monitor youth’s activities and behavior, help youth make safe choices, and talk with others who have 

a strong influence on young people.

•	 Prevent minors from getting unsupervised access to firearms at home, from family, and from friends. 

•	 Take advantage of help and share information and resources with others.

Action 6. Make choices that promote safety and opportunities to thrive.

•	 Stop and think before saying or doing anything that could hurt others, act in nonviolent ways, and get help 

from a trusted adult or safe place.

•	 Spend time with people and in places that are at low risk for violence. 

Action 7. Help others be violence-free. 

•	 Help others be violence-free, and support those who have been hurt by violence.

•	 Show others how to stay safe. 

•	 Get involved in violence prevention work. 
Preventing Youth Violence: Opportunities for Action 33

Community Leaders and Members

All adults, including neighbors, business owners, health care providers, appointed and elected leaders, and members 

of faith-based groups have reasons and opportunities to support the development and safety of young people and to 

contribute to community-wide efforts to prevent violence.

Action 1. Enhance the skills and experiences of individual youth. 

All adults can consider ways to help youth learn new problem-solving and communication skills and to have life-enriching 

experiences. These connections may occur between adults and youth who already interact as neighbors or members of the 

same faith-based groups. New relationships can also be formed. Implementation steps include:

•	 Serve as a mentor, tutor, or volunteer at schools and youth-serving organizations to support the healthy 

development of all young people. Even activities that are not specifically described as youth violence prevention 

can make a difference in the lives of young people. Community members can look for ways to use their experiences, 

skills, time, and talents to help guide youth. These opportunities can vary from being a trained mentor to 

volunteering at an afterschool program or joining with other community residents and youth to assist with 

community activities. These connections should be made with at-risk youth as well as young people who do not 

show obvious signs of difficulties. All young people can make better decisions in multiple aspects of their lives, 

including their involvement in violence, when they have a stable relationship with a caring adult who supports 

them and models nonviolence.

•	 Provide meaningful and appropriate opportunities through businesses and social/civic groups for youth to 

develop their interests, skills, and talents. Action by adults does not necessarily require joining new organizations. 

Adults can look for ways to incorporate young people into existing work or volunteer activities in order to provide 

training, educational, and networking experiences. Scheduling these opportunities immediately after school and 

during school breaks—when young people’s time is less structured and unsupervised—can be a powerful youth 

violence prevention approach.

•	 Praise good behavior and take immediate action to stop youth violence when it occurs. Community members 

should encourage and praise youth for making wise, nonviolent choices. Recognition and reinforcement of positive 

behaviors increases the likelihood of recurrence. All adults in the community have a role to play in letting youth 

know that violence is not acceptable. Adults should model nonviolence in all of their interactions and coach youth 

on how to resolve disputes calmly and nonviolently. Community members can involve other adults, such as the 

youth’s parents, siblings, neighbors, or teachers, to help deescalate conflict, support victims and perpetrators, and 

create a community belief that violence is never okay.

All adults can 

consider ways to 

help youth learn new 

problem-solving 

and communication 

skills and to have 

life-enriching 

experiences.
34 Preventing Youth Violence: Opportunities for Action

Action 2. Use and promote youth violence prevention strategies that are based 

on evidence to benefit the entire community. 

Communities can effectively prevent youth violence but far too often wait for 

violence to occur before acting. By increasing the use of evidence-based strategies 

that address local needs, communities can prevent youth violence from happening 

in the first place. Implementation steps include:

•	 Support local action by joining or starting a youth violence prevention 

coalition that works across groups and sectors. Critical partners to 

preventing youth violence will vary from community to community and 

will likely include education, public health, faith-based organizations, 

law enforcement, and local businesses. Encouraging collaborative action 

and creating opportunities for others to participate, including youth and 

residents impacted by youth violence, can help ensure planned activities will 

address local needs, build on local strengths, and be sustained over time. A 

collaborative approach also helps to ensure that a range of evidence-based 

prevention activities are used.

•	 Make prevention a community priority. Many prevention activities have 

been shown to have benefits that result in significant returns on investment, 

including savings to participants, victims, and taxpayers. A community can 

experience significant savings over time by making prevention a priority. 

Community members can work with partners to increase attention to acting 

before violence starts and having prevention be an essential complement to 

law enforcement and medical responses to violence. They can identify the 

public and private resources needed to achieve prevention goals and keep 

the activities going over time. This might include pooling existing resources 

across systems and coordinating with other violence prevention and health 

promotion activities in the community.

•	 Insist on the use of data to make decisions and put in place evidencebased approaches. When youth violence prevention strategic plans are 

based on data, implemented approaches are more likely to work. The 

opportunity for success increases by having information about violence in 

the community, differences across groups or neighborhoods, local risk and 

protective factors, and evidence that programs being considered or used 

actually reduce risk or enhance protective factors. Information can come 

from existing sources, such as police, school, or emergency department 

records, or new sources like neighborhood surveys.

•	 Use a comprehensive set of approaches to support and strengthen youth, 

families, schools, and communities. No one approach will solve an entire 

community’s youth violence problem. By implementing multiple activities 

that are based on the best available evidence, communities can address the 

needs of all youth, including those who are at immediate risk for violence. 

Complementary approaches can be identified that help strengthen 

young people’s skills and relationships as well as address issues in schools, 

communities, and society that influence the likelihood of violence. Examples 

of potential prevention approaches are presented in Table 1, on pages 22–23. 

Data-Driven Strategic 

Planning and 

Implementation 

Models

• STRYVE Online

• Communities that Care

• PROSPER Partnerships

• Mobilizing for Action through 

Planning and Partnerships

Examples of 

Youth Violence 

Prevention Approaches 

Based on the Best 

Available Evidence

Approaches for use in schools, 

homes, or communities:

•	 Universal School-based Youth 

Violence Prevention

•	 Parenting Skill and Family 

Relationship Approaches

•	 Policy, Environmental, and 

Structural Approaches

Approaches that focus on those at 

immediate risk:

•	 Intensive Family-focused 

Approaches

•	 Street Outreach and Community 

Mobilization

Approaches that focus on very 

young children:

•	 Early Childhood Home Visitation

•	 Early Childhood Education
Preventing Youth Violence: Opportunities for Action 35

•	 Seek out and use existing resources to learn about effective youth violence 

prevention activities and programs. In addition to learning from the experience of 

other communities and coalitions, online resources provide helpful information about 

effective youth violence prevention activities and programs, including descriptions 

of the risk and protective factors addressed, program effects found by research, types 

of participants helped, and the costs. When existing approaches are available and fit 

a community’s needs, their use should be promoted over the development or use of 

approaches that have not been evaluated. Online resources, including those listed on 

the right and and described in greater detail on pages 24-26, can be helpful in choosing 

the best programs to meet community needs as well as offer training and guidance on 

strengthening partnerships, strategic planning, and coordinating resources.

•	 Share progress and successes to raise awareness that youth violence is a 

preventable public health problem. Everyone can become a visible spokesperson for 

prevention by explaining how violence is not just a problem for law enforcement or 

schools. The facts that violence is also a public health issue and prevention is possible 

can be shared. Information about what is working can be provided through multiple 

formats, such as fact sheets, training/information sharing lecture series, and annual 

reports. Increased awareness of this information can help youth violence prevention 

efforts take hold and grow. 

Online Resources 

to Learn More on 

Evidence-based 

Youth Violence 

Prevention 

Activities

•	 STRYVE Strategies 

Selector Tool

•	 Blueprints for Healthy 

Youth Development

•	 Task Force for Community 

Preventive Services

•	 Crime Solutions

•	 National Registry of 

Evidence-based Programs 

and Practices
36 Preventing Youth Violence: Opportunities for Action

Public Health Professionals

Public health professionals can include researchers and practitioners working for local and 

state health departments, federal public health agencies, or schools of public health, as 

well as professionals from diverse backgrounds who are taking a public health approach 

to youth violence prevention. These groups have a clear responsibility to help reduce the 

health burden of youth violence. The ability of public health professionals to apply science 

to challenging health problems to reduce risk within large groups of people can be used to 

decrease youth violence.

Action 3. Help communities build their capacity to prevent youth violence.

Public health has a role to play in ensuring that existing information about what works to 

reduce youth violence is being used and our knowledge and evidence-based prevention 

strategies continue to grow. These professionals have the skills and expertise to help 

strengthen and coordinate the activities of multiple partners to plan and implement youth 

violence prevention activities. Implementation steps include:

•	 Actively disseminate the latest information about what works. Public health 

organizations can synthesize, translate, and disseminate the best and most recent 

information available from youth violence prevention research and practice. Multiple 

channels can be used, including in-person meetings or training sessions, webinars, 

distance learning programs, fact sheets, and action briefs.

•	 Join with partners to strategically plan and support widespread implementation of 

evidence-based youth violence prevention approaches. Public health organizations 

focus on improving the health of the entire community. Their skills and experiences 

can be applied to helping communities prevent violence by facilitating collaboration 

among community partners, assessing local needs, selecting strategies that work, 

implementing approaches well, and monitoring the outcomes.

•	 Expand and enhance data systems on youth violence and risk/protective factors 

and improve data integration and dissemination. Accurate and timely information 

is crucial to planning, implementing, and evaluating youth violence prevention 

strategies. Public health practitioners must work with partners to improve the 

availability, quality, and integration of relevant data systems from police, hospitals, 

schools, social services, housing, and labor. Particular attention can be given to 

integrating or creating information resources about circumstances of violence and 

contributing factors, establishing procedures to improve the efficiency of data sharing 

through secure, web-based systems, and analyzing data by neighborhood. This 

information should be shared to inform local prevention approaches.

•	 Establish and maintain dedicated youth violence prevention staff. A key challenge 

to preventing youth violence is the limited availability of staff with the necessary 

training and time to engage in these activities. The responsibility of coordinating 

youth violence prevention activities can be assigned to a staff person or team 

in the public health department who are supported and have protected time to 

sustain partnerships, implement approaches, and evaluate effects. Public health 

organizations can utilize existing networks of prevention researchers and mentoring/

training programs to connect graduate students and interns with on-the-ground 

opportunities to gain valuable experience in applying new knowledge and skills to 

preventing violence in real-world situations. 

Minneapolis: 

Implementing 

Prevention and 

Tracking Success

Homicide was the leading 

cause of death for youth in 

Minneapolis between 2003 

and 2006. In 2006, the City 

Council declared youth 

violence a public health 

problem and established 

a multisector Steering 

Committee. This group 

developed the Blueprint 

for Action to Prevent Youth 

Violence by reviewing 

research, meeting with local 

youth, consulting national 

experts, and assessing existing 

youth violence prevention 

programs. A prevention 

coordinator was hired in the 

public health department to 

oversee the implementation 

of this strategic plan, which 

included evidence-based 

approaches to strengthen 

families, mentoring, and 

employment opportunities. 

Through a collaborative 

data system called Results 

Minneapolis, prevention 

effects are monitored on 18 

indicators. Between 2006 

and 2010, Minneapolis had 

a 56% reduction in juvenile 

crime, 58% reduction in 

incidents involving firearms 

and juveniles, and 36% 

reduction in firearm-related 

injuries of youths and young 

adults.58 For more information, 

visit Minneapolis’ Health 

Department.
Preventing Youth Violence: Opportunities for Action 37

•	 Enhance public health leadership for youth violence prevention. Public 

health leaders can provide high-level support and guidance for youth 

violence prevention. Public health leaders can develop local, state, and 

national strategic plans for youth violence prevention. Public health 

leaders at multiple levels can also work to educate decision makers about 

the opportunities for prevention, help prioritize prevention resources 

for evidence-based approaches, and provide information to guide the 

development of policies that enhance protective factors and reduce risks 

for youth violence. 

Action 4. Continue innovative research to address gaps. 

To successfully prevent youth violence, gaps in knowledge must be filled. 

Continued research is needed about the factors that influence the likelihood of 

youth violence, prevention strategies that address community factors, and the 

best ways to disseminate and implement what works. Implementation steps 

include:

•	 Continue research about factors that protect youth, families, and 

neighborhoods from violence. Knowledge about risk and protective 

factors for youth violence is the backbone of effective prevention 

strategies, and knowledge about protective factors is limited. Continuing 

research in this area can inform the development of innovative 

prevention strategies to enhance protective factors for all youth as well as 

efforts directed at buffering against the risks faced by vulnerable youth, 

families, and communities. 

•	 Rigorously evaluate promising youth violence prevention strategies. 

Researchers’ development of new evidence-based, youth violence 

prevention approaches must continue until youth violence is prevented 

across all communities. Researchers can replicate and evaluate promising 

youth violence prevention strategies in different populations and 

settings to determine whether cultural and community adaptations are 

needed. Evaluation of new strategies should also consider the broader 

community factors that increase the likelihood of youth violence, including 

strategies that build the social cohesion of communities, improve physical 

environments, decrease inappropriate access to and use of firearms among 

minors, and modify societal norms about the acceptability of violence. 

•	 Study ways to strengthen communities’ ability to implement youth 

violence prevention strategies well. Research provides youth violence 

prevention approaches that have demonstrated effectiveness with 

diverse populations in different settings; however, many of these 

approaches are underutilized. Research should focus on strategies that 

bridge the gap between science and action so that more individuals, 

organizations, and communities are able to implement effective 

approaches and achieve positive outcomes. This research includes 

strategies to synthesize, translate, package, and implement evidencebased prevention approaches. Research is also needed to identify the 

types of technical assistance that are most helpful to communities.

VCU Clark-Hill Institute 

for Positive Youth 

Development: Advancing 

Prevention Research

The Virginia Commonwealth University 

(VCU) Clark-Hill Institute for Positive 

Youth Development is one of CDC’s 

National Centers of Excellence in 

Youth Violence Prevention. Clark-Hill 

researchers collaborate with education 

and public health partners to build local 

infrastructure, capacity, and activities to 

prevent youth violence. One activity is 

the continuous gathering, analysis, and 

interpretation of local data to engage 

the community, educate community 

leaders, and evaluate innovative 

prevention activities. For example, 

surveillance data analyzed by Clark-Hill 

researchers found that single-serve 

alcohol beverages were associated with 

increased rates of injury and violence. 

Local policy makers used these data 

to develop a new alcohol licensing 

policy. An evaluation of this policy by 

Clark-Hill researchers found that rates 

of violence-related ambulance pick-ups 

declined from 19.6 to 0 per 1,000 youth 

ages 15–24 years in the intervention 

community.51 For more information, 

visit the Clark-Hill Institute.

CDC’s Injury 

Research Agenda

CDC’s Injury Center developed a 

research agenda to describe research 

needs and priorities for 2009–2018. 

The research agenda includes chapters 

on multiple forms of intentional and 

unintentional injury, including youth 

violence. The research agenda is 

accessible from CDC’s Injury Center.
38 Preventing Youth Violence: Opportunities for Action

Families, Caregivers, and Adults Who Work with Youth

Parents, other caregivers, and adults who work with youth, including teachers, mentors, coaches, faith-based and club 

leaders, have a profound influence on young people’s beliefs and behaviors throughout their lives. 

Action 5. Reduce the risk for violence and promote the strengths of young people.

Young people’s risk for violence can be buffered by stable, healthy, and safe relationships with caring adults that are 

developed in early childhood and are sustained throughout adolescence. These adults can be powerful role models for how 

to successfully navigate difficult situations. They are also critical guides to young people throughout their development. 

Implementation steps include: 

•	 Be a consistent model for how to respond nonviolently to conflict, stress, and fear. Parents, other caregivers, 

and adults who work with youth can show young people how to stay calm in difficult situations, seek help when 

needed, and use nonviolent solutions. This modeling teaches young people how to avoid violence and choose 

positive ways to deal with difficulties.

•	 Pay attention when youth behave well and help them see the benefits that come from their good choices.

Violence prevention is about more than reducing risks. It is also about increasing positive behaviors. When adults 

praise youth for positive behaviors as they happen, such as sharing, talking through disputes, and respecting 

others, young people are more likely to repeat these behaviors. When adults help youth see how their good choices 

benefit them in other ways, like increasing opportunities to spend time with friends or to have fun, they are more 

likely to change their behaviors.
Preventing Youth Violence: Opportunities for Action 39

•	 Build a connection with young people that allows them to feel comfortable discussing violence and related 

concerns. The challenges faced by young people change over time as their relationships, experiences, and 

environments change. Youth can cope more effectively with these difficulties when adults who care about them 

continually monitor and discuss those concerns. Conversations about violence and related issues are best started in 

pre-school and continue throughout the teen years. Adults can build and strengthen the connections with positive 

activities that show they care by: 

• Spending time each day talking to youth about their activities and experiences, asking who they spent time 

with and what they did, listening to how they are doing, and talking about possible future difficulties and 

solutions.

• Setting age-appropriate expectations for behavior and noticing and praising good choices.

• Having clear and nonviolent consequences for misbehavior and consistently addressing rule breaking.

• Noticing warning signs, such as changes in how a youth is acting, and immediately and repeatedly discussing 

concerns with the youth and work with the youth as well as other adults, when necessary, to identify solutions. 

• Talking with youth about violence, letting young people know that adults expect them to be nonviolent, 

helping youth develop the skills to be violence-free, and encouraging young people to talk about and seek 

help when violence occurs or they are concerned about potential threats.

•	 Carefully monitor youth’s activities and behavior, help youth make safe choices, and talk with others who have 

a strong influence on young people. Adults who have a positive relationships and good communication with 

young people are better able to know who youth are spending time with, where they are, and what they are doing 

in the community and online. Parents, other caregivers, and adults who care for young people can also know what 

young people are doing by regularly talking with important people in young people’s lives, including the parents 

of youth’s closest friends, parents, teachers, mentors, and neighbors. This monitoring can significantly reduce the 

likelihood of violence. Adults can closely supervise young people’s activities and reduce time youth spend with 

peers who make poor choices and in environments where the likelihood of violence is high. Exposure to television 

programs, movies, music, and video games that promote violence can be limited. The level and type of monitoring 

needed will depend on the young person’s maturity and past behavior. Appropriate monitoring is not easy and is 

often not appreciated by young people, but it is a critical part of helping them make wise choices.

•	 Prevent minors from getting unsupervised access to firearms at home, from family, and from friends. When 

minors have unsupervised access to firearms, the potential for children to experience serious or deadly violence 

or unintentional injury can increase. By storing firearms safely and assuring that minors do not have unsupervised 

access to firearms at home or in the homes that they visit, adults can reduce the risk for firearm injuries and deaths 

of children and young people. 

•	 Take advantage of help and share information and resources with others. All adults want the young people 

in their lives to be healthy, happy, and safe, but the lack of information and other resources can make that 

a challenging goal. Parents, other caregivers, and adults who care for youth can take advantage of effective 

prevention approaches that help improve and strengthen adult-youth relationships, increase safety, and lower 

the risks for violent behavior. Help is available and should be sought out if violence is suspected in a child’s home, 

if a family is dealing with mental health or substance abuse problems, or if more guidance is needed on how to 

support the healthy development of a child. Parents and other caregivers can access local support with the help of 

teachers, pediatricians, and mental and behavioral health providers. Online resources also are available and provide 

information and guidance.
• Parent Resources on USA.gov links to information 

about health, education, safety, child care, and other 

resources for parents and grandparents.

• National Parent Helpline (or 1-855-4 A PARENT) 

provides parents access to information, emotional 

support from a trained provider by phone, and 

assistance connecting to local resources.

• CDC Parent Information provides information from 

CDC about how to protect the health of children. The 

information is organized by age group and covers 

topics like safety and milestones in development 

and includes CDC’s Division of Violence Prevention 

Essentials for Parenting Toddlers and Preschoolers, which 

offers videos, interactive activities, and other resources 

to help parents build healthy relationships with their 

young children and to prevent violence.

• Department of Education provides checklists, tips, and 

tools to help parents meet their child’s educational 

needs. 

• StopBullying offers information for service providers, 

parents, and youth about bullying, prevention 

approaches, and responses to bullying.

• FindYouthInfo provides access to information, tools, 

and other resources developed by multiple federal 

agencies for youth, families, schools, and community 

organizations to address a broad range of adolescent 

health topics, including youth violence, and to support 

higher risk groups, such as runaway and homeless 

youth.

• Violence Education Tools Online (Veto Violence) is 

developed by CDC’s Division of Violence Prevention and 

includes youth violence prevention information, free 

accredited prevention training, resources for program 

planning, and success stories from other communities.

40 Preventing Youth Violence: Opportunities for Action
Preventing Youth Violence: Opportunities for Action 41

Michigan Youth 

Developing 

Skills and 

Strengthening 

Prevention

The Michigan Youth 

Violence Prevention 

Center is one of CDC’s 

National Centers of 

Excellence in Youth 

Violence Prevention. It 

brings the University of 

Michigan School of Public 

Health and Medical school 

together with communitybased organizations and 

residents to prevent youth 

violence. One prevention 

component is Youth 

Empowerment Solutions 

(YES), which promotes 

positive development 

and prevents risky 

behaviors among youth 

by empowering them 

to change their physical 

and social environments. 

The 16-week curriculum 

and community project 

are youth-led. In 2013, 

YES youth talked with 

their congressmen about 

their ideas for a safer 

future. Youth are also 

an energizing force in 

the Safe and Healthy 

Futures Youth Festival in 

Flint, which showcases 

performances by local 

youth organizations. For 

more information, visit the

Michigan Youth Violence 

Prevention Center.

Young People

Young people are an important part of the solution to youth violence. They can contribute in 

meaningful and significant ways to preventing the violence that they and their peers experience. 

Action 6. Make choices that promote safety and opportunities to thrive.

Young people are the most directly affected by violence. By strengthening communication 

skills, avoiding or heading off risky situations, and choosing positive activities and relationships 

young people can help create opportunities for success for themselves and their peers, be 

buffered from some community risks, and help reduce violence. Implementation steps include:

•	 Stop and think before saying or doing anything that could hurt others, act in 

nonviolent ways, and get help from a trusted adult or safe place. When young 

people stay in control of their feelings and resolve conflicts in nonviolent ways, they 

reduce the chances that they or someone else could get hurt. Youth should seek help 

from a trusted adult, such as a family member, teacher, coach, faith-based leader, 

or neighbor to learn about ways to stay in control and to find nonviolent solutions. 

Minors who feel that they need to carry a weapon for protection should talk with an 

adult about safer ways to protect themselves.

•	 Spend time with people and in places that are at low risk for violence. Young people 

should think carefully about their close friends and what they do together. Friends who 

do not use drugs and alcohol, try to do well at school, and believe violence should be 

avoided can help youth stay safer. Young people can reduce their risk for violence by 

spending time with friends in places that are supervised by adults. Gangs and gang-like 

groups try to make youth think that they offer safety, but people in a gang are much 

more likely to be a victim of violence than those who do not join. That is one of the 

reasons that most young people do not join gangs, and those who do typically leave 

within a year. Youth can consider nonviolent alternatives to television programs, movies, 

music, and video games that promote violence. Activities such as sports, clubs, and 

volunteering provide opportunities to develop skills, interests, and connections with 

peers and adults who make good choices.

Action 7. Help others be violence-free. 

The actions of one young person can greatly influence the actions of others. Youth can 

help prevent violence by speaking out and letting others know that violence is never okay. 

Implementation steps include:

•	 Help others be violence-free, and support those who have been hurt by violence.

Young people are encouraged to not just wait and watch when violence is about to 

happen or is occurring around them. When youth see that their friends are getting 

upset, they can help them calm down and deal with the situation in a nonviolent way. 

Whenever it is safe to do so, youth can stop an argument from getting violent and let 

others know that they do not agree with bullying or other forms of violence. Young 

people should get help from others, like trusted adults, especially when it is not safe to 

address the problem on their own. It is also important for youth to support others who 

have been victims of violence so that they do not continue to be victimized or become 

violent themselves.
42 Preventing Youth Violence: Opportunities for Action

•	 Show others how to stay safe. By avoiding alcohol, drugs, or any form of violence, youth can increase their own 

safety and health and be positive models for their peers. Youth can also encourage their peers to make safe and 

healthy choices. When minors resolve conflicts in nonviolent ways and without involving weapons, they help keep 

themselves, their friends and families, their schools, and their neighborhoods safe.

•	 Get involved in violence prevention work. Young people can become involved in or initiate violence prevention 

work in their schools or communities. Having young people involved helps to ensure that violence prevention efforts 

are focusing on the right issues and working in ways that will engage youth. These are also opportunities for youth 

to build and share their experiences, skills, and talents to help others and to make connections with other nonviolent 

peers. Youth-led activities can help raise support for youth violence prevention among other youth and adults. 

Seizing the Opportunity and Responsibility 

to Prevent Youth Violence

The advances in our knowledge about youth violence and effective prevention strategies give us the opportunity to do 

more than simply wait and respond when violence occurs. We have learned how to proactively stop youth violence before 

our young people die or are injured. We have a responsibility to our young people and communities to use the evidencebased prevention approaches that are already available and to continue research to expand our ability to stop youth 

violence before it starts. This work includes ensuring that prevention is a prominent element of a community’s approach 

to violence and implemented prevention activities are based on what works. Communities are more likely to have an 

impact on youth violence and save money by using evidence-based prevention approaches over unproven ones. Existing 

knowledge about youth violence gives us the tools to act today and a solid foundation to continue to develop and test 

innovative prevention approaches that benefit all communities. 

Part of the opportunity and responsibility to prevent youth violence includes activating, integrating, and utilizing public 

health professionals. They have the expertise and skills to strengthen communities’ efforts to prevent youth violence. By 

partnering with and complementing the work of other sectors, including law enforcement, education, social services, and 

medical systems as well as faith-based, media, non-profit, and businesses, public health can contribute to and help lead 

the advancement of youth violence prevention activities. No matter who we are—community residents and leaders; public 

health practitioners; parents, teachers and others who work with youth; or young people—we all have an important role 

and actions we can take to protect America’s youth and to help prevent youth violence.
Preventing Youth Violence: Opportunities for Action 43

References

1. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) [Internet]. 

Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control [cited 2014 Jun 

30]. Available from: http://www.cdc.gov/injury/wisqars/index.html.

2. Centers for Disease Control and Prevention. Youth online: high school YRBS [Internet]. Atlanta, GA: Centers for Disease 

Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 2013 [cited 2014 Jun 12]. 

Available from: http://apps.nccd.cdc.gov/youthonline/App/Default.aspx.

3. Arseneault L, Walsh E, Trzeniewski K, Newcombe R, Caspi A. Bullying victimization uniquely contributes to adjustment 

problems in young children: a nationally representative cohort study. Pediatrics 2006;118(1):130-8.

4. Finkelhor D, Turner H, Ormrod R. Kid’s stuff: the nature and impact of peer and sibling violence on younger and older 

children. Child Abuse Negl 2006;30(12):1401-21.

5. Menard S. Short- and long-term consequences of adolescent victimization. Washington, DC: US Department of Justice, 

Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention; 2002.

6. Swahn MH, Bossarte RM. The associations between victimization, feeling unsafe, and asthma episodes among US highschool students. Am J Public Health 2006;96(5):802-4.

7. Federal Bureau of Investigation. Uniform crime reports: Crime in the United Stated, 2012 [Internet]. Washington, DC: US 

Department of Justice, Federal Bureau of Investigation [cited 2014 Mar 27]. Available from: http://www.fbi.gov/about-us/

cjis/ucr/crime-in-the-u.s/2012/crime-in-the-u.s.-2012.

8. Mercy J, Butchart A, Farrington D, Cerdá M. Youth violence. In: Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. 

World report on violence and health. Geneva (Switzerland): World Health Organization; 2002. p. 25-56.

9. Dahlberg LL, Krug EG. Violence a global public health problem. In: Krug E, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. 

World report on violence and health. Geneva, Switzerland: World Health Organization; 2002. p. 1-56.

10. Center for the Study and Prevention of Violence. Blueprints for healthy youth development [Internet]. Boulder, CO: 

University of Colorado Boulder, Institute of Behavioral Science, Center for the Study and Prevention of Violence [cited 2014 

Mar 27]. Available from: http://www.blueprintsprograms.com/.

11 David-Ferdon C, Simon TR. Striving To Reduce Youth Violence Everywhere (STRYVE): The Centers for Disease Control and 

Prevention’s national initiative to prevent youth violence foundational resource. Atlanta, GA: Centers for Disease Control and 

Prevention; 2012.

12. David-Ferdon C, Dahlberg LL, Kegler SR. Trends in rates of homicide among youth aged 10-24 years-United States, 1981–

2010. MMWR 2013;64(27):545-48.

13. Dahlberg LL. Public health and violence: moving forward in a global context. In: Flannery DJ, Vazsonyi AT, Waldman ID, editors. 

The Cambridge handbook of violent behavior and aggression. New York: Cambridge University Press, 2007. p. 465-85.

14. Blumstein A, Wallman J, editors. The crime drop in America, revised edition. New York, NY: Cambridge University Press; 2006.

15. Wilson JJ, Howell JC. Comprehensive strategy for serious, chronic and violent juvenile offenders. Washington, DC: US 

Department of Justice, Office of Juvenile Justice and Delinquency Prevention; 1993.

16. Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better 

understanding. Washington, DC: National Academies Press; 2011.

17. Centers for Disease Control and Prevention. Sexual identity, sex of sexual contacts, and health-risk behaviors among 

students in grades 9–12—youth risk behavior surveillance, selected sites, United States, 2001–2009. MMWR 2011;60:1-133.
44 Preventing Youth Violence: Opportunities for Action

18. Gladden RM, Vivolo-Kantor AM, Hamburger ME, Lumpkin CD. Bullying surveillance among youths: uniform definition 

for public health and recommended data elements, version 1.0. Atlanta, GA: Centers for Disease Control and Prevention, 

National Center for Injury Prevention and Control and U.S. Department of Education; 2014.

19. Nansel T, Overpeck M, Haynie D, Ruan W, Scheidt P. Relationships between bullying and violence among U.S. youth. Arch 

Pediatr Adolesc Med 2003;157(4):348-53.

20. Office of Juvenile Justice and Delinquency Prevention. National youth gang survey analysis [Internet]. Washington, DC: US 

Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention [cited 2013 Jun 1]. 

Available from: http://www.nationalgangcenter.gov/Survey-Analysis.

21. Decker SH, Curry GD. Addressing key features of gang membership: measuring the involvement of young members. J Crim 

Justice 2000;28(6):473‐82.

22. Robers S, Kemp J, Truman, J. Indicators of School Crime and Safety: 2012. Washington, DC: US Department of Education, 

National Center for Education Statistics, US Department of Justice, Bureau of Justice Statistics, Office of Justice Programs; 

2013. Report No: NCES 2013-036/NCJ 241446. Available from: http://nces.ed.gov/pubs2013/2013036.pdf. 

23 Glessmann C, Krisberg B, Marchionna S. Youth in gangs: who is at risk? Oakland, CA: National Council on Crime and 

Delinquency; 2009.

24. Howell JC. Why is gang membership prevention information. In: Simon T, Ritter N, Mahendra R, editors. Changing course: 

preventing gang membership. Washington, DC: US Department of Justice, Office of Justice Programs, Centers for Disease 

Control and Prevention; 2013. p. 7-18. Available from: http://nij.gov/publications/changing-course/Pages/welcome.aspx. 

25. Simon T, Ritter N, Mahendra R, editors. Changing course: preventing gang membership. Washington, DC: US Department 

of Justice, Office of Justice Programs, Centers for Disease Control and Prevention; 2013. Available from: http://nij.gov/

publications/changing-course/Pages/welcome.aspx.

26. Pew Center on the States. One in 31: the long reach of American corrections. Washington, DC: Pew Charitable Trusts; 2009.

27. Gini G, Pozzoli T. Association between bullying and psychosomatic problems: a meta-analysis. Pediatrics 2009;123(3):1059-65.

28. Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH. Adverse childhood experiences and the risk of 

premature mortality. Am J Prev Med 2009;37(5):389-96.

29. Haegerich TM, Dahlberg LL. Violence as a public health risk. Am J Lifestyle Med 2011;5(5):392-406.

30. Hawkins JD, Catalano RF, Arthur MW. Promoting science-based prevention in communities. Addict Behav 2002;27(6):951-76.

31. Herrenkohl TI, Maguin E, Hill KG, Hawkins JD, Abbott RD, Catalano RF. Developmental risk factors for youth violence. J 

Adolesc Health 2000;26(3):176-86.

32. US Department of Health and Human Services. Youth violence: a report of the surgeon general. Rockville, MD: US 

Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury 

Prevention and Control; Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 

National Institutes of Health, National Institute of Mental Health; 2001.

33. Pollard JA, Hawkins D, Arthur MW. Risk and protection: are both necessary to understand diverse behavioral outcomes in 

adolescence? Soc Work Res 1999;23(3):145-58. 

34. Resnick MD, Ireland M, Borowsky I. Youth violence perpetration: what protects? what predicts? findings from the national 

longitudinal study of adolescent health. J Adolesc Health 2004;35(5):424.e1-e10.

35. Stouthamer-Loeber M, Loeber R, Wei E, Farrington DP,Wikstrom PO. Risk and promotive effects in the explanation of 

persistent serious delinquency in boys. J Consult Clin Psychol 2002;70(1):111-23.

36. Aisenberg E, Herrenkohl T. Community violence in context: risk and resilience in children and families. J Interpers Violence 

2008;23(3):296-315.
Preventing Youth Violence: Opportunities for Action 45

37. Farrington D. Key results from the first forty years of the Cambridge Study in Delinquent Development. In: Thornberry TP, 

Krohn MD, editors. Taking stock of delinquency: an overview of findings from contemporary longitudinal studies. New York, 

NY: Kluwer Academic/Plenum; 2003. p.137-83.

38. Farrington DP, Loeber R, Ttofi MM. Risk and protective factors for offending. In: Welsh BC, Farrington DP, editors. The Oxford 

handbook of crime prevention. New York, NY: Oxford University Press; 2012. p. 46-69.

39. Herrenkohl TI, Farrington DP, Brewer D, Catalano RF, Harachi TW, Cothern L. Predictors of youth violence. Washington, DC: 

Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention; 2000.

40. Hardy MS. Keeping children safe around guns: pitfalls and promises. Aggress Violent Beh 2006;11(4):352-66.

41. Williams KR, Guerra NG. Prevalence and predictors of internet bullying. J Adolesc Health 2007;41(6):S14-S21.

42. Lyons-Ruth K. Attachment relationships among children with aggressive behavior problems: the role of disorganized early 

attachment patterns. J Consult Clin Psychol 1996;64(1):64-73.

43. Gorman-Smith D, Tolan P. The role of exposure to community violence and developmental problems among inner-city 

youth. Dev Psychopathol 1998;10(1):101-16.

44. Sampson RJ, Morenoff JD, Gannon-Rowley T. Assessing “neighborhood effects”: social processes and new directions in 

research. Annu Rev Sociol 2002;28:443-78.

45. Toomey TL, Erickson DJ, Carlin BP, Lenk KM, Quick HS, Jones AM, Harwood EM. The association between density of alcohol 

establishments and violent crime within urban neighborhoods. Alcohol Clin Exp Res 2012;36(8):1468-73.

46. Branas CC, Cheney RA, Macdonald JM, Tam VW, Jackson TD, Have TRT. A difference-in-differences analysis of health, safety, 

and greening vacant urban space. Am J Epidemiol 2011;174(11):1296-1306.

47. Garvin EC, Cannuscio CC, Branas CC. Greening vacant lots to reduce violent crime: a randomised controlled trial. Inj Prev 

2013;9(3):198-203.

48. Mair JS, Mair M. Violence prevention and control through environmental modifications. Ann Rev Public Health 2003; 

24(1):209-25.

49. MacDonald J, Golinelli D, Stokes RJ, Bluthenthal R. The effect of business improvement districts on the incidence of violent 

crimes. Inj Prev 2010;16(5):327-32.

50. Elder RW, Lawrence B, Ferguson A, Naimi TS, Brewer RD, Chattopadhyay SK, Toomey TL, Fielding JE. The effectiveness of tax 

policy interventions for reducing excessive alcohol consumption and related harms. Am J Prev Med 2010;38(2):217-29.

51. Masho SW, Bishop DL, Edmonds T, Farrell AD. Using surveillance data to inform community action: the effect of alcohol sell 

restrictions on intentional injury related ambulance pickups. Prev Sci 2014;15(1):22-30.

52. Egerter S, Barclay C, Grossman-Kahn R, Braveman P. Exploring the social determinants of health: violence, social 

disadvantage and health. Princeton, NJ: Robert Wood Johnson Foundation; 2011. Available from: http://www.rwjf.org/

content/dam/farm/reports/issue_briefs/2011/rwjf70452.

53. Kellerman AL, Fuqua-Whitley DS, Rivara FP, Mercy J. Preventing youth violence: what works? Ann Rev Publ Health 

1998;19(1):271-92.

54. Tremblay RE, Nagin DS, Séguin JR, Zoccolillo M, Zelazo PD, Boivi M, Pérusse D, Japel C. Physical aggression during early 

childhood: trajectories and predictors. Pediatrics 2004;114(1):e43-e50.

55. Dahlberg LL, Simon TR. Predicting and preventing youth violence: developmental pathways and risk. In: Lutzker JR, editor. 

Preventing violence: research and evidence-based intervention strategies. Washington, DC: American Psychological 

Association; 2006. p. 97-124.

56. Tolan P, Gorman-Smith D, Henry D. The developmental ecology of urban males’ youth violence. Dev Psychol 2003;39(2):274-91.
46 Preventing Youth Violence: Opportunities for Action

57. National Forum on Youth Violence Prevention. National forum on youth violence prevention [Internet]. Interagency Working 

Group on Youth Programs [cited 2014 Mar 27]. Available from: http://www.findyouthinfo.gov/collaboration-profiles/

national-forum-youth-violence-prevention.

58. City of Minneapolis Health Department. Blueprint for action: preventing youth violence in Minneapolis [Internet]. City of 

Minneapolis Health Department [cited 2014 Mar 27]. Available from: http://www.minneapolismn.gov/health/youth/yvp/

index.htm. 

59. Catalano RF, Berglund ML, Ryan JAM, Lonczak HS, Hawkins JD. Positive youth development in the United States: research 

findings on evaluations of positive youth development programs. Prev Treatment 2002;5:no pagination specified.

60. Durlak JA, Wells AM. Primary prevention mental health programs for children and adolescents: a meta-analytic review. Am J 

Community Psychol 1997;25(2):115-52.

61. Multisystemic Institute. Multisystemic therapy: research at a glance published MST outcome, implementation and 

benchmarking studies January 2014 [Internet]. Mount Pleasant, SC: Multisystemic Institute [cited 2014 Mar 27]. Available 

from: http://www.mstservices.com/outcomestudies.pdf.

62. Phillips Smith E, Gorman-Smith D, Quinn WH, Rabiner DL, Tolan PH, Winn DM. Community-based multiple family groups to 

prevent and reduce violent and aggressive behavior: the GREAT Families Program. Am J Prev Med 2004;26(1):39-47.

63. Thornberry TP. Membership in youth gangs and involvement in serious and violent offending. In: Loeber R, Farrington DP, 

editors. Serious and violent juvenile offenders: risk factors and successful interventions. Thousand Oaks, CA: Sage; 1998. p. 

147-66.

64. Hawkins JD, Catalano RF, Arthur MW, Egan E, Brown EC, Abbott RD, Murray DM. Testing communities that care: the rationale, 

design and behavioral baseline equivalence of the community youth development study. Prev Sci. 2008;9(3):178-90.

65. Hahn R, Fuqua-Whitley D, Wethington H, Lowy J, Crosby A, Fullilove M, Johnson R, Liberman A, Moscicki E, Price L, Snyder 

S, Tuma F, Cory S, Stone G, Mukhopadhaya K, Chattopadhyay S, Dahlberg L, Task Force on Community Preventive Services. 

Effectiveness of universal school-based programs to prevent violent and aggressive behavior: a systematic review. Am J 

Prev Med 2007;33(2):S114-S129.

66. Centers for Disease Control and Prevention. The guide to community preventive services: the community guide [Internet]. 

Atlanta, GA: Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services [cited 

2014 Mar 27]. Available from: http://www.thecommunityguide.org/index.html.

67. Substance Abuse and Mental Health Services Administration. National Registry of Evidence-based Programs and Practices 

(NREPP) [Internet]. Washington, DC: Substance Abuse and Mental Health Services Administration [cited 2014 Mar 27]. 

Available from: http://www.nrepp.samhsa.gov/.

68. DeVore ER, Ginsburg KR. The protective effects of good parenting on adolescents. Curr Opin Pediatr 2005;17(4):460-65.

69. Stanton B, Li X, Pack R, Cottrell L, Harris C, Burns JM. Longitudinal influence of perceptions of peer and parental factors on 

African American adolescent risk involvement. J Urban Health 2002;79(4):536-48.

70. Burrus B, Leeks KD, Sipe TA, Dolina S, Soler RE, Elder RW, Barrios L, Greenspan A, Fishbein D, Lindegren ML, Achrekar A, Dittus 

P, Community Preventive Services Task Force. Person-to-person interventions targeted to parents and other caregivers to 

improve adolescent health: a community guide systematic review. Am J Prev Med 2012;42(3):316-26.

71. Mercy JA, Saul J. Creating a healthier future through early interventions for children. JAMA. 2009;301(21):2262-64.

72. Mihalic SF, Irwin K, Elliott D, Fagan A, Hansen D. Blueprints for violence prevention. Washington, DC: US Department of 

Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, 2001. Available from: http://

npnnola.com/CMSuploads/Blueprint_Model_Programs.pdf. 
Preventing Youth Violence: Opportunities for Action 47

73. Centers for Disease Control and Prevention. School connectedness: strategies for increasing protective factors among 

youth. Atlanta, GA: U.S. Department of Health and Human Services; 2009. Available from: http://www.cdc.gov/

healthyyouth/protective/pdf/connectedness.pdf. 

74. Goodenow C, Szalacha L, Westheimer K. School support groups, other school factors, and the safety of sexual minority 

adolescents. Psychol Schools 2006;43(5):573-89.

75. O’Shaughnessy M, Russell S, Heck K, Calhoun C, Laub C. Safe place to learn: consequences of harassment based on actual or 

perceived sexual orientation and gender non-conformity and steps for making schools safer. San Francisco, CA: California 

Safe Schools Coalition; 2004.

76. Sampson RJ, Bartusch DJ. Legal cynicism and (subcultural?) tolerance of deviance: the neighborhood context of racial 

differences. Law Soc Rev 1998;32:777-804.

77. Simon TR, Dent CW, Sussman, S. Vulnerability to victimization, concurrent problem behaviors, and peer influence as 

predictors of in-school weapon carrying among high school students. Violence Vict 1997;12(3):277-89.

78. Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science 

1997;227(5328):918-24.

79. Zhang X, Cowling DW, Tang H. The impact of social norm change strategies on smokers’ quitting behaviours. Tob Control 

2010;19(Suppl 1):i51-i55.

80. Centers for Disease Control and Prevention. Essentials for childhood: steps to create safe, stable, and nurturing relationship. 

[Cited 2014 March 30]. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and 

Control. Available from: http://www.cdc.gov/violenceprevention/pdf/efc-01-03-2013-a.pdf.

81. Botvin GJ, Griffin KW, Nichols TR. Preventing youth violence and delinquency through a universal school-based prevention 

approach. Prev Sci 2006;7(4):403-8.

82. Molgaard VK, Spoth RL, Redmond C. Competency training the Strengthening Families Program: for parents and youth 

10–14. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency 

Prevention; 2000. Available from: https://www.ncjrs.gov/pdffiles1/ojjdp/182208.pdf.

83. Spoth RL, Redmond C, Shin C. Reducing adolescents’ aggressive and hostile behaviors: randomized trial effects of a brief 

family intervention 4 years past baseline. Arch Pediatr Adolesc Med 2000;154(12):1248-57.

84. Chamberlain P, Leve LD, DeGarmo DS. Multidimensional Treatment Foster Care for girls in the juvenile justice system: 2-year 

follow-up of a randomized clinical trial. J Consult Clin Psychol 2007;75(1):187-93.

85. Eddy J, Whaley R, Chamberlain P. The prevention of violent behavior by chronic and serious male juvenile offenders: A 

2-year follow-up of a randomized clinical trial. J Emot Behav Disord 2004;12(1): 2-8.

86. Skogan WG, Hartnett SM, Bump N, Dubois J. Evaluation of CeaseFire-Chicago, 2008. Chicago, IL: Northwestern University. 

Available from: https://www.ncjrs.gov/pdffiles1/nij/grants/227181.pdf. 

87. Olds D L, Eckenrode J, Henderson CR, Kitzman H, Powers J, Cole R, Sidora K, Morris P, Pettit LM, Luckey D. Long-term effects 

of home visitation on maternal life course and child abuse and neglect: 15-year follow-up of a randomized trial. JAMA 

1997;278(8):637-43.

88. Olds DL, Henderson CR, Cole R, Eckenrode J, Kitzman H, Luckey D, Pettitt L, Sidora K, Morris P, Powers J. Long-term effects 

of nurse home visitation on children’s criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. 

JAMA 1998;280(14):1238-44.

89. Olds D L, Kitzman H, Cole R, Robinson J, Sidora K, Luckey DW, Henderson CR, Hanks C, Bondy J, Holmberg J. Effects of nurse 

home visiting on maternal life course and child development: age 6 follow-up results of a randomized trial. Pediatrics 

2004;114(6):1550-59.
48 Preventing Youth Violence: Opportunities for Action

90. Schweinhart LJ, Barnes HV, Weikhart DP. Significant benefits: the High/Scope Perry Preschool Study through age 27. Child 

Welfare: Major Themes in Health and Social Welfare 2005:9-29.

91. Schweinhart L, Weikart D. The High/Scope Perry Preschool program. In: Price RH, Cowen RP, Lorion RP, Ramos-McKay J, editors. 

14 ounces of prevention: a casebook for practitioners. Washington, DC: American Psychological Association; 1988. p. 53-6.

92. Schweinhart LJ, Weikart DP. The High/Scope Preschool curriculum comparison study through age 23. Early Child Res 

Quarterly 1997;12(2):117-43.

93. McGowan A, Hahn R, Liberman A, Crosby A, Fullilove M, Johnson R, Moscicki E, Price L, Snyder S, Tuma F, Lowy J, Briss P, Cory 

S, Stone G, Task Force on Community Preventive Services. Effects on violence of laws and policies facilitating the transfer of 

juveniles from the juvenile justice system to the adult justice system: a systematic review. Am J Prev Med 2007;32(4):S7-S28.

94. Centers for Disease Control and Prevention. Source of firearms used by students in school-associated violent deaths-United 

States, 1992–1999. MMWR 2003;52(9):169-72.

95. Wellford CF, Pepper JV, Petrie CV. Firearms and violence: a critical review. Washington, DC: The National Academies Press; 2005.

96. Sheley JF, Wright JD. Gun acquisition and possession in selected juvenile samples. Washington, DC: National Institute of 

Justice, Office of Juvenile Justice and Delinquency Prevention; 1993.

97. Smith MD. Sources of firearm acquisition among a sample of inner-city youths: research results and policy implications. J 

Crim Just 1996;24(4):361-67.

98. Hankin A, Hertz M, Simon T. Impacts of metal detector use in schools: insights from 15 years of research. J School Health 

2011;81(2):100-6.

99. Grossman DC, Mueller BA, Riedy C, Dowd MD, Villaveces A, Prodzinski J, Nakagawara J, Howard J, Thiersch N, Harruff R. Gun 

storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293(6):707-14.

100. Horn A, Grossman DC, Jones W, Berger LR. Community based program to improve firearm storage practices in rural Alaska. 

Inj Prev 2003;9(3):231-34.

101. McGee KS, Coyne-Beasley T, Johnson RM. Review of evaluations of educational approaches to promote safe storage of 

firearms. Inj Prev 2003;9(2):108-11.

102. Miller M, Azrael D, Hemenway D, Vriniotis M. Firearm storage practices and rates of unintentional firearm deaths in the 

United States. Accid Anal Prev 2005;37(4):661-67.

103. Institute of Medicine, National Research Council. Priorities for research to reduce the threat of firearm-related violence. 

Washington, DC: National Academy of Sciences; 2013. Available from: http://www.iom.edu/Reports/2013/Priorities-forResearch-to-Reduce-the-Threat-of-Firearm-Related-Violence.aspx. 

104. Office of Justice Programs. Crime solutions [Internet]. Washington, DC: US Department of Justice, Office of Justice Programs, 

Office of Justice Programs [cited 2014 Mar 27]. Available from: http://www.crimesolutions.gov/.

105. Lee S, Aos S, Drake E, Pennucci A, Miller M, Anderson L. Return on investment: evidence-based options to improve statewide 

outcomes, April 2012. Olympia, WA: Washington State Institute for Public Policy. Doc No: 12-04-1201.

106. Washington State Institute for Public Policy. Cost-benefits results [Internet]. Olympia, WA: Washington State Institute for 

Public Policy [cited 2014 May 20]. Available from: http://www.wsipp.wa.gov/BenefitCost. 

107. Christens BD, Dolan T. Interweaving youth development, community development, and social change through youth 

organizing. Youth Soc 2011;43(2):528-48.

108. Powers JL, Tiffany JS. Engaging youth in participatory research and evaluation. J Public Health Manag Pract 2006;12:S79-S87.

109. Zeldin S. Preventing youth violence through the promotion of community engagement and membership. Am J Community 

Psychol 2004;32(5):623-41.
Preventing Youth Violence: Opportunities for Action 49

110. Zeldin S, McDaniel AK, Topitzes D, Calvert M. Youth in decision-making: a study on the impacts of youth on adults and 

organizations. Washington, DC: National 4-H Council; 2000. 

111. Centers for Disease Control and Prevention. School health guidelines to prevent unintentional injuries and violence. MMWR 

2001;50(RR-22):1-74.

112. Hawkins JD, Brown EC, Oesterle S, Arthur MW, Abbott RD, Catalano RF. Early effects of communities that care on targeted 

risks and initiation of delinquent behavior and substance use. J Adolesc Health 2008;43(1):15-22.

113. Hawkins JD, Oesterle S, Brown EC, Monahan KC, Abbott RD, Arthur MW, Catalano RF. Sustained decreases in risk exposure 

and youth problem behaviors after installation of the communities that care prevention system in a randomized trial. Arch 

Pediatr Adolesc Med 2012;166(2):141-48.

114. Kuklinski M, Briney J, Hawkins J, Catalano R. Cost-benefit analysis of communities that care outcomes at eighth grade. Prev 

Sci 2011;13(2):150-61. 

115. Sogolow ED, Sleet DA, Saul J. Dissemination, implementation, and widespread use of injury prevention interventions. In: 

Doll L, Haas EN, Bonzo S, Sleet D, Mercy, J, editors. Handbook of injury and violence prevention. New York, NY: Springer; 

2007. p. 493-510.

116. Wandersman A, Duffy J, Flaspohler P, Noonan R, Lubell K, Stillman L, Blachman M, Dunville R, Saul J. Bridging the gap 

between prevention research and practice: the interactive systems framework for dissemination. Am J Community Psychol 

2008;41(3-4):171-81.

Acknowledgments

Many federal and nonfederal organizations share the Centers for Disease Control and Prevention (CDC) Division of Violence 

Prevention’s (DVP) concern about the health and safety of America’s young people. During the development of the 

Preventing Youth Violence: Opportunities for Action, representatives from many partner organizations, including the Office of 

the Surgeon General, graciously gave their time and expertise as they reflected on early working drafts. Their constructive 

suggestions helped us ensure that this resource is grounded in research and guided by the best available evidence and 

practice. More information about the development of this resource is provided in Appendix A. Many of our CDC colleagues 

also provided considerable support during the development of this resource and its companion document, Taking Action 

to Prevent Youth Violence. We greatly appreciate the assistance offered by Sarah Bacon, Tiffany Cain, Linda Dahlberg, Linda 

Degutis, Alan Dowell, Sarah Foster, Jeffrey Hall, Sarah Harrier, Marci Hertz, Alida Knuth, Joanne Klevens, Greta Massetti, 

Jennifer Matjasko, James Mercy, Sara Patterson, Richard Puddy, Neil Rainford, Elizabeth Reimels, and Howard Spivak. The 

knowledge and experience offered by all of these experts greatly strengthened this work.
50 Preventing Youth Violence: Opportunities for Action

Appendix A. Development of Preventing Youth Violence: 

Opportunities for Action

Preventing Youth Violence: Opportunities for Action was prepared by the Division of Violence Prevention (DVP), National 

Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC). CDC is a part of the 

U.S. Department of Health and Human Services (HHS), which works to promote the health and safety of all Americans and 

provides essential human services. CDC is also a part of a larger community of federal and nonfederal organizations who 

support the healthy development of youth, families, and neighborhoods.

Representatives from many federal and nonfederal partners reviewed selections of early working drafts of this resource 

and provided constructive suggestions. From HHS, these partner agencies include the Administration on Children, Youth, 

and Families; National Institutes for Health; Offices of the Assistant Secretary of Health; Office of the Assistant Secretary for 

Planning and Evaluation; Office of the Surgeon General; and Substance Abuse and Mental Health Services Administration. 

Additional suggestions were sought from more than 25 nonfederal individuals and organizations that have expertise in 

youth violence prevention and in public health approaches to promoting youth and community safety and well-being. 

These nonfederal experts were drawn from diverse sectors, including city and state public health departments, public 

health practitioners, research and academic institutions, law enforcement, education, business, youth serving organizations, 

and other health promotion and violence prevention organizations.

As CDC developed the initial outline and drafts for Preventing Youth Violence: Opportunities for Action, suggestions were sought 

from partners through a process spanning a year and a half. The purpose of this process was to receive candid and critical 

comments to assist in the development of this resource and to ensure that it is grounded in research and guided by the best 

available evidence and practice. First, comments on the development of the document were solicited from the general public 

through the Federal Registry between January 19 and February 21, 2012. All received comments were considered during the 

development and revision of this resource. Then, between March and April 2012, representatives from HHS and nonfederal 

organizations provided input on drafted sections. Working drafts were shared and comments were solicited multiple times 

from HHS partners during this period. Between May and June 2012, external peer reviews were conducted by David Hawkins, 

Ph.D. and Deborah Gorman-Smith, Ph.D. Finally, through the end of 2012 and into mid-2013, federal and nonfederal partners 

gave input into clarifying language and examples that could help the evidence-based action steps be clear and useful to 

groups who have a role in preventing youth violence, such as parents and youth. Each of these stages helped to strengthen 

Preventing Youth Violence: Opportunities for Action and informed the development of its companion resource, Taking Action 

to Prevent Youth Violence. Throughout the development process, many constructive comments were received that helped to 

shape these materials. However, partners were not asked to approve the final documents. 

For more information

To learn more about youth violence prevention, call 

1-800-CDC-INFO or visit CDC’s violence prevention 

pages at www.cdc.gov/violenceprevention.

TM

National Center for Injury Prevention and Control

Division of Violence Prevention