The author(s) shown below used Federal funds provided by the U.S. 

Department of Justice and prepared the following final report:

Document Title: Protect, Heal, Thrive: Lessons Learned from the 

Defending Childhood Demonstration Program

Author(s): Rachel Swaner, Lama Hassoun Ayoub, Elise 

Jensen, Michael Rempel

Document No.: 248882

Date Received: May 2015

Award Number: 2010-IJ-CX-0015

This report has not been published by the U.S. Department of Justice. 

To provide better customer service, NCJRS has made this federally 

funded grant report available electronically. 

Opinions or points of view expressed are those 

of the author(s) and do not necessarily reflect 

the official position or policies of the U.S. 

Department of Justice.
Protect, Heal,

Thrive

Lessons Learned from the Defending

Childhood Demonstration Program

re s earch

By Rache l Swaner, Lama Has soun Ayoub, Eli s e J ens en, Michae l Rempe l

Submi t t ed to the U.S. Department of Just ice

May 201 5

This proj e c t was support ed by Grant No. 2010-IJ-CX-001 5 , awarded by the

National Institut e of Justi c e of the U. S. Department of Justi c e . The opinions, findings, and conc lusions or re commendations expre ss ed in this report are thos e of

the authors and do not ne c e ssaril y re fl e c t the positions or poli c i e s of the

Department of Justi c e .

A Project of the Fund for the City of New York
Abstract i

Abstract 

In order to address the high prevalence of children’s exposure to violence, eight sites around the 

country were selected by the Department of Justice for the Defending Childhood Demonstration 

Program. This national initiative aims: 1) to prevent children’s exposure to violence; 2) to 

mitigate the negative impact of such exposure when it does occur; and 3) to develop knowledge 

and spread awareness about children’s exposure to violence, both within and beyond the chosen 

pilot sites. 

The eight demonstration sites were tasked with developing and implementing comprehensive 

strategies that could include both universal and targeted prevention programs; case management 

and treatment interventions for children who had been exposed to violence; community 

awareness and education; and professional training designed to increase the knowledge of 

children’s exposure to violence, trauma-informed care, and the use of proven evidence-based or 

promising treatment practices. 

Part of the evaluation of the Defending Childhood Demonstration Program, this report is a crosssite synthesis of implementation strategies, lessons learned, and promising practices in six of the 

eight sites: Boston, MA; Chippewa Cree Tribe, Rocky Boy’s Reservation, MT; Cuyahoga 

County, OH; Grand Forks, ND; Rosebud Sioux Tribe, SD; and Shelby County, TN. 

This mixed-method study included three primary data collection methods: 1) multiple site 

visits involving interviews with key stakeholders and observations of meetings or events at 

each site; 2) quarterly site implementation reports tracking quantitative program outputs; and 

3) document review of important planning documents, program records, and other materials. 

The Defending Childhood sites made decisions about their strategies using their own needs 

assessments; discussions among their collaborative bodies; and informal evaluations of 

implementation feasibility. Program models vary greatly by site; however, general themes and 

lessons emerged as all of the sites worked to tackle children’s exposure to violence. 

Based on the identified findings and lessons, this report provides 58 distinct recommendations, 

which sub-divide into recommendations for: (1) other jurisdictions, (2) tribal sites, (3) funders, 

(4) technical assistance providers, and (5) evaluators who may be studying similar initiatives. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Acknowledgements ii

Acknowledgements 

This study was made possible through a grant from the National Institute of Justice (NIJ) and 

through the support of the Office of Juvenile Justice and Delinquency Prevention (OJJDP). We 

are grateful to our grant manager at NIJ, Dara Blachman-Demner, for her assistance throughout 

the project, and to our previous grant manager, Bernie Auchter, for his support during the first 

year of the initiative. 

We are also grateful to Dara Blachman-Demner for her careful review of an earlier version of 

this report, and we similarly thank Greg Berman of the Center for Court Innovation for his 

review. We thank Julia Kohn, Kathryn Ford, Peter Jaffe, David Wolfe, and Marcie Campbell for 

their assistance in the early stages of this project. Thanks to B.J. Jones and Lillian Jones for their 

guidance and insight throughout the project. Additional thanks to Kristie Brackens and Karen 

Bachar at OJJDP; Terri Yellowhammer and Ethleen Iron Cloud-Two Dogs at Native Streams; 

and Casey Corcoran, Lonna Davis, Leiana Kinnicutt, Laura Hogan, and Anna Marjavi at Futures 

Without Violence.

This report would not have been possible without the coordination and assistance of the staff and 

partners at all of the Defending Childhood Demonstration Program sites. Special thanks to the 

current and former project directors and coordinators: Malrie Shelton and Keisha Walker in 

Shelby County; Faye Kihne and Julie Christianson in Grand Forks; Stephanie Doyle and 

Catherine Fine in Boston; Trina Wolf Chief and Nate St. Pierre on Rocky Boy’s Reservation; 

Jakoyla Gordon and Jill Smialek in Cuyahoga County; and Vikki Eagle-Bear, Aisha Concha, 

Nate Livermont, Eric Antoine, Natalie Stites, and Mato Standing High on the Rosebud. Thank 

you so much for allowing us in to learn about your work and your communities and for your 

lasting commitment to improving the lives of children. 

Please direct all correspondence to Rachel Swaner at rswaner@nycourts.gov. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Table of Contents iii

Table of Contents 

Abstract i

Acknowledgements ii

Executive Summary iv

Chapter 1. Introduction 1

 About the Defending Childhood Initiative 1

 The Demonstration Program Sites 2

 The Harms of Children’s Exposure to Violence 3

 Social Context and Current Needs at the Demonstration Program Sites 6

 Process Evaluation Methodology 9

 Limitations 12

Chapter 2. Cross Site Themes and Lessons Learned 13

 Prevention 14

 Screening and Assessment 19

 Case Management and Advocacy 20

 Treatment and Healing 22

 Community Awareness and Education 26

 Professional Training 28

 System Infrastructure and Capacity Building 30

 Collaborative Bodies 31

 Local Politics 33

 Tribal Sites and Tradition 34

 Tribal and Non-tribal Sites 34

 Urban and Rural Sites 34

 Evidence-Based and Promising Practices 35

 Place-Based vs. City/County-wide Strategies 36

 Silos 37

 Transitions: Technical Assistance Providers and Federal Grant Managers 37

Chapter 3. Recommendations 39

 Recommendations For Jurisdictions Interested in Replication 39

 Recommendations For Tribal Communities 42

 Recommendations For Funders 43

 Recommendations For Technical Assistance Providers 48

 Recommendations For Researchers and Evaluators 49

Appendices

 Appendix A. Aggregate Program Outputs by Year

52

52

 Appendix B. Process Evaluation Stakeholder Interview Protocol 54

 Appendix C. Sample Quarterly Implementation Report 59

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary iv

Executive Summary 

The United States Department of Justice launched the Defending Childhood Initiative in 2010.

This national initiative aims: 1) to prevent children’s exposure to violence; 2) to mitigate the 

negative impact of such exposure when it does occur; and 3) to develop knowledge and spread 

awareness about the problem and about effective strategies to ameliorate its attendant harms. 

A major component of the Defending Childhood Initiative is the Defending Childhood 

Demonstration Program. With this program, the Office of Juvenile Justice and Delinquency 

Prevention (OJJDP) and the Office of Violence Against Women (OVW) provided funding to 

eight sites around the country to implement prevention programs; case management and 

treatment/healing interventions for children who had been exposed to violence; community 

awareness and education campaigns; and professional training designed to increase knowledge 

of children’s exposure to violence, trauma-informed care, and the use of proven evidence-based 

or promising treatment practices. In an approximately seven-month planning phase that began 

soon after October 2010, the eight sites each established collaborative bodies composed of a 

wide array of public and private agencies; conducted a local needs assessment; and developed a 

strategic plan. A subsequent implementation phase began October 2011 and will continue for at 

least five years through September 2016, with funding for some sites extending beyond that time. 

About the Multisite Evaluation 

In October 2010, the National Institute of Justice funded the Center for Court Innovation to 

evaluate both the planning and implementation phases of the demonstration program. A previous 

report identified and explored cross-site themes and lessons from the initial needs assessment 

and strategic planning process in all eight sites.1 The current report provides a multisite synthesis 

of findings, lessons, and recommendations based on the first three years of implementation 

(October 2011 through September 2014) at six of these sites: Boston, MA; Chippewa Cree Tribe, 

Rocky Boy’s Reservation, MT; Cuyahoga County, OH; Grand Forks, ND; Rosebud Sioux Tribe, 

SD; and Shelby County, TN. The Center for Court Innovation was not funded to study 

implementation in the two remaining sites, which are Portland, ME and Multnomah County, OR. 

In conjunction with this report, separate process evaluations of each of the six sites have also 

been released. Those evaluations provide details on the local context and strategies implemented 

in each site. Findings were based on: 1) multiple site visits featuring in-depth interviews with 

staff and stakeholders and observations of meetings or events; 2) quarterly site implementation 

reports tracking quantitative program outputs; and 3) document review of planning documents, 

program records, and other materials. Later in 2015, a single outcome evaluation on the same 

six sites will be released. 

 

1

 Swaner R and Kohn J. (2011) The U.S. Attorney General’s Defending Childhood Initiative: Formative Evaluation 

of the Phase I Demonstration Program. New York, NY: Center for Court Innovation. Available at 

http://www.courtinnovation.org/sites/default/files/documents/Defending_Childhood_Initiative.pdf. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary v

The Interplay of Local Context and Choice of Strategies 

Each of the six Defending Childhood sites had a distinctive social, historical, and demographic 

context that, along with the prevalence of different types of violence, influenced their choice of 

strategies. Three sites were located in major metropolitan areas, Boston, Cuyahoga County 

(including Cleveland), and Shelby County (including Memphis); one site featured both a small 

city and a rural surrounding area (Grand Forks); and two sites were set on sprawling Native 

American reservations (Rocky Boy’s and the Rosebud Sioux reservations). Programmatic 

activities to address violence included: 

 Place-Based Strategies: Both Boston and Shelby County adopted a place-based 

approach, concentrating many (although not all) of their strategies in select high 

risk/high need areas. In Boston, targeting was generally at the neighborhood level, 

whereas in Shelby, a significant portion of funding was used to provide three apartment 

complexes with a variety of new services and resources. 

 County-Wide Systems Change: In Cuyahoga, significant resources were applied to 

county-wide policy and infrastructure changes—epitomized by the establishment of a 

county-wide Central Intake and Assessment system to identify, refer, screen, assess, 

and treat children who are exposed to violence. Cuyahoga could not have taken this 

approach without a rich history of interagency collaboration, which facilitated buy-in to 

new policies, protocols and evidence-based and promising practices among service 

providers. (A prior history of collaboration was a key facilitator in other sites as well.) 

 

 Bullying and Primary Prevention: Grand Forks sees relatively modest levels of 

community violence. Planners determined that bullying, teen dating violence, and 

related socio-emotional violence comprised an important problem. Thus, Grand Forks 

opted to blanket elementary, middle, and high schools throughout the county, as well as 

select preschools, with evidence-based and promising prevention programs promoting 

healthy relationships. In promoting school-based prevention, Grand Forks benefited 

from a close and willing partner in the Grand Forks Public Schools administration and 

from recent state legislation in North Dakota that required new anti-bullying policies.

 Culturally-Specific, Community-Validated Strategies: The Rocky Boy’s and Rosebud 

Sioux initiatives sought to engage their communities and address the needs of children 

and families through traditional methods, formalized based on local knowledge and 

local expertise, passed down over generations. The tribal sites exemplify the 

interweaving of culture into site-specific responses to violence. 

 Multi-Media Community Awareness Campaigns: All six sites tended to adopt a countywide (or city- or reservation-wide) scale for their community awareness activities, often 

incorporating multi-media strategies, such as web sites, Twitter and Facebook postings, 

public transportation ads, flyers, and even a youth-created fictional web series (in the 

Boston site). Here, too, context mattered: for instance, given the intense focus on sports 

in Grand Forks, community awareness messages were often concentrated in sports 

venues and had sports themes. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary vi

Multisite Themes 

There were various overarching themes that emerged related to the different strategies sites 

chose. 

Prevention Programs 

 Universal Prevention: Some sites used universal prevention strategies (not targeted to a 

specific high-risk area or subgroup). The Rocky Boy’s and Rosebud Sioux initiatives 

focused on reconnecting youth to tribal culture as a form of prevention, holding events 

and activities that incorporated Native American traditions and culture as a protective 

factor. Grand Forks provided a county-wide school-based prevention model focused on 

bullying and healthy relationships. Lessons from these efforts include: 1) Efforts must be 

made to balance multi-year exposure with program fidelity (a desire not to repeat the 

same curricula topics imparted the prior year while also not making excessive changes to 

proven curricular materials); 2) Program managers must ensure that students do not 

receive conflicting messages (from different prevention programs); and 3) It is important 

to focus on both negative (e.g., anti-bullying) and positive (e.g., healthy friendships) 

messages. 

 Targeted Prevention: Some sites created targeted prevention programs, administered to 

young people who were considered “at-risk” for violence exposure due to living in 

neighborhoods with high levels of violence. Boston and Cuyahoga County implemented 

evidence-based or promising programs for families that sought to build parental nurturing 

and positive parenting skills. Shelby County supported an existing program that provided 

support services and training to managers at targeted apartment complexes, focusing on 

reducing crime and ensuring residents’ safety. Boston and Grand Forks administered the 

Coaching Boys into Men program, where athletic coaches educate their players about 

relationship abuse, harassment, and sexual assault. Shelby County also trained athletic 

coaches on this curriculum. The numbers served by these programs were limited, 

however. 

Intervention with Children Exposed to Violence 

 Screening and Assessment: Screening refers to how children are identified for potential 

treatment and healing programs. It is typically a brief process, designed to determine the 

need for further assessment and possible services, whereas assessment yields a more 

comprehensive understanding of trauma symptomology. Cuyahoga County was 

particularly notable for developing an ambitious universal screening, assessment, and 

treatment matching model. This system—which included a county-wide Central Intake 

and Assessment process—moved all children who screened for being exposed to violence 

from initial referral and screening (with a universal and newly created trauma tool) to full 

assessment and finally to treatment at partner agencies that were trained in and prepared 

to use evidence-based or promising practices. Lessons learned from this model related to: 

1) determining a suitable screening threshold (to balance identifying most of those who 

need treatment with avoiding an excessive expenditure of in-depth assessment resources 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary vii

where trauma is not likely to be present); 2) selecting appropriate screening agencies and 

locations; and 3) having consistent training and booster training efforts to ensure that 

staff turnover does not adversely affect implementation. 

 Treatment and Healing: The two tribal sites incorporated traditional healing ceremonies 

(sweat lodges, prayer, and smudging) as well as referrals to providers that offered 

counseling or addiction treatment. The most common therapeutic intervention across the 

non-tribal sites was the evidence-based Trauma-Focused Cognitive Behavioral Therapy 

(TF-CBT). The sites also implemented other interventions, many of which were 

evidence-based or promising. The resources commitment associated with ensuring 

adequate and continuous training for clinical providers emerged as a lesson for future 

implementation: programs will spend a significant amount of “upfront” time training staff 

on evidence-based and promising treatments, but if positions are grant-funded for a finite 

period of time, those who are trained may look for other positions that have more job 

security. This staff turnover may lead to gaps in service capacity, but will also require 

programs to have to reallocate other monies in order to train new staff. 

 Case Management and Advocacy: Three sites—the Chippewa Cree Tribe of Rocky Boy’s

Reservation, the Rosebud Sioux Tribe, and Shelby County—had case management and 

advocacy as major strategic components. Advocacy involved outreach to individuals in 

need with the aim of providing non-therapeutic forms of assistance and linkages to 

therapeutic clinical services where appropriate. Advocacy also involved advising and 

supporting individuals in legal proceedings. The two tribal sites determined that advocacy 

represented the greatest need in their communities. Shelby County implemented a placebased approach by concentrating case management staff in housing complexes where 

residents often required basic advice and services other than therapeutic treatment. 

Community and Professional Awareness and Education 

 Community Awareness: All sites created awareness about the existence of their 

Defending Childhood Initiative and had a website or social media presence. Some sites 

had campaigns designed to generate discussion about the topic of violence exposure. One 

unique example is Boston’s production of The Halls, an eight-part web series depicting 

the (fictional) lives of three young men of color in a local high school. One lesson learned 

from the sites was that it can be challenging to implement community awareness 

campaigns in rural areas, where dissemination of information is very difficult, especially 

during wintertime when snowstorms render certain areas inaccessible. Another lesson is 

that, in an age where social media outlets such as Facebook, Twitter, YouTube—the 

primary mediums of communication for today’s youth—require real-time postings and 

interactions, the federal approval process for all materials and postings was extremely 

frustrating and limiting. 

 Professional Training: All sites offered training to local professionals, including social 

workers, child care workers, educators, health staff, attorneys, faith/traditional leaders, 

and law enforcement officials. Training time ranged from a few hours to a full day and 

varied in topic. Boston committed to 18-month learning communities, which trained 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary viii

fewer people but focused on long-term, high-quality implementation of evidence-based 

treatments. High staff turnover rates at social service agencies proved to be a challenge at 

most sites; the effectiveness of training efforts was diminished as participants left for 

other jobs. 

Interagency Collaboration 

 Collaborative Bodies: All sites convened a collaborative body, which most commonly 

included law enforcement, social service agencies, community organizations, public 

health agencies, community leaders, and local school districts. Sites also incorporated the 

voices of youth and parents. Major themes related to the advantages of prior relationships 

amongst individuals and agencies, coupled with some “collaboration fatigue” in sites 

with multiple overlapping initiatives and regular meetings. 

 System Infrastructure and Capacity Building: Cuyahoga County’s universal screening, 

assessment, and treatment matching system, noted above, is a compelling example of a 

site taking steps to change the way that multiple agencies address children’s exposure to 

violence. Other examples include the Rosebud Sioux’s proposed revisions of tribal 

legislation around protecting children and Shelby County’s new shared data management 

system. 

Other Themes 

 Tribal Sites and Tradition: The tribal sites were similar in their commitment to tradition 

as a protective factor and the infusion of this philosophy into all of their efforts. For 

example, the Rosebud Sioux incorporated the Lakota way of life and the Lakota mental 

health model into their services and the Rocky Boy’s advocates were trained in 

traditional forms of healing. 

 Special Needs of Rural Sites: Three of the sites included rural areas. Stakeholders at rural 

sites felt that they were left out of a national dialogue on violence, which primarily 

focused on urban areas. Rural sites also faced unique logistical challenges in raising 

community awareness and simply reaching people. One of the technical assistance 

providers suggested a need for more intensive technical assistance in rural areas. 

 Local Politics: Local politics can be a barrier or facilitator. Turnover in political 

leadership created challenges at sites that had strong commitments from previous leaders 

and required efforts to bring new leaders on board. These issues arose at both tribal and 

non-tribal sites. 

 Silos: Sites were tasked with addressing all types of children’s exposure to violence in 

conjunction, rather than focusing on one type. This led stakeholders to work across 

sectors and form relationships between organizations across disciplines. However, some 

funder decisions—such as OVW’s requirement to spend money specifically on domestic 

violence direct service programming—counter-productively led to the rebuilding of silos, 

as sites that had planned to distribute funding to programs that bridged all types of 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary ix

violence (and maybe did not focus on direct services) had to redirect funds to domestic 

violence. 

 Managing Transitions: Several major transitions occurred that impacted the sites. First, 

the technical assistance provider during the initial strategic planning phase was replaced 

with a different provider for the implementation phase. New relationships therefore had 

to be built, and prior decisions had to be conveyed to the new technical assistance 

provider. (Otherwise, multiple sites reported positive experiences in working with the 

technical assistance provider during implementation.) Second, the implementation 

funding period was changed multiple times, from three to two years; back to three years; 

and then to five or six years. These changes influenced implementation decisions, 

timelines, and the scope of adopted strategies. Third, an OJJDP reorganization led to the 

assignment of new grant managers partway through implementation. Managing 

transitions is an important consideration for future large-scale, federally-funded 

initiatives. 

Recommendations 

The 58 recommendations listed here were developed through interviews with staff and 

stakeholders at each site, the technical assistance providers, and some OJJDP grant managers. 

The recommendations also reflect independent observations and conclusions of the research 

team. Chapter 3 of the full report provides greater discussion of the rationale for each 

recommendation. 

For Jurisdictions Interested in Replication 

These recommendations are divided into three major sections: 1) planning; 2) implementation; 

and 3) sustainability. 

 Planning: 

1. Consider where to anchor your initiative (e.g., an important city or county office 

or a community-based agency). 

2. Carefully weigh the benefits and drawbacks of geographic (place-based) 

targeting. 

3. When possible, use consensus to make decisions. When stakeholders feel like 

they have been able to voice their opinions as part of the process and can see how 

a decision is made, they are more likely to accept programmatic decisions that 

may not have been their ideas or may not provide funding to their organization. 

4. Use a consultant early on to drive the planning and early implementation 

processes. Hiring an external consultant—especially one with strategic planning 

experience—to facilitate meetings and synthesize action steps can help move the 

initiative along early in the process. 

5. Involve researchers early (e.g., to promote data-driven decision-making). 

6. Fully understand overlapping initiatives and consider folding a new initiative into 

established collaborative bodies in order to prevent collaborative and evaluation 

fatigue. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary x

7. Budget for an administrative assistant who can work on the various reporting 

requirements for funders, evaluators, and technical assistance teams. 

8. Create a classification system to organize types of programming (e.g., such as: 

screening and assessment; case management and advocacy; treatment and 

healing; prevention; community awareness; professional training; and systems 

infrastructure/capacity building) to help facilitate strategic decision making about 

resource allocation. 

9. Plan for sustainability early on, as considering how to sustain staffing and 

services beyond the length of immediate funding can often inform choice of 

strategies and programs. 

 Implementation: 

10. Offer home-based services to overcome transportation obstacles (especially in 

rural areas). 

11. Look for unique ways to leverage existing resources to disseminate information 

about an initiative.

12. Focus on positive friendships, healthy relationships, and building resiliency.

13. Beware of mission creep (e.g., providing social services and assistance that extend 

beyond children’s exposure to violence to families with multiple needs).

 Sustainability: 

14. For smaller communities, consider focusing on prevention in schools (e.g., as in 

Grand Forks), where teachers can be trained to continue programming after initial 

grant funding ends. 

15. Prepare for unintended consequences such as a long-term increase in service 

utilization due to increased awareness. 

16. Promote institutional adoption of best practices (e.g., changing clinical practice 

throughout target agencies rather than one-off trainings for specific individuals). 

17. Focus on systems change (e.g., as in Cuyahoga County).

For Tribal Communities 

The tribal site staff, tribal technical assistance providers, grant managers, and others were asked 

about their recommendations for other Native American and Alaskan Native communities 

seeking to address children’s exposure to violence. The following are their recommendations: 

1. Have faith: Have faith that what you do will help people, despite the challenges of 

working on children’s exposure to violence. 

2. Work together and take care of each other: Team members should be proactive in 

supporting each other and draw on each other’s skillsets. Self-care is important, 

especially for frontline staff working directly with victims. 

3. Adopt a strengths-based approach: This approach draws on such as building on the roles 

of elders, focusing on relationship structures, and connecting to tradition, nature, and 

spirituality. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary xi

4. Consider local politics: Changes in political leadership can impact support for long-term 

projects. Working with grant managers and ensuring appropriate qualified individuals fill 

key positions for effectively implementing chosen strategies is important. 

5. Streamline processes: Tribal communities should reflect on how to constructively address 

the need to ensure continued political support and staff for long-term projects. 

Streamlining processes and ensuring accountability are important considerations. 

For Funders 

Funders, especially federal funders, face challenges ensuring that large initiatives meet their 

goals while remaining flexible in working with individual sites. These recommendations aim to 

help funders accomplish their goals—and to help sites to implement their strategies with greater 

ease. 

 Communicate clear and realistic expectations: Funders should strive to: 

1. Make goals specific and achievable. 

2. Be realistic about impact. 

3. Evaluate outcomes and impact only after sites have had sufficient time to 

implement chosen strategies.

 Fund for a longer timeline: Local implementation often runs into challenges. Funders 

should incorporate this knowledge into the structure of new grant programs. Specifically, 

funders should: 

4. Allow time for recruitment of high quality staff. 

5. Allow time for impact, acknowledging that sites need time to build the necessary 

infrastructure to implement programming successfully. 

 Incorporate certain structural requirements into the original request for proposal: 

Common issues emerged across sites that could have been addressed in the original RFP. 

In the future, funders should: 

6. Ensure that sites budget for an administrative assistant.

7. Ensure that sites budget for a local research partner.

8. Ensure that original RFP fully discloses different funding sources and the 

programmatic requirements of each source. 

 Improve internal and external coordination: Site staff and stakeholders interact with grant 

managers, technical assistance providers, researchers, and each other. Improving 

coordination would facilitate knowledge sharing and reduce duplicative efforts. Funders 

should: 

9. As much as possible, minimize the number of grant manager and technical 

assistance provider transitions. 

10. Improve coordination among key partners. 

11. Connect new sites with original demonstration sites.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary xii

 Hasten approval process for public messaging: Federal approval processes for 

publications, conferences, trainings, and other products restricted many of the sites and 

delayed their trainings and awareness campaigns. Given this, funders should: 

12. Set realistic and reasonable timeframes for approval.

13. Create a policy for social media that gives sites flexibility to tweet or post about 

events without seeking prior approval. 

 Allow for more flexibility: In certain areas, greater flexibility would create opportunities 

for testing new ideas. Funders might consider whether it is possible to: 

14. Allow grant funds to be used for food to increase attendance rates at events.

15. Encourage research partners to incorporate non-western research practices (e.g., 

storytelling, case studies) where appropriate. 

16. Support both evidence-based and non-evidence-based programming (e.g., the 

latter where potentially innovative, yet under-evaluated, strategies are available). 

 Understand tribal communities: The inclusion of tribal sites provides for great 

opportunities but also unique challenges. 

17. Understand that the spending processes may be more complex for tribal sites.

18. Given high unemployment rates, grant-funded positions can become a contested 

political issue. 

19. Provide support for evaluation and technical assistance work with tribal 

communities in order to facilitate discussion of best practices and alternative 

research designs. 

For Technical Assistance Providers 

In general, the sites had positive impressions of their technical assistance (TA) providers; the 

tribal sites found the inclusion of a tribal TA provider valuable. TA providers working with 

similar initiatives might consider these recommendations. 

1. Help sites understand relevant laws: Sites do not necessarily have the time or ability to 

gain an in-depth understanding of federal laws (e.g., the Affordable Care Act, the Health 

Insurance Portability and Accountability Act) that impact their work. 

2. Focus on the science of implementation: Moving initiatives from paper to reality can be 

challenging and TA providers can facilitate this and provide “on the ground” assistance.

3. Provide onsite technical assistance: Frequent visits with constructive goals can provide an 

opportunity to cater TA efforts to each site’s specific needs. 

4. Be mindful of differences between urban and rural populations. Considering the unique 

challenges of rural areas can ensure that staff and stakeholders at these sites do not feel as 

though they are left out of the conversation. 

5. Work with a native TA provider. TA providers should partner with a native-run 

organization that can provide culturally-appropriate assistance to tribal sites. 

6. Provide webcasts. TA providers should live stream or archive videos of meeting speakers 

for greater reach to program staff. 

7. Host podcasts that highlight unique strategies. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Executive Summary xiii

8. Reduce the number of meetings as time goes on. Once sites have been up and running for 

multiple years, consider holding meetings on an ad-hoc basis. 

9. Provide both proactive and reactive technical assistance. TA providers should react to the 

needs of the sites as they work to implement their strategies, but should also work to 

identify trends and missing knowledge and to plan for emerging issues. 

For Researchers and Evaluators 

Evaluating a national multisite initiative can be challenging. The following recommendations 

emerged for future large-scale evaluations. 

1. Develop local knowledge. Strong relationships and familiarity with the work that is 

implemented are important for successful evaluation. 

2. As much as possible, streamline reports. To ensure that sites are not duplicating efforts, 

researchers should consider the grant reporting requirements and how to best to work 

with them. 

3. Give back. Researchers that take data and information from sites should look for 

opportunities to assist them by helping to design local evaluations, presenting research 

findings, or sharing data with local researchers. 

4. Ask the sites for their input. And then ask again. Sites should be involved at multiple 

stages of the evaluation. 

5. Conduct a process evaluation. A process evaluation can provide valuable implementation 

lessons, especially when an outcome evaluation is not practical. 

6. Employ a mixed-methods study. Evaluations must use a combination of quantitative and 

qualitative data in order to fully understand the effects programs have had on 

communities.

7. Embrace non-western approaches to working with tribal sites. Tribal sites may be 

particularly receptive to research when evaluators demonstrate flexibility in their 

methods.

8. Be mindful. Evaluation reports can have positive and negative impacts on sites and their 

ability to sustain their work. Outcome and impact evaluations, although ideal, should 

only be done for sites that are ready to be evaluated. Process evaluations are important, 

and need to be candid about barriers and shortcomings; yet, humility on the part of 

evaluators is also important in acknowledging the daunting challenge of successfully 

implementing numerous strategies, involving multiple agencies and individuals, to 

address a serious social problem. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 1

Chapter 1 

Introduction 

About the Defending Childhood Initiative

A 2009 national survey found that 60 percent of American children have been exposed to 

violence, crime, or abuse in their homes, schools, or communities—and that 40 percent were 

direct victims of two or more violent acts.2 In an effort to address children’s exposure to 

violence, the United States Department of Justice (DOJ), under the leadership of former Attorney 

General Eric Holder, launched the Defending Childhood Initiative. This national initiative aims: 

1) to prevent children’s exposure to violence; 2) to mitigate the negative impact of such exposure 

when it does occur; and 3) to develop knowledge and spread awareness about children’s 

exposure to violence. The motto of the initiative is “Protect, Heal, Thrive.”

A major component of this initiative is the Defending Childhood Demonstration Program, where 

the Office of Juvenile Justice and Delinquency Prevention (OJJDP) and the Office of Violence 

Against Women (OVW) provided funding to eight sites around the country to address children’s 

exposure to violence through prevention; intervention and treatment; community awareness and 

education; and professional training. Besides the multisite demonstration program, other 

components of the larger Defending Childhood Initiative, which are outside the scope of the 

current evaluation, include the Task Force on Children’s Exposure to Violence3 and the Task 

Force on American Indian and Alaskan Native Children Exposed to Violence.4

The National Institute of Justice (NIJ) funded the Center for Court Innovation to conduct the 

evaluation of the demonstration program, and OJJDP funded Futures Without Violence, a 

national non-profit organization focused on ending domestic and sexual violence, to serve as the 

technical assistance provider. This report is a cross-site synthesis of findings, lessons learned, 

and promising practices from six of the eight demonstration program sites, based on 

implementation activities from October 2011 through September 2014. Separate in-depth process 

evaluations of each of the six sites have also been completed.5 These site-specific reports provide 

details on the social and historical context and implementation experiences at each site. Later in 

2015, a single outcome evaluation spanning all six sites will be released as well.6

 

2

 Office of Juvenile Justice and Delinquency Prevention. (2009) Children’s Exposure to Violence: A Comprehensive 

National Survey. Available at https://www.ncjrs.gov/pdffiles1/ojjdp/227744.pdf. Last retrieved 12/1/14. 

3

 The full report of this task force can be found here: http://www.justice.gov/defendingchildhood/cev-rpt-full.pdf. 

4

 The full report of the American Indian and Alaskan Native Task Force can be found here: 

http://www.justice.gov/sites/default/files/defendingchildhood/pages/attachments/2014/11/18/finalaianreport.pdf. 

5

 The six process evaluation reports can be found at http://www.courtinnovation.org/. 

6

 Whereas the current research focuses on the implementation of chosen strategies, a previous report issued in 2011 

explored and identified cross-site themes and lessons from the initial strategic planning process. See Swaner R and 

Kohn J. (2011) The U.S. Attorney General’s Defending Childhood Initiative: Formative Evaluation of the Phase I 

Demonstration Program. New York, NY: Center for Court Innovation. Available at 

http://www.courtinnovation.org/sites/default/files/documents/Defending_Childhood_Initiative.pdf. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 2

Demonstration Program Sites 

The eight Defending Childhood Demonstration Program sites are: Boston, MA; Chippewa Cree 

Tribe, Rocky Boy’s Reservation, MT; Cuyahoga County, OH; Grand Forks, ND; Multnomah 

County, OR; Portland, ME; Rosebud Sioux Tribe, SD; and Shelby County, TN (see Figure 1). 

Figure 1. Defending Childhood Initiative Sites (only red markers are part of this evaluation) 

These sites created broad, multi-disciplinary partnerships that implemented a wide range of 

responses, spanning prevention, intervention/treatment programs, community awareness, 

professional training, and system infrastructure. Phase I was initiated in October 2010, when 

OJJDP and OVW awarded each site over $150,000 to conduct a needs assessment and strategic 

planning process for addressing children’s exposure to violence. Phase II of the initiative started 

in October 2011 and focused on implementation. Table 1.1 (next page) shows the funding 

amounts awarded to each site. 

Because the Portland, ME and Multnomah County, OR sites received a lower amount of funding 

at the start of Phase II, they were not able to fully implement the original strategic plans that they 

developed during Phase I. Because of this, NIJ decided that the Center for Court Innovation 

should concentrate their evaluation on the six sites that received at least $1 million; therefore, 

Portland, ME and Multnomah County, OR are not included in this cross-site report. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 3

Table 1.1 Defending Childhood Grant Funding

Grantee Phase I Phase II Phase III Total

Oct 2010 –

Sep 2011

Oct 2011 –

Sep 2013

Oct 2013 –

Sep 2014

Oct 2014

Boston, MA $160,000 $2 million $610,000 $612,260 $3,382,260 

Grand Forks, ND $159,967 $2 million $610,000 $612,260 $3,382,227 

Shelby County, TN $159,099 $2 million $610,000 $612,260 $3,381,359 

Cuyahoga County, OH $157,873 $2 million $610,000 $612,260 $3,380,133 

Portland, ME $160,000 $500,000 $610,000 $612,260 $1,882,260 

Multnomah County, OR $159,349 $500,000 $610,000 $612,261 $1,881,610 

Rocky Boy’s Reservation, 

MT $153,210 $1 million $360,000 $300,000 $1,813,210 

Rosebud Sioux Tribe, SD $159,534 $1 million $360,000 $300,000 $1,819,534 

The Harms of Children’s Exposure to Violence

Childhood exposure to violence in the United States is a persistent problem. In the United States, 

a recent survey found that more than 60% of children nationwide were exposed to violence 

within the past year, either directly or indirectly.7 Children’s exposure to violence generally 

transcends socioeconomic status, community, race, and education. Children are exposed to 

violence in different parts of their lives: at school, at home, and in their communities. 

Community violence. Research with seventh- to twelfth-graders found that 12% had someone 

pull a knife or gun on them, 5% had been cut or stabbed, and 1% saw someone get shot.8 A study 

in Chicago found that, of 10-19 year-olds, 39% had witnessed a shooting, 11% had been shot at, 

and 3% had been shot.9 Children living rural areas are also exposed to community violence; 

research shows that that 61% of children in rural areas report witnessing at least one violent act 

in their community in their lifetime.10 Exposure to trauma is also prevalent among Native 

American youth. An average of 4.1 lifetime trauma experiences were found among a sample of 

89 Native American youth, with the trauma events most commonly being a threat of injury and 

witnessing injury.11

 

7

 Office of Juvenile Justice and Delinquency Prevention. (2009) Children’s Exposure to Violence: A Comprehensive 

National Survey. Office of Juvenile Justice and Delinquency Prevention. Available at: 

http://www.ojp.usdoj.gov/ojjdp. 

8

 Guterman NB, Hahm HC, & Cameron M. (2002) “Adolescent victimization and subsequent use of mental health 

counseling services.” Journal of Adolescent Health, 30:336-345.

9 Bell CC and Jenkins EJ. (1993) “Community violence and children on Chicago’s south-side.” Psychiatry, 56:46-

54.

10 Luthar SS and Goldstein A. (2004) “Moderators of Children’s Exposure to Community Violence.” Journal of 

Clinical Child and Adolescent Psychology, 33:499-505. 

11 Deters PB, Novins DK, Fickenscher A, and Beals J. (2006) “Trauma and posttraumatic stress disorder 

symptomatology: Patterns among American Indian adolescents in substance abuse treatment.” American Journal of 

Orthopsychiatry, 76(3):335-345. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 4

School violence. School violence may include incidents of bullying, threats, carrying a weapon to 

school, homicide, spree shootings, and fatalities.12 Results from the CDC’s 2013 National Youth 

Risk Behavior Survey (YRBS) indicate that 7.1% of students nationally did not go to school 

because of safety concerns. 13 In 2000, a total of 128,000 students between the ages of 12 and 18 

were victims of violent crimes at school, such as rape and assault, and almost 10% of students in 

grades nine through twelve stated that they had been threatened or injured by a weapon on school 

property.14 One study found that almost 30% of sixth- through tenth-graders had moderate or 

frequent involvement in bullying, with 13% being the bully, 11% being bullied, and 6% both.

15

The YRBS also found that 15% of students nationally reported being electronically bullied and 

20% reported being bullied on school property, in the last 12 months. Studies have also found 

that dating violence is prevalent among students. According to the 2013 YRBS, 10% of students 

in grades nine through twelve had experienced physical dating violence within the past 12 

months. Another 10% of students had been kissed, touched, or forced to have sexual intercourse 

by a dating partner when they did not want to at some time.

Violence at home. The United Nations Population Division found that from 133 to 275 million 

children across the globe are exposed specifically to domestic violence, including an estimated 

2.7 million children in the United States.16 It is the most common and earliest trauma that 

children experience, occurring within their own homes and is often perpetrated by a parent or 

caregiver. In 2013, the national rate of child fatalities due to abuse or neglect was 2.04 deaths per 

100,000 children. 17Other research has further determined that more than half of the domestic 

violence victims were from a racial or ethnic minority group, although additional analyses 

indicated that living in poverty, rather than race or ethnicity per se, was the more important 

factor. Findings indicated that children were present in almost half (44%) of the domestic 

violence incidents that involved police, with the majority of the children (58%) younger than six 

years old. The majority of children that were present during the incidents saw and heard the 

violence (60%), 18% only heard the violence, and 5% only saw the violence.18 Of those surveyed 

in the 2011 National Survey of Children’s Exposure to Violence, 1 in 10 (10%) suffered from 

child maltreatment (including physical and emotional abuse, neglect, or a family abduction), 8% 

had witnessed a family assault, and 6% had witnessed a parent assault another parent (or parental 

partner) in the last year.19

 

12 Flannery DJ, Wester KL, and Singer MI. (2004) “Impact of exposure to violence in school on child and 

adolescent mental health and behavior.” Journal of Community Psychology, 32(5): 59-573.

13 Center for Disease Control. (2013) “Youth Risk Behavior Surveillance—United States, 2013.” Morbidity and 

Mortality Weekly Report: Surveillance Summaries, 63:1-168.

14 Department of Education, 2002; Flannery et al., 2004. 

15 Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, and Scheidt P. (2001) “Bullying behaviors 

among US youth: Prevalence and association with psychosocial adjustment.” Journal of the American Medical 

Association, 25:2094-2100. 

16 UNICEF. (2006) Behind Closed Doors: The Impact of Domestic Violence on Children. London: UNICEF 

and The Body Shop International Plc. Available at 

http://www.unicef.org/protection/files/BehindClosedDoors.pdf, last accessed December 5, 2014. 

17 US Department of Health & Human Services. Child Maltreatment 2002. Washington, DC: US Department of 

Health & Human Services, Administration on Children, Youth and Families. 

18 Fantuzzo JW and Fusco RA. (2007) “Children’s direct exposure to types of domestic violence crime: A 

population-based investigation.” Journal of Family Violence, 22(7):543-552.

19 Finkelhor D, Turner H, Shattuck A, and Hamby SL. (2013) “Violence, Crime, and Abuse Exposure in a National 

Sample of Children and Youth: An Update.” Journal of American Medical Association Pediatrics, 167(7):614-621.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 5

Suicide. The Centers for Disease Control and Prevention define suicide as “when people direct 

violence at themselves with the intent to end their lives,” and that risk factors include family 

history of violence and alcohol or drug abuse.20 A 2012 report stated that suicide is the second 

leading cause of death among American Indian/Alaskan Native youth aged 10 to 34, and that in 

2009 the rate of suicide among American Indian/Alaskan Native youth aged 10 to 18 years was 

10.37 per 100,000, compared with an overall U.S. rate of 3.95 per 100,000.21 On the two tribal 

reservations included in this report, exposure to suicide—be it suicide ideation of the individual 

youth, or having had a friend or family member commit suicide—is considered exposure to 

violence. 

Impact of Exposure to Violence on Children 

Experts agree on the detrimental effects of children’s exposure to violence on a child’s 

emotional, psychological, and physical development. Children can experience post-traumatic 

stress disorder (PTSD), desensitization to violence, and hyper-arousal.22 Children can also be at 

an increased risk for substance abuse, externalized behavior problems such as aggression, and 

internalized problems such as depression, anxiety, and suicidal ideation.23 Exposure to violence 

may decrease empathy and pro-violence attitudes, heightening the cycle of violence once the 

children become adults.24

Exposure to community or school violence specifically has been shown to be associated with 

both externalizing behavior problems, such as antisocial behavior and aggression, and 

internalizing problems, such as depression, suicidal ideation, and anxiety.25 Exposure to 

domestic violence can also produce feelings of guilt, anger, and self-blame.26 The children may 

rationalize the aggressor’s (e.g., their father’s) behavior, which may lead, later, to rationalizing 

their own abusive behaviors in intimate relationships.27 Furthermore, children may feel they need 

 

20 Centers for Disease Control and Prevention. (2014) Understanding Suicide: Fact Sheet 2014. Available at 

http://www.cdc.gov/violenceprevention/pdf/suicide_factsheet-a.pdf. Last retrieved 3/31/15. 

21 Office of the Surgeon General and National Action Alliance for Suicide Prevention. (2012) 2012 National 

Strategy for Suicide Prevention: Goals and Objectives for Action. Available at 

http://www.ncbi.nlm.nih.gov/books/NBK109917/, retrieved 8/14/14. 

22 Lynch M. (2006) “Children exposed to community violence.” In MM Feerick & GB Silverman (Eds.), Children 

exposed to violence (pp. 29-52). Baltimore, MD: Paul H. Brookes Publishing Co. 

23 See A) Lynch M and Cicchetti D. (1998) “An ecological-transactional analysis of children and contexts: The 

longitudinal interplay among child maltreatment, community violence, and children’s symptomatology.” 

Development and Psychopathology, 10:235-257; B) Fehon D, Grilo C, and Lipschitz D. (2001) “Correlates of 

community violence exposure in hospitalized adolescents.” Comprehensive Psychiatry, 42:283-290.

24 Anderson CA. (2004) “An update on the effects of playing violent video games.” Journal of Adolescence, 27:113-

122.

25 Campbell SB. (1995) “Behavior Problems in Preschool Children: A Review of Recent Research.” Journal of 

Child Psychology and Psychiatry, 36:113-149. 

26 Moylan CA, Herrenkohl TI, Sousa C, Tajima EA, Herrenkohl RC, and Russo MJ. (2010) “The Effects of Child 

Abuse and Exposure to Domestic Violence on Adolescent Internalizing and Externalizing Behavior Problems.”

Journal of Family Violence, 25:53-63. 

27 Cunningham A and Baker L. (2004) “What about me! Seeking to understand a child’s view of violence in the 

family.” Centre for Children & Families in the Justice System. London, ON: London Family Court Clinic Inc. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 6

to take on certain roles to mediate, protect, or save the family.28 These roles can put them under 

extreme stress, adversely affecting numerous aspects of their lives. Research has found that, of 

the young children and their parents who were identified in communities as in need of 

intervention due to exposure to family or community violence, one quarter of the children and 

nearly half of their parents evidenced clinical levels of stress, suggesting the need to intervene at 

the family level as well as the individual level.29 Children’s exposure to maternal domestic 

violence (i.e. when their mother is victim) has also been shown to be associated with academic 

problems and health concerns.30

Community violence is often connected to community level risk factors such as high 

unemployment, poverty, decreased levels of community participation, poor housing conditions, 

and limited service access and provision.31 However, communities may also exhibit protective 

factors, including positive social norms, high levels of social cohesion, rewards for pro-social 

community involvement, or a stable economy.32 These protective factors are particularly 

important when considering indigenous communities. 

Different systems have attempted to create effective interventions to decrease the prevalence of 

exposure and to minimize its negative impact. Promising approaches include therapeutic 

interventions, psycho-educational and supportive group interventions, and advocacy 

interventions.33 Although some programs have featured collaboration across systems, such as 

shelters, courts, police, healthcare, and child welfare, research on the effectiveness of these 

multi-system approaches has been minimal. 

 

28 Goldblatt H and Eisikovits Z. (2005) “Role taking of youths in a family context: Adolescents exposed to 

interparental violence.” American Journal of Orthopsychiatry, 75(4):644-657.

29 Kaufman JS, Ortega S, Schewe PA, Kracke K, and the Safe Start Demonstration Project Communities. (2011) 

“Characteristics of Young Children Exposed to Violence: The Safe Start Demonstration Project.” Journal of 

Interpersonal Violence, 26(10):2042-2072. Safe Start was a previous Department of Justice initiative to address the 

impact of family and community violence on young children (primarily from birth to age 6) and their families. For 

more information, see http://www.ojjdp.gov/programs/ProgSummary.asp?pi=15#Overview. Last accessed 4/23/15. 

30 Kernic MA, Holt VL, Wolf ME, McKnight B, Huebner CE, and Rivara FP. (2002) “Academic and School Health 

Issues among Children Exposed to Maternal Intimate Partner Abuse.” Archives of Pediatric and Adolescent 

Medicine, 156:549-555. 

31 See, for example, A) American Psychological Association Task Force on Socioeconomic Status. (2006) Report of 

the APA Task Force on Socioeconomic Status; Department of Health and Human Services; B) Office of the Surgeon 

General (US). (2001) Youth violence: A report of the Surgeon General; C) Resnick MD, Ireland M, and Borowsky I. 

(2004) “Youth violence perpetration: What protects? What predicts? Findings from the National Longitudinal Study 

of Adolescent Health.” Journal of Adolescent Health, 35:424-434; D) World Health Organization. (2002) World 

report on violence and health. Geneva: World Health Organization.

32 See: A) Arthur MW, Hawkins JD, Pollard JA, Catalano RF, and Baglioni AJ Jr. (2002) “Measuring risk and 

protective factors for substance use, delinquency, and other adolescent problem behaviors. The Communities That 

Care Survey.” Evaluation Review, 26:575-601; B) Hawkins JD, Van Horn ML, and Arthur MW. (2004) 

“Community variation in risk and protective factors and substance use outcomes.” Prevention Science, 5:213-220; 

C) Kegler MC, Oman RF, Vesely SK, McLeroy KR, Aspy CB, Rodine S, et al. (2005) “Relationships among youth 

assets and neighborhood and community resources.” Health Education and Behavior, 32:380-397.

33 Groves BM and Gewirtz A. (2006) “Interventions and promising approaches for children exposed to domestic 

violence.” In MM Feerick & GB Silverman (Eds.), Children exposed to violence (pp. 107-133). Baltimore, MD: 

Paul H. Brookes Publishing Co. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 7

Social Context and Current Needs at the Demonstration Program Sites 

Baseline Prevalence: Community Survey Results 

As part of the outcome evaluation of the Defending Childhood Demonstration Program, the 

Center for Court Innovation conducted telephone surveys of adults in five of the evaluation sites. 

While the full description of the methods and results of these surveys will be reported in the 

forthcoming outcome evaluation report, a summary of the key baseline results across all sites is 

included here.34

Survey administration for Boston, Cuyahoga County, and Grand Forks County was conducted in 

November and December of 2011. The final count of completed surveys was 1,001 in Boston, 

1,200 in Cuyahoga County, and 801 in Grand Forks. The survey was completed separately for 

the Rocky Boy’s and Rosebud Sioux reservations and was conducted in May and June of 2012. 

The final count of completed surveys was 211 at Rocky Boy and 692 at Rosebud. The total 

sample was 3,905 respondents. 

Respondents were asked about their own exposure to violence as adults as well as children’s 

exposure to violence. About 58% of respondents reported either witnessing violence or being a 

direct victim. Those witnessing violence represented a greater proportion than those who were 

direct victims, with about half reporting having witnessed violence and about 20% reporting 

having been a direct victim. The most common exposure was seeing someone else being 

threatened with physical harm. 

Parents and caregivers of children under 18 who were living in the home were asked additional 

questions. If they had more than one child, respondents were asked to indicate whether any of 

their children had been exposed to various types of violence. These respondents reported that 

65% of children had been exposed to violence, either through direct victimization or through 

witnessing violence. 

Table 1.2 provides more details on the results by site. Though levels of violence exposure were 

high across all locations, it is worth noting the much higher levels in the two tribal sites. 

Community Strengths at the Demonstration Program Sites 

The Defending Childhood Demonstration Program sites have many strengths and resources. 

Some locations, like Cuyahoga and Shelby counties, had previous initiatives that brought major 

health, early childhood, law enforcement, and social service agencies together to collaborate 

around issues affecting children and youth. This history of cross-agency relationships helped set 

the stage for a new collaboration to address children’s exposure to violence. Other sites, such as 

 

34 The community survey was developed to evaluate change in community awareness about violence and available 

local resources to address it, as well as levels of self-reported victimization. It was a random digit dial telephone 

survey of the full city, county, or reservation for each site. Because Shelby County chose a place-based strategy that 

concentrated their efforts in three apartment complexes in Memphis, a random digit dial survey of the whole county 

was not an appropriate method for capturing levels of awareness. Therefore, Shelby County was excluded from the 

community survey. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 8

Boston and the Rocky Boy’s initiative, had support from major political actors such as the mayor 

or the tribal council. One site, Grand Forks, had a strong relationship with the local school 

districts, making it an ideal location for extensive primary prevention programming. Another 

site, the Rosebud Sioux tribe, had a strong commitment to using traditional culture as a form of 

violence prevention. Table 1.3 highlights some of the strengths for each site. 

Table 1.2 Baseline Community Survey Results

Site Urban/Rural Baseline Survey Results Summary*

Boston, MA Urban

 Big problems: violent crime, gang violence, and 

bullying

 53% of adults exposed to violence in the past 

year

 54% of parents of children under 18 said their 

children had been exposed to violence in the 

past year

Cuyahoga County, OH Urban

 Big problems: violent crime, gang violence, and 

child abuse/neglect

 52% of adults exposed to violence in the past 

year

 62% of parents of children under 18 said their 

children had been exposed to violence in the 

past year

Grand Forks, ND Both

 Big problems: bullying, relationship violence, 

and child abuse/neglect

 41% of adults exposed to violence in the past 

year

 61% of parents of children under 18 said their 

children had been exposed to violence in the 

past year

Rocky Boy’s 

Reservation, MT Rural

 Big problems: gang violence, violent crime, and 

relationship violence

 87% of adults exposed to violence in the past 

year

 84% of parents of children under 18 said their 

children had been exposed to violence in the 

past year

Rosebud Sioux Tribe, 

SD Rural

 Big problems: gang violence, violent crime, and 

relationship violence

 88% of adults exposed to violence in the past 

year

 76% said their children had been exposed to 

violence in the past year

* Exposure to violence includes both direct victimization and witnessing violence.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 9

Table 1.3 Community Strengths

Site Strengths

Boston, MA

 Resource rich environment with many local organizations 

working on children’s exposure to violence issues

 History of cross-agency collaboration

 Political will

Cuyahoga County, OH

 Strong history of children’s exposure to violence related 

programs

 History of cross-agency collaboration

 Strong local research capacity

Grand Forks, ND  Strong relationships with local schools

Rocky Boy’s 

Reservation, MT

 Strong commitment to tribal tradition and culture as protective 

factors

 Consistent support of Tribal Council and local agencies

 History of cross-agency collaboration

Rosebud Sioux Tribe, SD  Strong commitment to tribal tradition and culture as protective 

factors

Shelby County, TN  History of cross-agency collaboration

 Strong local research capacity

Process Evaluation Methodology 

A full process evaluation was conducted for each site. The process evaluations provided rich 

accounts of the strategies that were undertaken; a separate report for each site has been written in 

conjunction with this synthetic report. Each report provides details on local context; structure, 

scope, and staffing of the initiative; the program model; implementation; barriers and facilitators 

to implementation; and sustainability of the initiative after federal funding ends. 

The process evaluations were mixed-method studies that included three primary data 

collection methods: 1) site visits to interview key stakeholders and program administrators, 

and, in some cases, to observe collaborative meetings or community events; 2) quarterly site 

implementation reports that kept track of quantitative outputs of the program; and 3) 

document review of important program records and materials. For the purposes of this 

umbrella report, additional interviews were conducted with other relevant stakeholders, 

including grant managers and technical assistance providers. Early on in the project, all 

stakeholders—at the demonstration program sites, OJJDP, NIJ, and Futures Without 

Violence—received an opportunity to help shape the outline of the process evaluation reports. 

Additionally, sites were able to read their respective process evaluation reports to provide 

feedback before they were finalized. 

Site Visits 

As part of the process evaluations, the evaluation team conducted at least two site visits to the 

six Defending Childhood Demonstration Program sites. During these 2-3 day visits, key 

informant interviews were conducted with members of the local Defending Childhood

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 10

collaboratives, as well as with Defending Childhood program administrators and staff 

members. In some cases, interviews or focus groups were also conducted with community 

members who received services or who participated in programming. Interviews were 

conducted in face-to-face meetings and lasted 30 minutes to an hour. Interviews were not 

digitally recorded but detailed notes were taken. The site visit schedule can be found in Table 

1.4. 

Table 1.4 Evaluation Site Visits

Site Dates of 1st Visit Dates of 2nd Visit Dates of 3rd Visit

Boston, MA 10/22/12-10/23/12 2/26/14-2/28/14

Cuyahoga County, OH 10/8/12-10/9/12 5/20/14-5/21/14

Grand Forks, ND 11/8/12-11/9/12 5/8/14-5/9/14

Rocky Boy’s Reservation, MT 5/2/13-5/3/13 6/2/14-6/3/14

Rosebud Sioux, SD 5/9/12-5/10/12 12/17/12-12/18-12 5/12/14-5/13/14

Shelby County, TN 9/23/12-9/24/12 10/18/13-10/20/13 4/16/14-4/17/14

The interviews included questions about site-level strategies and implementation successes and 

challenges. All interviews collected basic information about respondent agency affiliation, job 

responsibilities, role/responsibilities within the initiative, and experience with addressing 

children’s exposure to violence. The interview protocol is included in Appendix B. Questions 

covered several broad categories, including: 

 Initiative Management and Oversight: Core management team, collaborative body, 

governance board. 

 Program Infrastructure: Number of staff members, staff credentials, staff turnover, 

organizational structure, relationships between key public health and law enforcement 

agencies. 

 Program Model: Detailed description of chosen strategies and activities to address 

children’s exposure to violence.

 Obstacles and Facilitators to Program Implementation: barriers encountered while trying 

to implement the chosen models, if and how those barriers were overcome, external 

catalysts that quickened the pace of implementation or made programming successful. 

 Environmental Factors: Political, legislative, community events, and other violence 

prevention and/or police initiatives that may be positively or negatively affecting the 

potential impact of the program. 

 Technical Assistance: Types of assistance requested from Futures Without Violence. 

 Sustainability: Plans for continued programming after grant funding ends, other available 

resources to sustain programs. 

A total of 153 interviews with 145 Defending Childhood stakeholders were conducted across the 

sites. In addition, in one site, Shelby County, three focus groups were conducted with 14 female 

program participants. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 11

Some site visits were scheduled specifically to allow the research team to observe particular 

events. Researchers observed four collaborative meetings, three community awareness events, 

two tribal council meetings, and one full day of professional training. In addition, the research 

team participated in a sexual assault awareness walk on Rocky Boy’s Reservation. 

Quarterly Implementation Reports 

The sites implemented work across seven major domains: 1) prevention; 2) screening and 

assessment; 3) case management and advocacy, 4) treatment, healing, and direct intervention 

services; 5) community awareness and education; 6) professional training; and 7) systems change 

and capacity building. A standard quarterly implementation report was developed to capture 

quantitative information about the programming, including information on reach (e.g., how many 

people participated in a training) and dose (e.g., how many hours of training people received). 

Appendix C includes a blank copy of the quarterly implementation report, which includes the 

following sections: 

 Collaborative body and subcommittee meetings 

 Professional trainings 

 Community awareness events 

 Publications and other printed materials 

 Direct services and screening 

 Policies, protocols, and procedures 

For each of these domains, sites recorded for each activity the date, time, target audience, 

attendance, and a brief description of the event. Additional space allowed sites to discuss sitespecific activities that did not fall under other categories. 

These Excel spreadsheet reports were filled out by Defending Childhood program managers and 

submitted quarterly to the research team. For each year of the project, sites submitted the reports 

in January, April, July and October for the previous quarter. Twelve reports were collected from 

each site covering the time period of October 1, 2011 through September 30, 2014. 

Document Review 

Research staff reviewed all planning documents including strategic plans, reports, protocols, 

screening and assessment tools, training curricula and summaries, prevention program curricula, 

provider checklists, flyers, brochures, pamphlets, presentations, and meeting agendas and 

minutes. Defending Childhood program managers submitted these documents quarterly with 

their implementation reports, and researchers also collected documents during their site visits. 

Cross-Site Synthesis Interviews 

Additional interviews were conducted with members of the Futures Without Violence technical 

assistance team and OJJDP grant managers. Specifically, a group interview was held with four 

members of the Futures Without Violence technical assistance team, and individual interviews 

were conducted with two OJJDP grant managers and one technical assistance subcontractor from 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 1. Introduction Page 12

the Native Streams Institute. The interviews involved questions on the progress of the Defending 

Childhood Initiative, successes and challenges, lessons learned, and recommendations. 

Limitations 

We have identified three major limitations regarding the findings in this report, related to 

methodology, impact, and generalizability. 

1. Methodology: Although the mixed method study of the sites’ program implementations 

provided rich data on the sites, the process evaluations could have been even stronger 

with more data. Specifically, because the evaluation team was located in New York City, 

it was difficult to observe program activities on a regular basis. When activities could be 

observed (e.g., during a site visit), program staff and participants were aware of when the 

visit would take place and were aware of the evaluators’ purpose for being there. This 

dynamic potentially made staff less likely to behave naturally (also known as the 

“Hawthorne effect,” where people perform better when they know they are being 

observed). Additionally, because program observations were limited, there is no data in 

the reports on the physical settings where programming took place. Descriptions of these 

locations—schools, community centers, training facilities—could help in understanding 

whether or not the places were conducive to effective program implementation and 

acceptance (e.g., was a school classroom set up in such a way that made learning 

difficult). Finally, the findings herein could have been strengthened through other 

methods such as in-depth case studies and participant interviews, the latter only taking 

place in Shelby County. 

2. Impact: While this report has generated lessons learned and documented unique strategies 

across sites, without knowing the impact the programs have had on its participants and 

communities, it is ultimately hard to say what the most effective strategies to produce 

positive outcomes (e.g., reductions in prevalence of violence in the community, 

reductions in trauma symptoms for children exposed to violence) are. Therefore, although 

we highlight effective, promising, and potentially innovative implementation strategies 

and uncover practical challenges, we cannot draw rigorous conclusions regarding which 

strategies worked to produce successful outcomes and which did not. 

3. Generalizability and Replicability: Many of the strategies outlined in this report require 

significant resources to design, implement, and sustain. It may be difficult for 

jurisdictions interested in addressing children’s exposure to violence in their communities 

to obtain the funding to implement a large-scale initiative such as Defending Childhood. 

Additionally, some of the demonstration sites had a strong preexisting service 

infrastructure, a history of interdisciplinary collaboration, and a greater local research 

capacity than what may be found in otherwise comparable sites. As described in the next 

chapter, most sites had difficulty bringing local schools—the most logical setting for 

large-scale violence prevention programming for children and youth—on board in a 

substantial way; it would most likely be just as challenging for many jurisdictions, 

making the universal prevention programming that the Grand Forks site was able to 

implement difficult to replicate. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 13

Chapter 2 

Cross-Site Themes and Lessons Learned 

This chapter provides a discussion of the themes and lessons learned. The chapter starts by 

summarizing the strategies that the six sites implemented, highlighting common and unique 

approaches and challenges in the following core areas: 

 Prevention (both universal prevention and targeted prevention for high-risk groups); 

 Screening and assessment; 

 Case management and advocacy; 

 Treatment and healing (therapeutic clinical services);

 Community awareness and education; 

 Professional training; and 

 Systems infrastructure and capacity building. 

The strategies that sites chose to implement was based on findings from their original needs 

assessment, discussions among their collaborative bodies, and informal feasibility assessments; 

hence, program models differ by site. For example, one site (Cuyahoga County) focused heavily 

on treatment and healing and had a limited focus on prevention, while another (Grand Forks) 

concentrated their resources mostly on universal prevention. Table 2.1 shows the strategies 

chosen by each site, and whether it was a primary or secondary focus of each site’s initiative.

Appendix A provides tables of the aggregate site outputs by year for some of the activities listed 

below. 

Table 2.1 Chosen Strategies by Site

Boston Cuyahoga 

County

Grand 

Forks

Rocky 

Boy Rosebud Shelby County

Case Management & Advocacy

Screening & Assessment

Treatment & Healing

Prevention

Community Awareness/Education

Professional Training

System Infrastructure/Capacity Building

Key: Primary

Focus

Secondary Blank = Not a focus

Focus

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 14

A Note on Terminology and Justification: “Evidence-Based” and “Promising” Programs 

Throughout individual site reports as well as this report, certain programs are designated as 

evidence-based or promising. The use of evidence-based programs, practices, or interventions 

has received increasing attention, while the definition of what constitutes “evidence” continues 

to be debated. In general, evidence-based programs and interventions are supported by rigorous 

evidence of effectiveness.35 These programs, if implemented with fidelity to the program 

developer’s model, are likely to produce positive impacts. Program effectiveness must be 

demonstrated using an evaluation design with sufficient scientific merit, specifically randomized 

controlled trials or strong quasi-experimental designs. Programs and interventions evaluated with 

diverse populations, multiple replications, or longitudinal studies also contribute to the strength 

of the evidence of effectiveness or to findings of whether positive effects may be sustained over 

time. The lowest levels of evidence may exist in studies conducted through non-experimental 

designs, defined as designs that lack a true comparison group that did not receive the 

intervention. 

For the purposes of this study, programs and interventions with at least two strong evaluation 

designs (randomized trials or quasi-experiments) that have shown positive impacts are 

considered evidence-based. Programs with research studies supporting their effectiveness that 

do not reach this threshold are considered promising.36 It is important to note that there is a 

continuum of effectiveness and that some programs promoted as “effective” may not meet this 

standard. Some programs may just barely meet this standard (with two or three strong 

evaluations) and still other programs may be supported by a truly large body of evidence. In fact, 

in the public health and criminal justice fields, there are programs, policies, and interventions 

that are designated as evidence-based because they have been supported by dozens, if not 

hundreds, of studies. 

Prevention Programming 

Prevention programming is defined as efforts to prevent initial or subsequent exposure to 

violence. While all sites implemented some form of prevention programming, only the Grand 

Forks site chose to concentrate their resources on universal prevention. 

 

35 In determining whether a program or intervention is evidence-based, no distinction is made between formal 

efficacy and effectiveness studies. Efficacy studies test the impact of a program model under “ideal” conditions, 

carefully controlled and monitored by the researchers in order to ensure high model fidelity. Effectiveness studies

test the impact of a model under “real world” conditions where imperfect implementation is expected. For current 

purposes, the use of the term “effective” refers simply to positive impacts with either type of study design, although 

ideally, two or more formal “effectiveness” studies would demonstrate that a program model is truly appropriate for 

broad dissemination in the real world (e.g., see Society for Prevention Research Standards of Evidence: Criteria for 

Efficacy, Effectiveness, and Dissemination, available at: 

http://www.preventionresearch.org/StandardsofEvidencebook.pdf). 

36 There are a variety of approaches to determining whether a program or intervention is evidence-based. The Office 

of Justice Programs website (http://www.crimesolutions.gov) and SAMSHA’S National Registry of Evidence-Based 

Programs and Practices (http://www.nrepp.samsha.gov) require one rigorous study for a program or intervention to 

be deemed “effective.” The What Works Clearinghouse of the Institute of Education Sciences 

(http://ies.ed.gov/ncee/wwc/default.aspx) and the Society for Prevention Research (footnote 1) use distinct, yet 

complex, processes to rank programs and include many different criteria. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 15

The Grand Forks Universal School-Based Prevention Model 

Schools are the most logical setting for large-scale prevention programming for children and 

youth. However, implementing extensive prevention programming in schools is no easy task, 

given that many counties include major metropolitan school districts and multiple suburban 

districts. Because of its relatively small size, Grand Forks, ND, however, is one site where 

universal school-based programming was potentially feasible. Indeed, Grand Forks was largely 

successful in implementing prevention programming county-wide, spanning city, rural, and 

parochial schools. The programming is “universal” because it was offered to everyone, 

regardless of previous exposure to violence or at risk status. Children ages 3-17 learned about 

different kinds of violence (e.g., bullying, dating violence) and ways of preventing it, as well as 

about how to have positive relationships with others. A summary of all of the programming in 

Grand Forks, much of which was evidence-based or promising, is included as Table 2.2. 

Grand Forks’ extensive focus on prevention programming is a replicable model for jurisdictions 

across the country that have problems with bullying in schools, dating violence, and domestic 

and child abuse. Even larger school districts may wish to replicate what Grand Forks 

accomplished—but more up-front funding may be required. 

Moreover, in the long-term, blanketing a jurisdiction with universal prevention programming is 

potentially sustainable, as the costs are mostly up-front in terms of buying curricula and having 

school staff trained. Because the programming is mostly administered by teachers and coaches 

who remain in the district for years, once they are trained they may be able to continue to offer 

the programs with little to no additional training after the first year. 

Prevention through Traditional Culture at the Rocky Boy and Rosebud Sites 

The two tribal sites held activities that sought to incorporate traditional Lakota or Chippewa Cree 

culture as a means of universal prevention, under the belief that youth who are disconnected 

from Native culture contributed to violence in their communities. At Rocky Boy, smudging, 

drumming, and traditional arts and crafts were incorporated into community events and 

programming; at Rosebud, smudging and traditional foods were incorporated. Rosebud also 

plans to host a Lakota naming ceremony for youth on the reservation who do not have a 

traditional name. 

Targeted Prevention Models 

Boston, Cuyahoga County, and Shelby County contracted with community-based organizations 

to support or create targeted prevention programs. Targeted prevention programs are 

administered to young people who are considered “at-risk” for exposure to violence due to living 

in neighborhoods with high levels of violence. 

 Coaching Boys into Men: Boston administered this leadership program that provides 

athletic coaches with the strategies and resources to educate young males about 

relationship abuse, harassment, and sexual assault. Shelby County also trained athletic 

coaches in the county school district on the Coaching Boys into Men curriculum.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 16

Table 2.2 Grand Forks’ Safer Tomorrows Prevention Programming Summary

Prevention Program Schools Grades Description

Al’s Pals37** and Al’s Caring Pals38** Head Start, Childcare Centers Ages 3-8

Resilience-based curriculum used to develop the social, emotional, 

multi-cultural, and behavioral skills of children. 

Olweus Bullying Prevention 

Program39** All high schools in the county K-8

Prevention of bullying through individual actions, school environment, 

and community members. 

The Fourth R40** All high schools in the county 9 & 10

A comprehensive, school-based program designed to reduce violence 

and associated risk behaviors by focusing on relationship goals and 

challenges that influence decision-making. 

Lessons from Literature Larimore High School Only 9-12

Uses existing literature curriculum and additional books and stories to 

increase awareness about the damaging effects of physical, sexual and 

verbal abuse, and how to recognize abusive uses of power and control 

and alternatives to violence.

Friendships that Work: A Positive 

Friendship Curriculum All high schools in the county 5 & 7

Increase healthy relationship skills among early adolescents and 

decrease characteristics commonly thought of as precursors to intimate 

partner violence.

Project Northland

41* Grand Forks Public Schools Only 6, 8, 10

This curriculum is proven to delay the age at which young people 

begin drinking, reduce alcohol use among young people that have 

already tried drinking, and limit the number of alcohol-related 

problems.42 See http://www.hazelden.org/web/go/projectnorthland for 

more information.

 

37 Studies that document Al’s Pals’ effectiveness include: A) Lynch K, Geller S, and Schmidt M. (2004) “Multi-Year Evaluation of the Effectiveness of a ResilienceBased Prevention Program for Young Children.” The Journal of Primary Prevention, 24, 3:335-353; B) Loos M. (2010) Highlights of Findings of Al’s Caring Pals: A 

Social Skills Toolkit for Home Child Care Providers Arkansas Statewide Controlled Study Conducted in 2009-2010. Wingspan, LLC.

38 Studies that document Al’s Caring Pals’ effectiveness include: A) Loos M. (2010) Highlights of Findings of Al’s Caring Pals: A Social Skills Toolkit for Home Child 

Care Providers Arkansas Statewide Controlled Study Conducted in 2009-2010. Wingspan, LLC; B) Loos M. (2011) Highlights of Findings of Al’s Caring Pals: A 

Social Skills Toolkit for Home Child Care Providers Virginia Statewide Controlled Study Conducted in 2010-2011. Wingspan, LLC.

39 Studies that document the Olweus Bullying Prevention Program’s effectiveness include: A) Bauer N, Lozano P, and Rivara F. (2007) “The effectiveness of the 

Olweus Bullying Prevention Program in middle schools: A controlled trial.” Journal of Adolescent Health, 40:266-274; B) Olweus D. 1991. “Bully/victim problems 

among school children: Basic facts and effects of a school based intervention program.” In DJ Pepler and KH Rubin (Eds.), The development and treatment of childhood 

aggression (pp. 411–448). Hillsdale, NJ: Erlbaum. 

40 Studies that demonstrate the Fourth R’s effectiveness include: A) Cissner A and Hassoun Ayoub L. (2014) Building Healthy Teen Relationships: An Evaluation of the 

Fourth R Curriculum with Middle School Students in the Bronx. New York, NY: Center for Court Innovation; B) Wolfe D, Crooks C, Jaffe P, Chiodo D, Hughes R, Ellis 

W, Stitt L, and Donner A. (2009) “A universal school-based program to prevent adolescent dating violence: A cluster randomized trial.” Archives of Pediatric and 

Adolescent Medicine, 163:693-699.

41 For research on Project Northland, see: Perry C, Williams C, Veblen-Mortenson S, Toomey T, Komro K, Anstine P, McGovern P, Finnegan J, Forster J, Wagenaar A, 

and Wolfson M. (1996) “Project Northland: Outcomes of a communitywide alcohol use prevention program during early adolescence.” American Journal of Public 

Health, 86, 956-965. 

42 Alcohol programming is relevant because of its long-established relationship to violence (both used by perpetrators and victims) and criminal activity. See, for 

instance https://ncadd.org/images/stories/PDF/factsheet-alcoholandcrime.pdf and http://www.bjs.gov/content/pub/pdf/ac.pdf. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 17

Digital Citizenship Grand Forks Public Schools Only K-12

This curriculum teaches students responsible behavior in regard to 

technology use, including personal safety. See 

http://www.digitalcitizenship.net/Home_Page.html for more 

information.

NetSmartz Rural and Parochial Schools Only K-12

Teaches children to make safe decisions, both online and offline. 

NetSmartz addresses issues such as cyber-bullying, inappropriate 

content, predators, revealing too much information, sexting, and scams. 

See http://www.netsmartz.org/Parents for more information.

Coaching Boys into Men43* All high schools in the county 9-12

This is a curriculum for high-school athletic coaches that is designed to 

inspire them to teach student athletes about the importance of respect 

for themselves and others in their relationships.

Rachel’s Challenge Grand Forks Public Schools and 

two Rural Schools

Middle school (GFPS), K-12 

(rural)

A series of motivating presentations that provide students and staff 

with the skills to create a supportive learning environment.

Healthy Families44** N/A Ages 0-3 An evidence-based home visiting model for families at-risk or in need.

* Promising ** Evidence-based

 

43For a study on Coaching Boys into Men, see Miller E, Tancredi D, McCauley H, Decker M, Virata M, Anderson H, Stetkevich N, Brown E, Moideen F, and Silverman 

J. (2012) “Coaching Boys into Men”: A cluster-randomized controlled trial of a dating violence prevention program.” Journal of Adolescent Health, 51, 431-438.

44 Studies that demonstrate Healthy Families’ effectiveness include: A) DuMont K, Mitchell-Herzfeld S, Greene R, Lee E, Lowenfels A, Rodriguez M, and Dorabawila 

V. (2008) “Healthy Families New York (HFNY) randomized trial: Effects on early child abuse and neglect.” ChildAbuse & Neglect, 32(3):295–315; B) LeCroy C and 

Krysik J. (2011) “Randomized trial of the Healthy Families Arizona home visiting program.” Children and Youth Services Review, 33:1761-1766. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 18

 Family Programs: Boston administered the evidence-based Family Nurturing Program45, 

which is designed for parents and children to build their nurturing skills and 

understanding of healthy development, appropriate expectations, and discipline with 

dignity. Cuyahoga County administered Adults and Children Together (ACT) 46, a 

promising program that teaches positive parenting skills to parents and caregivers of 

children from birth to age eight. 

 Project Safeways: Shelby County supported Project Safeways, a Memphis-based program 

that provides support services and training to apartment complex managers to prevent 

crime and ensure residents’ safety. The use of this particular program model dovetailed 

with the overall philosophy of the Shelby County initiative of infusing a small number of 

high-risk apartment complexes with a panoply of advocacy, case management, and 

prevention services (see further discussion below). 

Challenges Related to Prevention 

Three important challenges emerged concerning the focus of prevention, especially when the 

programming is universal. First, staff across all sites believed that in addition to the focus on 

negative prevention (e.g., anti-violence, anti-bullying), programs might consider incorporating 

positive promotion (e.g., healthy relationships, building resiliency), as those messages may 

resonate with and be applicable to a more general (not necessarily “at risk”) youth audience. 

Second, jurisdictions interested in implementing multiple programs in schools over multiple 

years will find a lack of any existing comprehensive prevention program that goes across all 

ages. As depicted in Table 2.2, Grand Forks used multiple curricula and struggled with the 

challenge of making the curricula complimentary rather than repetitive. Realistically, students 

may become exposed to the same concepts repeatedly. As interviews with program managers 

suggest, it is important for staff to be sensitive to this reality—students will tune out if they hear 

the same message too often. On the other hand, administrators must be careful not to alter 

evidence-based programs—fidelity to the model is crucial to successful implementation. 

Navigating these conflicting impulses can be a challenge. 

Third, some programs have similar goals but take different approaches. Staff should be mindful 

of this where multiple programs are implemented in the same settings. There is potential for 

conflicting messages. For example, as an anti-bullying program, Olweus trains school staff to 

keep parties who bully others separate from those they bully; a key tenet of restorative justice 

programs, however, is to bring those parties together; thus, their messages could conflict if 

administered to the same students. 

 

45 The Family Nurturing Program is considered evidence-based. For studies demonstrating its effectiveness, see: A) 

Hodnett RH, Faulk K, Dellinger A, and Maher E. (2009) “Evaluation of the statewide implementation of a parent 

education program in Louisiana's child welfare agency: The Nurturing Parent Program for infants, toddlers, and 

preschool children.” Final evaluation report submitted to Casey Family Foundations; B) Bavolek SJ, Comstock CM, 

and McLaughlin JW. (1983) “The Nurturing Program: A validated approach for reducing dysfunctional family 

interactions.” Final report submitted to the National Institute of Mental Health. 

46 ACT is considered a promising program. See Portwood SG, Lambert RG, Abrams LP, and Nelson EB. (2011) 

“An Evaluation of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids 

Program.” Journal of Primary Prevention, 32:147-160. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 19

Screening and Assessment

Screening is an important first step in identifying children who have been exposed to violence. 

Screening is typically a brief process, designed to determine the need for further assessment and 

possible services, whereas assessment yields a more comprehensive understanding of trauma 

symptomology in order to determine which specific services are appropriate. 

Most of the sites that focused on providing treatment had formal screening and assessment tools. 

For example, Shelby County used the VanDenBerg “Strength, Needs, and Culture Discovery” 

assessment, the UCLA PTDS Trauma Index, and the Ages and Stages Questionnaire. Boston 

used the Child and Adolescent Needs and Strengths (CANS) assessment. 

The Cuyahoga County Universal Screening and Assessment Model 

Cuyahoga County concentrated resources on comprehensive screening and assessment, creating 

a streamlined system that moves children ages 0-18 who have been exposed to violence and may 

be experiencing trauma symptoms from identification/screening to treatment. Fifteen agencies in 

the county use a universal screener. If a child screens positively and the parent consents, the 

family’s screener and contact information are sent to a Central Intake and Assessment location. 

If Central Intake staff administer an assessment and deem that the child should receive treatment, 

they refer to one of seven local agencies for service provision. It is worth describing their unique 

model a little more in depth: 

 Development of a Universal Screening Tool: The Cuyahoga County research team 

piloted and developed a short, one-page screener that asks questions related to violence 

exposure and trauma. The research team established separate screeners for children seven 

years of age and younger (completed by the caregiver) and for children eight years of age 

and older (completed by the child). The screeners were based on existing violence 

exposure and trauma instruments (e.g., Juvenile Victimization Questionnaire47, Trauma 

Symptom Checklist for Children48, Trauma Symptom Checklist for Young Children49

, 

and the Child Behavior Checklist50).

 

47 For more information about the Juvenile Victimization Questionnaire, see Finkelhor D, Hamby SL, Ormrod R, 

and Turner H. (2005) “The Juvenile Victimization Questionnaire: Reliability, validity, and national norms.” Child 

Abuse and Neglect, 29(2005):383-412; http://www.unh.edu/ccrc/juvenile_victimization_questionnaire.html. 

48 For more information about the Trauma Symptom Checklist for Children, see A) Briere J. (1996) Trauma 

Symptom Checklist for Children: Professional manual. Florida: Psychological Assessment Resources Inc.; B) Nader 

KO. (2004) “Assessing traumatic experiences in children and adolescents: Self-reports of DSM PTSD Criteria B-D 

symptoms.” In J. Wilson & T. Keane (Eds.), Assessing psychological trauma and PTSD, 2nd ed. (pp. 513-537). 

New York: Guilford Press; C) Ohan JL, Myers K, and Collett BR. (2002) “Ten-year review of rating scales. IV: 

Scales assessing trauma and its effects.” Journal of the American Academy of Child and Adolescent Psychiatry, 

41:1401-1422. 

49 For more information about the Trauma Symptom Checklist for Young Children, see A) Briere, J. (2005) Trauma 

Symptom Checklist for Young Children: Professional manual. Florida: Psychological Assessment Resources Inc.; B) 

Briere J, Johnson K, Bissada A, Damon L, Crouch J, Gil E, Hanson R, and Ernst V. (2001) “The Trauma Symptom 

Checklist for Young Children (TSCYC): Reliability and association with abuse exposure in a multi-site study.”

Child Abuse & Neglect, 25:1001-1014.

50 For more information on the Child Behavior Checklist, see A) Achenbach TM and Rescorla LA. (2000) Manual 

for the ASEBA Preschool forms and Profiles. Burlington, VT: University of Vermont Department of Psychiatry; B) 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 20

 Administration of the Screening Tool: The two primary screening agencies have been the 

Cuyahoga County Division of Children and Family Services (DCFS) and the Cuyahoga 

County Juvenile Court, resulting in over 16,000 children screened in a little over two 

years. The agencies that received a contract to provide treatment services also use the 

screener. 

 Countywide Central Intake and Assessment: If a child screens as having been exposed to 

violence or trauma, they are referred to a Central Intake and Assessment (“Central 

Intake”) office for a full assessment. Central Intake—available 24 hours a day, 365 days a 

year—is the site for all diagnostic assessments and crisis response in the county’s service 

system. The diagnostic assessment is comprehensive, with core components from valid 

and reliable instruments such as the Juvenile Victimization Questionnaire, Trauma 

Symptom Checklist for Children, Trauma Symptom Checklist for Young Children, 

Violent Behavior Questionnaire, and the Child Behavior Checklist. Once Central Intake 

receives a referral, staff have 24 hours to reach out to the family. 

 Assessment-driven Treatment Planning: Once an assessment is complete, Central Intake 

staff make a diagnosis and recommendation for appropriate treatment and then link 

families to a Defending Childhood contract agency that can provide the child with the 

most appropriate trauma-informed intervention, driven by the results of the assessment. 

All trauma treatment services that Central Intake refers to are evidence-based or 

promising. 

Cuyahoga’s experiment in countywide screening and assessment yielded valuable lessons. First, 

it is important to find a delicate balance between not setting the screening threshold so high that 

children who need services fail to flag, and not setting the threshold so low that too many 

children are identified but then found not to need services after a full assessment or not to be able 

to receive services because community-based providers are over-stretched. 

Second, if one of the primary screening agencies will be the local Children and Family Services 

agency, intake may not be the best point of screening; while the number of children potentially 

screened will be highest if done at intake, at that point in time many parents may not be fully 

honest when filling out the screener, for fear that it might affect their child welfare case. Finally, 

because there is often turnover at major screening agencies (e.g., court, child welfare service), 

there may be a need for regular new or booster trainings on how to administer the screener. 

Case Management and Advocacy 

Case management and advocacy are major components of the two tribal sites’ programming and 

of the place-based service linkage model adopted in Shelby County. These activities involve 

outreach to individuals in potential need with the aim of providing non-therapeutic forms of 

 

Achenbach TM and Rescorla LA. (2001) Manual for the ASEBA School-Age Forms and Profiles. Burlington, VT: 

University of Vermont, Research Center for Children, Youth, and Families; C) Nakamura BJ, Ebesutani C, 

Bernstein A, and Chorpita BF. (2009) “A Psychometric Analysis of the Child Behavior Checklist DSM-Oriented 

Scales.” Journal of Psychopathology and Behavioral Assessment, 31:178–189. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 21

assistance as well as providing linkages to clinical services where appropriate. Advocacy also 

involves assistance in supporting individuals in legal proceedings and working to ensure they 

receive appropriate educational services. 

Three Examples of Case Management and Advocacy Models 

 The Rocky Boy’s Domestic Violence/Sexual Assault and Child Advocacy Model: The 

domestic violence advocacy model includes safety planning, intake and referral, shortterm and emergency housing assistance, court and law enforcement accompaniment, and 

support groups. The child advocacy model focuses on child abuse and neglect cases. 

Child advocates receive case referrals from multiple Rocky Boy agencies, including 

social services, TANF, and Rocky Boy Schools. Their advocacy work involves spending 

time with the child and remaining involved throughout the abuse/neglect case, taking 

him/her to the hospital or doctor’s appointments, and playing an advocacy role in court 

proceedings and other formal events. 

 The Rosebud Care Advocacy Model: This model relies on referrals from three sources: 1) 

the juvenile detention center (which supplies the majority of referrals); 2) community 

partners such as the police, Department of Social Services, and local wellness and mental 

health programs; and 3) family/guardians. Staff refer to the case management work as 

“care advocacy.” They work with the young people to create individualized action plans, 

make referrals to local service providers, and do civil legal advocacy and court 

accompaniment. Many of the people they work with are from court-involved families; 

thus, case managers assist with things such as preparing paperwork for a protection order 

and accompanying a child to a protection order hearing. Case managers also advocate 

within the school system to ensure that the educational needs of youth are met. 

 The Shelby County Place-Based Case Management Model: Case management and 

advocacy was also a major component for Shelby County, the only site to institute a 

place-based approach by concentrating resources in three public housing apartment 

complexes in Memphis. The site hired family service providers to work in these 

apartments. The family service providers were not licensed clinicians; rather, they were 

intended to play an intermediary role, providing a safe space for people to come to 

discuss their problems with a caring person, while also referring potential clients to social 

service agencies. The case managers, called connectors, received space at the target 

complexes, helping to connect families to the services they might need (e.g., receiving 

therapy, filing court orders, paying their utility bills, finding daycare for their children). 

Their onsite presence meant that they were accessible to residents on a regular basis. The 

connectors also put together a written resource guide for residents. 

Challenges Related to Case Management and Advocacy 

Advocacy work has many challenges. The work itself is exhausting, since advocates are on call 

24 hours a day, seven days a week. The advocates were concerned about self-care and helping 

themselves not to burn out. In the Rosebud site, another challenge was the lack of transportation 

and the size of the reservation—it could take over an hour to drive to a child’s home, and then 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 22

there would be no guarantee that the person will be there. Additionally, the children and youth at 

the tribal sites often lack transportation to get to and from social service agencies. Finally, many 

families are lacking food, shelter, and clothing. It is often hard to engage them in services related 

to violence when they need their basic needs met first. The onsite presence of advocates in highrisk apartment complexes in Shelby is a model that may be replicable in other urban contexts.

Treatment and Healing 

Therapeutic programs designed to treat the psychological effects in children who have been 

exposed to violence are categorized as “treatment and healing.” This category differs from case 

management and advocacy, which involves outreach to individuals in potential need with the aim 

of providing non-therapeutic forms of assistance and linkages to clinical services where 

appropriate. The two tribal sites largely adopted an advocacy model (described above), while 

referring to other preexisting service providers to administer therapeutic treatment. However, the 

tribal sites did also offer traditional healing ceremonies such as sweat lodges and smudging. 

Through varying mechanisms, the non-tribal sites all utilized Defending Childhood funding to 

support direct therapeutic treatment, in most cases using known, evidence-based or promising 

treatment models. Most of the treatment recipients were Medicaid-eligible, meaning that the 

treatment agencies could be reimbursed through Medicaid; the Shelby model also directly funded 

services that existing insurance options would otherwise not pay for. 

Table 2.3 provides a description of most of the different treatments across the sites. As described 

above, if a treatment is classified as “evidence-based,” it means that at least two rigorous 

evaluations provide evidence that the program is effective in achieving intended outcomes (e.g., 

decreased trauma symptoms). Programs with research supporting their effectiveness that do not 

reach this threshold are considered “promising.” It is important to note, however, that the 

research that supports the use of evidence-based practices does not usually include evaluations of 

interventions with Native American and/or Alaskan Native communities. None of the western 

treatments outlined in Table 2.3 have evidence on their use with Native communities. TF-CBT 

has been adapted for tribal use, but its adaptation “Honoring Children, Mending the Circle,” is 

considered a “promising practice” by the National Child Traumatic Stress Network, since 

evaluation is ongoing. 

Some tribal practices, however, may be considered effective in healing based on non-western 

approaches to evaluating them. For example, sweat lodges, used at both the Rocky Boy and 

Rosebud sites, fall under “Local community validation” according to the First Nations 

Behavioral Health Association.51

 

51 FNBHA Catalogue of Effective Behavioral Health Practices for Tribal Communities. (2009) First Nations 

Behavioral Health Association. Available at: 

http://www.fnbha.org/pdf/fnbha_catalogue_best_practices_feb%2009.pdf 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 23

Table 2.3 Treatment and Healing Interventions

Treatment Description EvidenceBased?

Site(s)

Implementing

Trauma-Focused Cognitive 

Behavioral Therapy (TF-CBT)

TF-CBT is a treatment designed to help 

children, adolescents, and their parents to 

overcome the negative effects of trauma. The 

model blends fundamentals of CBT with 

traditional child abuse therapies, thereby 

enabling clients to regain trust and a personal 

sense of integrity. It targets the symptoms, such 

as intrusive thoughts of the traumatic event, 

avoidance, and trouble sleeping or 

concentrating that are characteristic of posttraumatic stress disorder.

EvidenceBased52

Cuyahoga County

Grand Forks

Shelby County

Structured Psychotherapy for 

Adolescents Responding to 

Chronic Stress (SPARCS)

SPARCS is a group intervention specifically 

designed to address the needs of chronically 

traumatized adolescents who may still be living 

with ongoing stress and experiencing problems 

in their adjustment. Goals of the program often 

focus on affect regulation, self-perception, 

coping and relationship building while also 

reducing somatization, dissociation, avoidance, 

and hopelessness. SPARCS draws heavily from 

cognitive-behavioral and dialectical behavior 

therapy concepts and techniques.

Promising53 Cuyahoga County

Grand Forks

Sweat Lodge

Traditional native ceremonies for wiping the 

trauma (e.g., through heat, prayer, and sage 

plants) from a child.

Community 

Validated54

Rocky Boy

Rosebud

Multisystemic Therapy (MST)

MST is an intensive family- and communitybased treatment that addresses the multiple 

determinants of anti-social behavior in 

adolescents. As such, MST treats the factors 

(e.g., family, school, peer group, community, 

etc.) that contribute to behavior problems. On a 

highly individualized level, treatment goals are 

developed in collaboration with the family, and 

EvidenceBased56 Cuyahoga County

 

52 Studies that demonstrate the effectiveness of TF-CBT include: A) Deblinger E, Lippman J, and Steer R. (1996) 

“Sexually Abused Children Suffering From Posttraumatic Stress Symptoms: Initial Treatment Outcome Findings.”

Child Maltreatment 1(3):10–21; B) Cohen J, Deblinger E, Mannarino A, and Steer R. (2004) “A Multisite 

Randomized Trial for Children With Sexual Abuse–Related PTSD Symptoms.” Journal of the American Academy 

of Child and Adolescent Psychiatry, 43:393–402. 

53 For SPARCS research, see, for example: A) Weiner D, Schneider A, and Lyons J. (2009) “Evidence-based 

treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes.” Children and 

Youth Services Review, 31:1199-1205; B) Habib M, Labruna V, and Newman J. (2013) “Complex histories and 

complex presentations: Implementation of a manually-guided group treatment for traumatized adolescents.” Journal 

of Family Violence, 28:717-728.

54 See A) McCormick RM. (1997) “Healing through Interdependence: The Role of Connecting in First Nations 

Healing Practices.” Canadian Journal of Counselling, 31(3):172-184; B) Colmant SA and Merta RJ. (1999) “Using 

the sweat lodge ceremony as group therapy for Navajo youth.” The Journal for Specialists in Group Work, 24:55-

73; C) Gossage JP et al. (2003) “Sweat lodge ceremonies for jail-based treatment.” Journal of Psychoactive Drugs, 

35(1):33-42; D) Eason A, Colmant S, and Winterowd C. (2009) “Sweat Therapy Theory, Practice, and Efficacy.” 

Journal of Experiential Education, 32(2):121-136.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 24

Table 2.3 Treatment and Healing Interventions

Treatment Description EvidenceBased?

Site(s)

Implementing

family strengths are used as levers for family 

change.55

Parent-Child Interaction 

Therapy (PCIT)

PCIT provides coaching to parents and other 

caregivers who want to help their children to 

learn how to relate and behave better. Discipline 

skill building and coached parent/caregiverdirected play occur with the assistance of a 

PCIT therapist. Parent/caregivers are also given 

a homework assignment after each session to 

practice PRIDE skills (praise, reflect, imitate, 

describe, enthusiasm) with children every day 

for 5-10 minutes.

EvidenceBased57 Cuyahoga County

Kids Club

Kids Club is a nine-week preventative 

intervention designed to address children’s 

knowledge, attitudes, and beliefs about family 

violence, reduce behavioral adjustment 

problems, and teach them safety and conflict 

resolution skills and the ability to identify and 

regulate emotions related to violence.

Promising58 Shelby County

Attachment, Self-Regulation, 

and Competency (ARC)

ARC is a comprehensive framework for 

intervention with youth exposed to complex 

trauma. It identifies 3 core principals of 

understanding trauma: trauma derails healthy 

development; trauma does not occur in a 

vacuum, not should service provision; and good 

intervention goes beyond individual therapy. 

Promising59 Boston

 

56 Studies that demonstrate MST’s effectiveness include: A) Timmons-Mitchell J, Bender MB, Kishna MA, and 

Mitchell CC. (2006) “An Independent Effectiveness Trial of Multisystemic Therapy with Juvenile Justice 

Youth.” Journal of Clinical Child and Adolescent Psychology, 35(2):227-236; B) Borduin C, Mann BJ, Cone 

LT, Henggeler SW, Fucci BR, Blaske DM, and Williams RA.(1995) “Multisystemic Treatment of Serious Juvenile 

Offenders: Long-Term Prevention of Criminality and Violence.” Journal of Consulting and Clinical Psychology, 

63(4):569-578. 

55 Though designed to directly address trauma, MST was chosen because, for some individuals, before trauma can 

be addressed, the family and home environment needs to be stabilized. For these individuals, MST may be an 

important first intervention to reduce out-of-home placements such as incarceration, residential treatment, and 

hospitalization. Staff members understand that after a young person completed MST, he or she may need to be 

referred to a second intervention to address trauma symptoms. 

57 Studies that demonstrate PCIT’s effectiveness include: A) Chaffin M, Silovsky J, Funderburk B, Valle LA, 

Brestan EV, Balachova T, et al. (2004) “Parent-Child Interaction Therapy with physically abusive parents: Efficacy 

for reducing future abuse reports.” Journal of Consulting and Clinical Psychology, 72(3):500-510; B) Schuhmann 

EM, Foote RC, Eyberg SM, Boggs SR, and Algina J. (1998) “Efficacy of Parent-Child Interaction Therapy: Interim 

report of a randomized trial with short-term maintenance.” Journal of Child Clinical Psychology, 27(1):34-45.

58 For Kids Club research, see Graham-Bermann S, Lynch S, Banyard V, Devoe E, and Halabu H. (2007) 

“Community based intervention for children exposed to intimate partner violence: An efficacy trial.” Journal of 

Consulting and Clinical Psychology, 75:199-209.

59 For ARC research, see, for example: Arvidson J, Kinniburgh K, Howard K, Spinazzola J, Strothers H, Evans M, 

Andres B, Cohen C, & Blaustein M. (2011) “Treatment of complex trauma in young children: Developmental and 

cultural considerations in application of the ARC intervention model.” Journal of Child & Adolescent Trauma, 

4(1):34-51.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 25

Table 2.3 Treatment and Healing Interventions

Treatment Description EvidenceBased?

Site(s)

Implementing

Thus, three core domains are addressed: 

attachment, self-regulation, and competency.

Child Parent Psychotherapy 

(CPP)

CPP involves the restoring the child and parent 

relationship as a means of improving the child’s 

sense of safety, attachment to the parent, and 

their cognitive, behavioral, and social 

functioning. Parents work on their negative 

associations with their child and maladaptive 

parenting strategies.

EvidenceBased60 Shelby County

Eye Movement Desensitization 

and Reprocessing (EMDR)

EMDR is a psychotherapy used to treat posttraumatic stress disorder (PTSD), where the 

patient’s traumatic memories are treated with 

rapid eye movement.

EvidenceBased61 Grand Forks

Restorative Justice Program

RJ involves a face-to-face meeting between the 

victim and the offender to discuss a violent 

incident and focuses on repairing the harm 

between the parties involved in a dispute 

through understanding each other’s sides rather 

than solely punishing offenders.

No Grand Forks

Challenges Related to Treatment and Healing 

Across sites, there were two primary lessons. First, although programs may assess and connect a 

family to an appropriate intervention to address a child’s trauma, it is common for families to 

drop out or refuse services. This happens for multiple reasons, but for many of the evidencebased or promising treatments described above, time commitment is the primary issue. Once 

families see how long treatment will take—usually somewhere between three and six months—

they often feel they cannot commit to the therapy. While research has shown these treatments to 

improve outcomes for participants, these results can only be expected if participants complete the 

program. This finding regarding the importance of program completion may also indicate that 

sites should include brief treatment modalities as options, in addition to longer term programs—

recognizing that high retention rates in longer-term programs may be difficult to maintain. 

The second lesson relates to the need for continuous training. When choosing the different 

treatments described above, the local Defending Childhood sites needed to provide training for 

clinicians who had not previously used these treatments. This was an upfront cost for the sites. 

 

60 Studies that demonstrate CPP’s effectiveness include: A) Lieberman AF, Van Horn PJ, & Ghosh Ippen C. (2005) 

“Toward evidence-based treatment: Child-Parent Psychotherapy with preschoolers exposed to marital violence.”

Journal of the American Academy of Child and Adolescent Psychiatry, 44:1241-1248; B) Cicchetti D, Rogosch FA, 

& Toth SL. (2006) “Fostering secure attachment in infant in maltreating families through preventive interventions.”

Development and Psychopathology, 18: 623-650.

61 Studies that demonstrate EMDR’s effectiveness include: A) Soberman G, Greenwald R, and Rule D. (2002) “A 

controlled study of eye movement desensitization and reprocessing (EMDR) for boys with conduct problems.”

Journal of Aggression, Maltreatment, and Trauma, 6:217-236; B) Ahmad A, Larsson B, and Sundelin-Wahlsten V. 

(2007) “EMDR treatment for children with PTSD: Results of a randomized controlled trial.” Nordic Journal of 

Psychiatry, 61:349-54.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 26

However, for some of the therapists, there was a lack of job security given the finite nature of the 

grant funding, leading them to look for other positions. This staff turnover not only left gaps in 

service capacity, but also required the sites to reallocate funds in order to train new staff. 

Community Awareness and Education 

Community awareness and education seeks to increase knowledge of children’s exposure to 

violence and available resources and services. The audiences for these campaigns tended to fall 

into two categories: the general public and professionals who work with children and youth. 

Subject matter of the campaigns tended to fall into two categories as well: information about the 

existence of the local Defending Childhood initiative and the services it could offer, and 

information about violence exposure and its impact. All sites had either a website or Facebook 

page where they would post information and upcoming events, and some hired a local public 

relations agency to help spread their message. While for some sites (e.g., Cuyahoga County), 

community awareness and education programming was limited, for others (e.g., Rocky Boy) it 

was a primary component. Table 2.4 provides a summary of the awareness activities for each 

site. 

A few sites had unique strategies for discussing violence, including. 

 “The Halls” Web Series in Boston: Boston’s web series, “The Halls,” was accompanied 

by a massive marketing campaign that included advertisements throughout the city of 

Boston. The web series and its advertisements were intentionally developed to feel 

different from a public service announcement. Instead, they resemble standard television 

show advertising and do not include any Defending Childhood logos or discussion about 

violence; the goal was to speak to young people using language and media they would 

respond to. The web series attracted 12,500 clicks for its first episode. 

Table 2.4 Community Awareness and Education Activities by Site

Site Examples of Awareness Activities

Boston, MA

 Supported youth leaders in developing and leading

education and organizing projects to promote healthy teen 

relationships in their neighborhood. These projects 

included workshops, public service announcements, and 

public dialogues.

 Created a web series (“The Halls”) designed to engage 

young men in a conversation to end violence, particularly 

gender-based violence against women and girls. The 

series consisted of professional television-style episodes 

that told the stories of three young men in Boston and 

their struggles through relationships, trauma, masculinity, 

and identity.

Cuyahoga County, OH

 Held a neighborhood-based “We Have the Power to Stop 

the Violence!” youth art contest.

 Held a broad campaign to let the county know that they 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 27

could call 211 to get help for children who have been 

exposed to violence.

Grand Forks, ND

 Created banners and displayed them at local sporting 

events, as well as banners for sexual assault awareness 

and child abuse awareness months.

 Had a bus wrap about the initiative on a highly visible city 

bus route.

 Distributed window cling decals with the initiative’s 

name.

 Distributed flash drives to local service providers that 

stored important information about the initiative.

 Developed a “Winners Way” campaign as a code of ethics 

for fans at sporting events, especially at the high school 

level.

 Filmed a public service announcement that was shown at 

local sporting events and at the movie theater.

 Created a website for practitioners that gave them access 

to information about children’s exposure to violence.

Rocky Boy’s Reservation, 

MT

 Developed and distributed items (e.g., t-shirts, backpacks, 

bumper stickers, water bottles) with the project’s logo.

 Held Family Fun Nights and Cultural Fairs.

 Hosted Community Summits for practitioners.

 Organized Awareness Walks.

 Created and distributed brochures and information cards, 

varying in topic and design, for distribution at events such 

as family fun nights. All publications contain information 

about the project itself, as well as awareness information 

about the central topic of the document (e.g., violence or 

bullying).

Rosebud Sioux Tribe, SD

 Made presentations about the project in schools and in the 

different communities on the reservation.

 Hosted a weekly radio show to discuss relevant topics.

Shelby County, TN

 Created a trifold brochure (including a Spanish 

translation) to be handed out by first responders when 

they respond to a domestic violence call.

 Hosted community fairs and monthly meetings in targeted 

apartment complexes.

 Developed a password-protected portal for professionals 

that gave them access to webinars and training materials 

on topics related to children’s exposure to violence.

 Sports-based Public Awareness Campaign in Grand Forks: Grand Forks created a public 

service announcement (PSA) that involved sporting references—sports are a significant 

part of life for residents in Grand Forks. The PSA was shown at the local cinema before 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 28

each movie. Additionally, some of the campaign focused on positive messaging as 

opposed to using words such as “don’t” and “violence.” For example, their Winner’s 

Way campaign used the slogan “We like to win, and the way we win matters.” The 

message was: “WE are the team. RESPECT the effort. EVERYONE has a role. It’s the 

WINNER’S WAY.” The awareness campaigns in Grand Forks further reinforced the 

universal prevention messages that the children were receiving in schools. 

Challenges Related to Community Awareness and Education 

The rural nature of the two reservations and parts of Grand Forks County made dissemination of 

information challenging. This problem was especially pronounced during wintertime, when 

snowstorms rendered certain areas inaccessible. 

In addition to the challenges of geography, community awareness activities faced obstacles 

related to the nature of the Defending Childhood Initiative as a federally funded demonstration. 

In particular, the sites encountered many federal restrictions on publications, distributed 

materials, social media posts, and public messaging. Many of these had to receive approval from 

OJJDP before dissemination. This approval process could take anywhere from weeks to months. 

In an age where social media outlets such as Facebook, Twitter, and YouTube require real-time 

postings and interactions, this approval process was frustrating and limiting, especially to 

contracted public relations firms who were not used to working within such restrictions. As one 

person put it: “How do we plan ahead for our spontaneous tweets two months from now?” 

Staff at all sites found that there was a need to provide food at community events. Gathering 

around food is culturally important for many ethnic groups in particular. Additionally, in order to 

accommodate work schedules, many times these events are offered in the evening around 

dinnertime. Staff and stakeholders reported feeling hindered by federal restrictions that do not 

allow grant funds to be used for food. 

Professional Training 

All sites offered training to local professionals who work with children and youth on issues 

related to children’s exposure to violence. The audience for these trainings included social and 

human service agencies, social workers, childcare workers, educators, healthcare staff, attorneys, 

court personnel, faith and traditional leaders, and law enforcement officials. Topics included: 

 The effects of trauma on children; 

 Wraparound services; 

 Resiliency factors for children and parents in domestic violence situations; 

 Confidentiality and sharing information and data across systems; 

 Sexual abuse; 

 Trauma-informed care; 

 How to use screening tools;

 Compassion fatigue; and 

 Specific evidence-based or promising treatments such as Trauma-Focused Cognitive 

Behavioral Therapy and Structured Psychotherapy for Adolescents Responding to 

Chronic Stress.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 29

Table 2.5 provides counts of the number of professional trainings each site offered and the 

number of individuals trained between October 2011 and September 2014. 

Table 2.5 Professional Trainings by Site

Site # of Trainings Held # of Individuals Trained

Boston, MA 34 1,006

Cuyahoga County, OH 42 798

Grand Forks, ND 116 1,534

Rocky Boy’s Reservation, 

MT 8 213

Rosebud Sioux Tribe, SD 26 773

Shelby County, TN 407 5,414

TOTAL 633 9,738

The Boston Learning Communities Model 

The Boston site took a comprehensive approach to training, focusing on training a smaller 

number of people in depth through learning communities, which require clinicians to make a 

longer-term commitment (18 months) in the hopes that it will lead to institutional adoption of 

best practices. Learning communities involve two-to-four in-person training sessions and 24 case 

conferencing and supervision phone calls. Boston created three of these communities on mentalhealth interventions for children exposed to violence: Trauma-Focused Cognitive Behavioral 

Therapy; Child Parent Psychotherapy; and Attachment, Self-Regulation, and Competency. 

Eligible clinicians had to have a master’s degree and some practical experience. 

Challenges Related to Professional Training 

For many of the sites, it took quite some time to get training efforts off the ground. Two reasons 

were the lack of staff dedicated to training and the local and federal approval process. For 

example, at the Boston site, it took much longer than anticipated to hire someone due to the 

hiring restrictions (e.g., must be a city resident) of the Boston Public Health Commission, as well 

as the finite nature of the federal grant, which meant that good people were less likely to apply 

due to the lack of job security. At the Grand Forks site, staff put together many training 

presentations on various topics, but it took many months to get these presentations approved by 

OJJDP. As with several of the barriers to community awareness campaigns, the OJJDP-related

restrictions were only a barrier in the context of the Defending Childhood federal grant process 

and would not apply to a jurisdictions seeking to replicate strategies with local funding sources. 

Limited options exist for trainings that cut across the various types of children’s exposure to 

violence; in many cases, training options are narrow in scope and only address one type of 

violence. Some existing trainings may not span the full range of childhood (ages 0 to 18) and 

some of the sites had to adapt or develop new training curricula to address their needs. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 30

Across all sites, staff also expressed the need for consistent trainings for new staff due to high 

turnover rates at social service agencies, as well as booster trainings for previously trained staff. 

These needs proved difficult to meet, however, because of insufficient monies budgeted to 

training. Transforming entire organizations and agencies to be trauma-informed may be the most 

successful approach for sustainability. 

System Infrastructure and Capacity Building

System infrastructure changes varied by site, and not all sites devoted resources to making these 

changes. Table 2.6 summarizes activities in each site.

Table 2.6 System Infrastructure and Capacity Building

Site Activity

Boston, MA  Provided recommendations to the Massachusetts Departments of 

Public Health and Early Education and Care to include standards and 

guidelines for early education sites, home visiting, and early 

intervention programs in order to improve the identification of 

children exposed to violence and trauma-informed responses.

 Developed a briefing document and supporting materials that were

sent to the Massachusetts Department of Public Health and the 

Prevention Trust Fund to make the case to include exposure to 

violence as a preventable and prevalent health condition and to 

recommend evidence-based practices for addressing violence and 

trauma.

 Worked with the Boston Police Department to update incident 

reports to include a check box to indicate if a child has witnessed 

domestic or community violence.

 Implemented an intensive, long-term, training curricula for local 

child care organizations to become trauma-informed 

Cuyahoga County, 

OH

 Created a streamlined service system that involved moving children 

from screening to assessment to treatment in a systematic way, 

involving major systems (e.g., court, child welfare agency) doing 

screening and referring children to one central location (Central 

Intake and Assessment) for assessment.

Rosebud Sioux, SD  Revised tribal legislation and policy to be more responsive to 

children’s exposure to violence, providing the tribal council with 

suggested amendments to the Child Protection Code. 

Shelby County, TN  Built and implemented a shared data management system that allows 

partner agencies to, after signing Memorandums of Understanding, 

be able to share client data if their clients sign a Release of 

Information. This allows agencies to search the system to see if a 

client they are encountering for the first time has had previous 

interactions with a Defending Childhood partner agency.

Challenges Related to System Infrastructure and Capacity Building 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 31

One of the major lessons learned relates to fully understanding federal laws that regulate the use 

and disclosure of protected health information (e.g., the Health Insurance Portability and 

Accountability Act). Many believe this act completely prevents data sharing; it does not, but 

certain memorandums of understanding and releases of information must be in place. 

Additionally, it is important to understand state statutes regarding sharing of information (e.g., 

police investigative reports) so as to avoid creating something that could lead to unintended 

consequences. For example, in some states a police report is automatically public record, and any 

changes to a police report (e.g., adding space to discuss whether children were present during a 

domestic violence incident) may be increasing risk to victims by making their address public. It 

is also important to understand the unintended risks to victims in subsequent family matters or 

child protective proceedings. The lesson is to fully understand the necessary components to 

tracking and sharing certain data, and the potential unintended consequences of doing so. 

Collaborative Bodies 

Every Defending Childhood site assembled a collaborative body, as required by their grants. 

These bodies varied in size, with the smallest having 12 partners and the largest having over 65. 

In general, all of the sites ensured that key public health, law enforcement, social service, and 

education stakeholders participated. Table 2.7 provides details on the collaborative bodies at all 

of the sites. 

In some sites, organizations that had previously never worked together collaborated to make 

Defending Childhood happen. In other sites, especially Boston, Cuyahoga County, and Shelby 

County, there was a long history of interagency collaboration. 

Role of External Consultants and Researchers 

Two of the sites (Cuyahoga County and Shelby County) chose to hire an external consultant to 

drive the planning phase and early implementation. The consultant was reportedly able to see 

“big picture” issues when the collaborative body members would at times get “stuck in the 

weeds.” 

Additionally, Cuyahoga and Shelby, as well as Grand Forks, had early involvement of local 

research partners, who helped provide data to inform the focus of the initiatives. These 

researchers conducted community needs assessments during Phase I that helped inform their 

site’s program model design and geographic target areas. Additionally, researchers helped collect 

local implementation data that was fed back to the initiative to inform and improve programming 

in real-time. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 32

Table 2.7 Collaborative Body and Management Across Sites

Site

Number of 

Collaborative 

Body 

Members

Core 

Management 

Team

Governance/

Leadership 

Team

Formal Subcommittees

Boston, MA 65 

organizations Yes Yes None (some put together on ad-hoc basis)

Cuyahoga 

County, OH

60 

organizations Yes Yes

1) Services

2) Policies & Procedures

3) Training

4) Data & Evaluation

5) Community Engagement, Awareness & 

Prevention

6) Funding & Sustainability

Grand Forks, 

ND

40 

organizations; 

91 participants

Yes Yes

1) Stakeholders

2) Prevention (3 working groups)

3) Intervention (3 working groups)

4) Data (1 working group)

5) Rural Coalition

6) Healthy Families Advisory Committee

Rocky Boy’s 

Reservation, 

MT

12 

organizations No No None

Rosebud Sioux, 

SD 9 organizations No No None (some put together on ad-hoc basis)

Shelby County, 

TN

30 

organizations; 

80 participants

Yes No

1) Transforming Cultural Norms

2) Building Child and Family Resiliency

3) Screening and Referral for Children 

Suspected of Having Been Exposed to 

Violence

4) Identification, Linkage, Referral for Children 

Who Have Been Direct Victims of Violence

5) Identification, Linkage, Referral for Children 

Who Have Been Exposed of Violence

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 33

The Risk of Collaboration Fatigue 

Having multiple collaboratives with many of the same players can lead to “meeting fatigue” or 

“collaborative fatigue.” In many cases, collaborative body members were pulled in several 

directions and were attending meetings for similar or overlapping initiatives, many of which are 

federally-funded (e.g., National Forum on Youth Violence). As the initiative matured, some sites 

chose to merge similar collaborative bodies or fold Defending Childhood into a preexisting one. 

Nonetheless, across all sites, there remained a real need to think creatively about how to keep 

organizations and their representatives engaged throughout implementation. Some organizations 

that were represented on the collaborative body early on became less interested once their 

programming did not receive funding or support. 

Including the Voice of Local Communities, Parents, and Youth 

At nearly all of the sites, staff and stakeholders repeatedly mentioned community buy-in as vital. 

Some sites partnered with local organizations in order to achieve additional buy-in and to include 

youth and parent voices with a deep understanding of the complex cultural and social context of 

the community. 

Local Politics 

Local politics can serve as both a barrier and a facilitator to implementing any large-scale 

initiative, and indeed, that was the case for the Defending Childhood sites. For some sites, early 

support from political leaders helped push implementation along, generating political will and 

mandates “from above.” In Cuyahoga County, for example, turnover in county leadership, 

particularly within Public Safety and Justice Services (where the local Defending Childhood 

Initiative is anchored), presented a challenge. Part of the decision to embed the initiative within 

the county was for sustainability purposes, but the original leaders who had children’s exposure 

to violence constantly on their radar left, and the staff had to start over with new executives.

While the new leadership has been supportive, it has been time-consuming to bring new leaders 

up to speed. 

The Rosebud site faced challenges related to local tribal politics. The person who was the tribal 

council president at the start of the project fully supported the initiative. However, elections saw 

a change in tribal council administration, and when the new president came on board, he wanted 

to replace Defending Childhood staff. 

A few of the urban sites had originally worked to develop relationships with the major school 

districts in their counties, but district mergers and turnover made it hard to consistently have the 

right people at the table. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 34

Tribal Sites and Tradition 

The Chippewa Cree Tribe of Rocky Boy’s Reservation has an estimated population of 3,500 

tribal members, while the Rosebud Sioux Tribe has a population of over 24,000 members on 

Rosebud Reservation. Both reservations are rural in nature, with large expanses of land but few 

residents. However, Rocky Boy’s Reservation is much smaller, with about 140 square miles 

compared to over 1,400 square miles at Rosebud. The two tribes have different languages and 

customs; their tribes have different laws and community norms. 

Despite these differences, both tribal sites emphsized a return to tradition and culture as 

protective factors. At Rosebud, the Lakota way of life, or Lakal Wicohan, was incorporated into 

all the work of the Rosebud Defending Childhood Initiative. This approach manifested itself in 

multiple ways. For instance, service recipients are referred to as relatives, not clients. 

Collaborative meetings begin and end with saying “Mitakuye oyasin,” Lakota for “all my 

relatives,” reflecting their belief in the interconnectedness of all forms of life. Voluntary services 

offered included Wopakinte, a spiritual cleansing in the form of a sweat. Project staff attended a 

Lakota mental health first aid training to help guide their treatment and healing work. There are 

future plans for offering a Lakota naming ceremony for young people who do not have Lakota 

names. 

Similarly, at Rocky Boy’s Reservation, the staff focused on culture and language as central to 

their efforts. They stated, “Culture is prevention. Culture is unity. Culture is identity.” The 

project puts a quote from Chief Rocky Boy at the center of its work: “Love one another and take

care of each other.” The philosophy of their initiative centers around the belief that a return to 

Chippewa Cree culture, tradition, and language is a protective factor for families and children on 

the reservation. At least one of the advocates is trained in traditional forms of healing (e.g., 

smudging and sweat lodges), and the staff incorporates song, dance, drumming, and prayer in 

their programming. The staff open meetings and events with prayers and sweet grass and use 

sage to cleanse and clarify the mind, body, and soul. At their community events, they incorporate 

traditional healing and ceremonial practices, spirituality, arts and crafts, tribal stories, native 

language, and native plants.

Tribal and Non-tribal Sites 

The tribal communities have suffered from decades of trauma. Federal policy has historically 

disrupted the cultural and familial ties of the native communities. Many of the non-tribal sites are 

home to large African-American populations who have also suffered historical trauma related to 

federal policy. Both of these populations are disproportionately represented in the criminal 

justice and child welfare systems. They also have a distrust of law enforcement, service 

providers, and researchers. Both communities also have a long history of oral tradition and 

storytelling and non-nuclear family models. For future initiatives that bring tribal and non-tribal 

sites together, it may be worth intentionally highlighting similarities in cultural norms and 

historical struggles. 

Urban and Rural Sites 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 35

Three of the sites, Boston, Cuyahoga County (which encompasses Cleveland), and Shelby 

County (which encompasses Memphis) can be described as large urban areas, and the remaining 

three, including the two tribal sites, are more rural (although Grand Forks does have a small city, 

the full county has many rural areas). Vast differences exist between implementing programming 

in urban areas and rural ones, many of which involve the challenges of access to services, 

especially during inclement weather. 

While the grantees each had a deep understanding of their respective environments, those in rural 

areas felt that they were not learning from the national dialogue on violence, which tended to 

focus on urban issues. Additionally, as Defending Childhood grantee all-sites meetings started 

becoming combined with all-sites meetings for other Department of Justice violence-related 

initiatives such as the National Forum on Youth Violence, which focuses on gang violence in 

urban areas, representatives of the rural sites felt more and more left out of the conversation. 

As discussed further in Chapter 3, one of the technical assistance providers highlighted the need 

for more intensive technical assistance in rural areas. 

Evidence-Based and Promising Practices 

Since the inception of the Defending Childhood Initiative, emphasis has been placed on the use 

of evidence-based or promising practices to address children’s exposure to violence. Most sites 

used the National Child Traumatic Stress Network (NCTSN) as a resource, which focuses on 

empirically supported and/or promising treatment practices. The most commonly used practice 

across the sites was Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). 

Despite the emphasis on evidence-based practices, nearly every site used additional programs 

that were not evidence-based. At one site, staff stated that the requirement to focus on evidencebased practices hampered innovation and that working with new and promising programs could 

be important for learning more about what works in the field of children’s exposure to violence. 

Additionally, some stated that while a program could be evidence-based, it may not be applicable 

to the populations that the sites are working with. 

One of the lessons learned from the implementation of the Defending Childhood Demonstration 

Program is that it may be challenging to engage children who have been exposed to violence for 

the full length of time that many evidence-based treatments require. Sites might have benefited 

from clearer information regarding what makes an approach evidence-based and the functions 

and limits of evidence-based treatments. 

The two tribal sites adopted several well-established approaches within tribal communities that 

only have local community validation as their evidence base. The NCTSN does highlight some 

promising practices for use by tribal communities, including: 1) Honoring Children, Making 

Relatives for ages 3 to 7; 2) Honoring Children, Mending the Circle for ages 3 to 18; and 3) 

Honoring Children, Respectful Ways for ages 3 to 12. These programs are adaptations of TFCBT. The Rocky Boy’s initiative utilized the Medicine Wheel Model, which is considered to be 

a promising practice, and Honoring Children, Mending the Circle. The medicine wheel model is 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 36

used to address trauma and events that have affected American Indians.62 Going forward, it is 

worth exploring: 1) greater incorporation of promising practices at tribal sites; or 2) further study 

of other potentially innovative practices and methods that target tribal populations.

Adaptions and Fidelity 

When evidence-based or promising program models are selected for implementation, one key 

consideration is program fidelity. Program fidelity refers to the degree to which the delivery of 

the program adheres to the model as intended by the program developers. 

In many situations, programs may deviate from the model because of context, target population, 

staff, or other important reasons. Program adaptations are often deemed necessary by 

practitioners in order to make the program more suitable for a particular population. In fact, 

recognizing the importance of adapting evidence-based programs for local context, the U.S. 

Department of Health and Human Services’ Office of Adolescent Health and the Centers for 

Disease Control and Prevention’s Division of Reproductive Health have developed guidelines to 

help local organizations adapt adolescent reproductive and sexual health evidence-based 

programs.63

In Boston, the Coaching Boys into Men curriculum was adapted extensively to make it more 

appropriate for a different age group and for the inclusion of girls. Working closely with the 

program developers, the adaptations involved the incorporation of components of two other 

programs and resulted in a new version of the program, titled “Boston’s Coaching Boys into 

Men”, that was believed to be the best fit for the target audience. In Grand Forks, 

implementation of school-wide universal prevention led to the adaptation of some evidencebased programs-- particularly during its second year of implementation--in order to ensure that 

lessons on topics such as bullying continued to resonate with students, who otherwise might be 

disengaged because of having been exposed to the same lesson plans and activities the previous 

year. 

Program fidelity is most accurately measured across five areas: program adherence, quality of 

delivery, program exposure, participant responsiveness, and program differentiation.64 Only an 

appropriate evaluation of the fidelity of the program or intervention can produce an assessment 

of the impact of the adaptations on outcomes. Absent such formal fidelity assessments, it cannot 

be determined whether any observed impact, or lack thereof, is attributable to the adaptations, 

implementation factors, program design, or other issues. 

 

62 Gray JS and Rose WJ. (2011) “Cultural Adaptation for Therapy with American Indians and Alaska Natives.” 

Journal of Multicultural Counseling and Development, 40:82-92.

63 More information about these adaptations specifically can be found at: 

https://preventyouthhiv.org/content/promoting-evidence-based-approaches-adaptation-guidelines

64 For more information on evaluating fidelity, please see: A) Mowbray CT, Holter MC, Teague GB, and Bydee D. 

(2003) “Fidelity Criteria: Development, Measurement, and Validation.” American Journal of Evaluation, 24:315-

340; B) Durlak JA and DuPre EP. (2008) “Implementation Matters: A Review of Research on the Influence of 

Implementation on Program Outcomes and the Factors Affecting Implementation.” American Journal of Community 

Psychology, 41:327-350; and C) Fagan AA, Hanson K, Hawkins JD, and Arthur MW. (2008) “Bridging Science to 

Practice: Achieving Prevention Program Implementation Fidelity in the Community Youth Development Study.” 

American Journal of Community Psychology, 41:235-249.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 37

Place-Based v. City/County-wide Strategies 

The four non-tribal sites took two distinct approaches in terms of targeting. Two sites chose to 

focus their work throughout their whole jurisdictions (Grand Forks, Cuyahoga County) and two 

sites (Boston, Shelby County) chose to target select high-risk neighborhoods for most 

programming. 

There are advantages and disadvantages to each approach. Choosing to target a whole 

jurisdiction may seem like a daunting task for large cities, especially when the goal is to reduce 

violence across that whole geographic area. However, if the strategies include creating citywide 

or countywide infrastructure, the initiative may be sustainable after grant funding ends. 

Further, if the jurisdiction is small enough and the local school district is willing to be a partner, 

prevention programming can potentially reach nearly all children and youth in the community. 

Universal prevention may be especially desirable if the types of violence that are most prevalent 

are teen dating violence and bullying. In-school prevention programs may also be sustainable 

after grant funding ends, given low costs after initial expenditures on curricula and training. 

In many cases, it may make more sense to offer targeted efforts in select neighborhoods that are 

disproportionately affected by violence. In large urban environments, where one neighborhood 

may be very different from the next, needs and strategies may vary for each area. However, this 

means that some children who do not live in the targeted neighborhoods but who have been 

exposed to violence may not be reached. 

Silos 

The Defending Childhood Initiative is one of the few national programs to look at all different 

types of violence—domestic violence, community violence, teen dating violence, bullying, child 

abuse and neglect—and to try to encourage public health, law enforcement, education, and social 

services to work together. The formation of collaborative bodies to encourage collaboration 

among disciplines that usually work in silos was a great accomplishment. However, early on in 

the initiative, federal funding streams forced some of the demonstration sites to rebuild these 

silos in specific, prescribed ways. For example, in early collaborative meetings, the collaborative 

bodies at each site made decisions about which types of projects to fund based on community 

need. However, when the sites were to start implementation, they were notified that some of their 

grant money would be coming from the Office of Violence Against Women, which required 

them to spend a portion of their money specifically on domestic violence direct service work.

This change was problematic because collaborative bodies had to develop new plans and budgets 

with more restrictions, which those at some sites felt worked counter-productively to rebuild the 

silos between domestic violence and community violence that they had worked so hard to tear 

down. 

Transitions: Technical Assistance Providers and Federal Grant Managers 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 2. Cross-Site Themes and Lessons Learned Page 38

In Phase I (October 2010 – September 2011) of the Defending Childhood Demonstration 

Program, sites were tasked with conducting a community needs assessment and developing a 

strategic plan. Strategies were chosen, and, in some cases, funding allotments were made 

collaboratively through a consensus process. During Phase I, the technical assistance (TA) 

provider was JBS International, Inc. However, OJJDP awarded the technical assistance grant for 

Phase II (beginning October 2011) to Futures Without Violence. The new TA provider needed to 

spend time developing relationships at a critical point in implementation. As one project director 

stated: 

The first TA provider we had a relationship with. The new group comes in and is like, 

‘Let’s get to know each other’ as we’re trying to hold our head above water trying to 

implement our system. We were at different places. Now we’re coming closer together 

but during that transition, we were on different tracks. We’ve already done that. We went 

through a long community process, made our decisions; we can’t go back and change 

things. 

Another project director stated, “I don’t think this was ever explicitly stated, but Futures always 

seemed to be several steps behind what was actually needed in regards to training and webinars.” 

Some said that the Center for Disease Control’s Science of Implementation training that Futures 

Without Violence invited them to was extremely helpful, but it happened in March 2014—three 

years after implementation began. 

These sentiments were less a reflection on Futures Without Violence, whom the sites identified 

as helpful, than an indication of the difficulty in changing TA providers at a critical juncture of 

the initiative. As part of this transition, the new TA provider had to spend necessary time getting 

to know the sites—and the strategic plans that each site had already forged in Phase 1. Futures 

Without Violence staff expressed similar sentiments. 

There were transitions at the federal level as well. Years into implementation, a reorganization at

OJJDP led to a change in grant managers for the sites. Similar to the change in TA provider, it 

took a while for the new grant mangers to establish relationships with the sites. Trust is often a 

crucial element during the startup of new and complicated initiatives. While staff transition is 

inevitable (and often a good thing), federal funders might consider how best to manage changes 

in personnel to minimize disruptions for sites. This might include creating systems to pass along 

historical knowledge to new grant managers and TA providers and creating opportunities for 

new personnel to interact informally with sites (not just on site visits or training sessions). 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 39

Chapter 3

Recommendations 

This chapter highlights recommendations for jurisdictions that want to address children’s 

exposure to violence. The chapter also provides recommendations for funders, technical 

assistance providers, and researchers. Some recommendations are specific to multi-pronged 

efforts to address children’s exposure to violence, whereas others may have broad applicability 

to analogous large-scale, multi-site, independently funded and evaluated justice initiatives. The 

58 total recommendations were developed both through interviews (staff and stakeholders at 

each site were directly asked about their recommendations) and independent observations by the 

research team. 

Recommendations for Jurisdictions Interested in Replication 

These recommendations are divided into three major sections: (1) planning; (2) implementation; 

(3) sustainability. 

Planning 

1. Consider where to anchor your initiative. There are pros and cons to having the initiative 

run out of local government. The potential constraints of local government include 

residency requirements for staff, bureaucratic approval processes for spending money, 

social media restrictions, and limitations on advocacy work. The potential benefits 

include strong infrastructure to run a large initiative, and the political support that comes 

with endorsement by key local leaders (e.g., mayor). Sites may also choose to anchor 

their initiative at a community-based organization that has a longstanding history of 

addressing issues of violence (e.g., a local treatment provider). 

2. Carefully weigh the benefits and drawbacks of geographic (place-based) targeting. 

Before designing any initiative, a jurisdiction should conduct a needs assessment to 

identify high-risk communities and assess existing service capacity. In some cases it may 

make sense to target programming where there is the greatest need—neighborhoods with 

high concentrations of violence and scant services. This is especially true when resources 

are limited and need is disproportionately concentrated. In other cases, when is not 

concentrated in certain neighborhoods, it may make sense to try to reach the whole 

community (e.g., Grand Forks). Where feasible, implementing professional training (e.g., 

Boston) or jurisdiction-wide changes to policies, protocols, and processes (e.g., 

Cuyahoga) may comprise effective community-wide approaches.

3. When possible, use consensus to make decisions. Consensus and transparency in 

decision-making regarding the choice of strategies may help maintain high levels of 

active involvement among collaborative members. Additionally, when stakeholders feel 

like they have been able to voice their opinions as part of the process and can see how the 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 40

decision is made, they may be more likely to accept programmatic decisions that may not 

have been their ideas or may not provide funding to their organization.

4. Use a consultant early on to drive the planning and early implementation processes. 

Hiring an external consultant—especially one with strategic planning experience—to 

facilitate meetings and synthesize action steps can help move the initiative along early in 

the process. 

5. Involve researchers early. Bringing a local research team on board early will help 

facilitate data-driven decision making, as well as allow for collection of baseline 

information on activities that are not included in the external evaluator’s outcome 

evaluation (e.g., individual-level outcomes for young people going through a treatment 

program). For this to occur effectively, sites and federal partners will need to think 

carefully about respective roles of local research partners and national evaluators to avoid 

role confusion and duplicative work. 

6. Fully understand overlapping initiatives. Some of the Defending Childhood sites had 

other Department of Justice grants (e.g., National Forum on Youth Violence) that 

required collaborative efforts among the same community players. Others had existing 

collaborative bodies that addressed a different topic (e.g., early childhood education) but 

involved all the same health, mental health, education, and law enforcement stakeholders. 

Jurisdictions should fully understand initiatives and consider folding their new initiative 

into one of the established collaborative bodies in order to prevent collaborative—and 

evaluation—fatigue. 

7. Budget for an administrative assistant. There are many reporting requirements involved 

in such a large initiative: quarterly reports to funders, evaluators, and technical assistance 

providers. Additionally, there are many administrative tasks related to budgets, grant 

management, collaborative coordination, and hiring processes. The project director also 

has to focus on the big picture, including, planning, reporting, and high-level decision 

making. It may not be best use of the project director’s time to handle time-consuming 

tasks or direct service management, and sites should budget for an administrative 

assistant to help ease the bureaucratic burden. 

8. Create a classification system to organize types of programming. The Defending 

Childhood Demonstration Program sites’ chosen strategies fit into the following 

classifications: screening and assessment, case management and advocacy, treatment and 

healing, prevention, community awareness, professional training, and systems 

infrastructure/capacity building. Organizing activities into these or similar classifications 

may be a good way to help collaborative bodies make strategic decisions about resource 

allocation.

9. Plan for sustainability. Although sustainability recommendations are discussed in detail 

below, it is important for sites to begin thinking about sustainability at the start of the 

initiative. Early on, sites must consider how they will be able to sustain staffing and 

services beyond the length of their immediate funding, and this can often inform their 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 41

choice of strategies and programs, such as investing in large-scale systems change, 

capacity building, organizational movement to becoming trauma-informed or 

professional training. Building local and political buy-in can be instrumental to ensuring 

long-term sustainability and leverage local funds to move strategies beyond the initial 

stages. Sites should also identify funding streams available for direct service provision, 

such as health insurance, Medicaid/Medicare, or local and state funding. 

Implementation 

10. Offer home-based services to overcome transportation obstacles. Many families face 

barriers to access services, be it lack of transportation, lack of money, or lack of service 

availability in convenient or accessible geographic locations. Offering home- or schoolbased services may help reach more people than office-only services; this is particularly 

true in rural areas. 

11. Look for unique ways to leverage existing resources. Some of the Defending Childhood

sites were able to leverage available resources to disseminate information about their 

initiatives. For instance, in Shelby County, a local public relations firm was able to obtain 

a donation of flash drives, which were then loaded with Defending Childhood

information and distributed to local social service agencies. Similarly, in Grand Forks, 

the public relations team knew that advertising on local buses was an efficient, low-cost 

way to promote the initiative. 

12. Focus on the positive. Particularly for universal prevention programs that target both 

those at-risk for violence exposure and those not at-risk, jurisdictions should consider 

choosing programs that focus on healthy relationships, positive friendships, and building 

resiliency—principles reflected, for example, in the approach to prevention in Grand 

Forks. 

13. Beware of mission creep. Many people who are exposed to violence are also victims of 

associated social problems such as poverty and structural racism. While these other needs 

are important too, jurisdictions should be mindful of mission creep. This is especially true 

for sites doing place-based outreach and case management, where it is easy to shift focus 

away from addressing children’s exposure to violence to addressing issues related to 

concentrated poverty and housing instability. 

Sustainability 

14. For smaller communities, consider focusing on prevention in schools. A potentially 

effective way to ensure continued programming is for schools to be the site of prevention 

programming and initial grant funds to be spent on buying curricula and training school 

staff to run the program. These kinds of prevention efforts may subsequently be 

institutionalized at low costs. 

15. Prepare for unintended consequences. Increased awareness of children’s exposure to 

violence may lead to increases in local service utilization—more children referred to 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 42

local services, school counselors, child welfare, foster care, and the court system. This 

can place a burden on local capacity and can strain existing resources. Preparing for the 

potential for a long-term increase in service utilization and ensuring the agencies and 

organizations can take on the additional work or have access to greater resources is 

important. 

16. Promote institutional adoption of best practices. Because individual staff may not stay 

with an agency for a long period of time—indeed, there was a lot of turnover in frontline 

staff across the demonstration sites—an approach that relies on training individual staff 

may not be sustainable, as new staff will constantly have to be retrained. Therefore, when 

offering professional training, sites should focus not strictly on increasing the knowledge 

of individual staff members, but also on promoting specific outcomes for agencies, such 

as adoption of agency-wide protocols, practices, and treatment modalities. In this way, 

after grant funding ends, agencies will have already incorporated best practices into their 

organization. 

17. Focus on systems change. While funding treatment, healing, and prevention programs 

may address immediate needs, these programs may be hard to maintain after grant 

funding ends. Instead, new sites should think about systems changes that will help to 

sustain the work after grant funding has ended. Specifically, sites should consider 

emphasizing strategies such as universal adoption of tools (e.g., screeners, assessments) 

and the creation of centralized intake and referral mechanisms. Sites should also focus on 

training as a vehicle for institutionalization, as doing so may improve the capacity of 

agencies to offer specific treatments, as opposed to funding the treatment services 

themselves. 

Recommendations for Tribal Communities 

Native American and Alaskan Native communities are diverse with respect to language, culture, 

history, governance, and relationships with the United States federal government. Some tribes 

may have a history of working with the federal government; others may not be open to any 

collaboration or funding from non-tribal individuals. Many tribes are accustomed to receiving 

funding from sources such as the Bureau of Indian Affairs or the Indian Health Service; fewer 

have experience working with funders like the Office of Juvenile Justice and Delinquency 

Prevention. Many tribes around the country are considering the impact of historical trauma and 

injustice as they work through issues of violence in their communities and the lives of their 

children. 

We asked the project coordinators, staff, tribal TA providers, grant managers, and tribal leaders 

of the Chippewa Cree and the Rosebud Sioux about recommendations they may have for other 

tribal communities that aim to work on the issue of children’s exposure to violence. This is a 

summary of their recommendations, along with observations from the research team. 

1. Have faith. Working in the area of children’s exposure to violence can be challenging, 

especially in an environment where people may not understand the topic, may be in 

denial about its prevalence, or may think it is taboo to discuss. Children’s exposure to 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 43

violence is connected with other problems such as poverty, substance abuse, mental 

health issues, education, and employment. The obstacles to success can be 

overwhelming. As one tribal project coordinator stated, “Have faith that what you do will 

help people.”

2. Work together and take care of each other. Success is usually based on the collaborative 

efforts of all members of a team, who must remember they that they cannot do everything 

themselves and that they need to work together. Team members have to draw on each 

other’s skillsets. An important aspect of working as a team is self- and community-care, 

particularly for frontline staff working directly with victims. Ensuring that staff are taking 

care of themselves and feel supported is essential. Tribal teachings also say that humor is 

part of life. Although the work is obviously serious, humor can provide a way of healing 

and contribute to self-care. Another suggestion is to provide opportunities for everyone to 

come together over food, prayer, and smudging. 

3. Adopt a strengths-based approach. Typically, communities identify a problem and then 

work to address the problem using a deficit-focused perspective. Tribal communities are 

more likely to focus on the strengths of a situation which can then lead to seeking 

solutions through a collaborative and consensus building approach. A strengths-based 

approach draws on the strengths of communities in areas such as indigenous knowledge, 

the role of elders, extended families and relationship structures, and connections to nature 

and spirituality.65 One of the ways this approach was apparent in the tribal sites of the 

Defending Childhood Initiative was their focus on tribal tradition and culture as a 

protective factor for youth in their communities. 

4. Consider local politics. Multi-year, grant-funded projects often do not account for 

changing governance and local political support. Programs may be supported by one 

tribal council, but the next tribal council may have different priorities. Sites should work 

closely with their grant managers to ensure that grant-funded positions are filled with 

qualified staff and not given out as a form of payback for political support. Staff turnover 

that follows from local politics may affect staff morale, program quality, and program 

consistency. 

5. Streamline processes. While much of the onus is on the federal government to ensure 

program and staff stability, tribal communities need to reflect on how to constructively 

address the issue of ensuring continued political support and staffing for grant-funded 

opportunities that tackle issues that are important for their communities. Streamlining 

processes and ensuring accountability and transparency about funding and hiring may 

help to ensure sustainability. Another recommendation is to set up an advisory or 

decision-making board in advance of grant funding that is permanent for the length of the 

grant and that includes key tribal members who are respected and unlikely to change, 

such as tribal elders or peacemakers. If staff turnover is inevitable, some efforts can be 

made to reduce the impact, including establishing clear written protocols and procedures 

 

65 Tagalik S. (2010) A Framework for Indigenous School Health: Foundations in Cultural Principles. National 

Collaborating Centre for Aboriginal Health. Available at: 

www.nccah-ccnsa.ca/docs/nccah%20reports/nccah_cash_report.pdf. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 44

and ensuring that grant managers, TA providers, and other key individuals have detailed 

knowledge about the ongoing work. 

Recommendations for Funders 

With an initiative as comprehensive as Defending Childhood, funders face challenges ensuring 

that requirements of the larger initiative are met while providing flexibility for individual 

demonstration sites. Here we provide a summary of recommendations to funding agencies 

synthesized from the feedback of the program site staff, technical assistance providers, grant 

managers, and the research team. 

Communicate Clear and Realistic Expectations 

The sites were tasked with addressing children’s exposure to violence in three primary ways: 1) 

preventing children’s exposure to violence, 2) reducing its negative impact, and 3) increasing 

public awareness. This is a colossal ask for a two- to three-year project. Each site faced its own 

challenges, from large urban environments where it is challenging to make a citywide impact 

(e.g., Boston, Cuyahoga, and Shelby) to less populated rural areas where it is hard to reach 

people and engage them (e.g., Chippewa Cree, Grand Forks, and Rosebud). The tribal sites had 

their own additional challenges, with high rates of unemployment, alcoholism, substance abuse, 

and historical trauma. Funders should strive to: 

1. Make goals specific and achievable. Funders should specify realistic process and 

outcome goals at the start of the project and continue to reinforce those over the course of 

the grant. As one grant manager stated: “We don’t do a good job of messaging 

expectations when we put something together that is so complex.”

2. Be realistic about impact. While outcome evaluations are important, when the timeframe 

for producing change is under five years, and funds are limited, it will be difficult to 

move county-wide or citywide indicators of violence. 

3. Evaluate outcomes and impact only after sites have had sufficient time to implement 

chosen strategies. Requiring an outcome evaluation of sites that are not ready to be 

evaluated—because their programming has taken a while to get up and running—can do 

more harm than good. An outcome evaluation could potentially show no impact, thereby 

having a negative effect on future funding or local support, when in fact the program was 

simply not ready for evaluation. Moreover, because all sites implemented community 

awareness campaigns, some core community indicators might move in a negative 

direction: it may in fact look like violence has increased when numbers may just be 

capturing more awareness and more reporting. Funders should be mindful about making 

judgments about success or lack thereof based on outcome evaluations that are done over 

the course of a short timeframe. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 45

Fund for a Longer Timeline 

The original implementation funding was supposed to be for three years, but when sites were 

notified about their awards, they were told the timeframe had to be changed to two years due to 

the constraints of the funding streams. While program implementation was supposed to start in 

October 2011, many sites’ revised budgets were not approved by OJJDP until early 2012. Some 

community members who were the intended targets of the initiative expressed concerns about 

another well-intentioned program only coming to their community for a short time period. 

Although sites were twice given additional funding that extended the project by multiple years, 

the original timeframe created challenges for the sites. Specifically, funders should fund for 

longer periods of time to: 

4. Allow for recruitment of high quality staff. Hiring key staff such as licensed therapists or 

training coordinators takes time, especially when job postings need to get approval by 

local governments. Then staff may need to be trained. Sites found it challenging to hire 

qualified candidates when they were only able to offer them a year to a year and a half of 

job security. 

5. Allow time for impact. In order to achieve large-scale impact, sites should be given at 

least five years of funding up front in order to build the necessary infrastructure to 

implement successfully. Evaluations should be funded for at least two years after the end 

of programming to allow for data collection through the end of implementation, as well 

as post-implementation (to test for the sustainability of any observed effects). 

Incorporate Certain Structural Requirements into the Original Request for Proposal (RFP) 

Common “we wish we had known earlier” themes emerged across the sites, specifically around 

items they wish they had been told to budget for. In future request for proposals, funders should: 

6. Ensure that sites budget for an administrative assistant. Project directors spent a 

significant amount of time responding to requests for information from OJJDP, the 

technical assistance team, and the evaluation team. Additionally, for those sites that

offered grants to local community-based organizations, there was a lot of paperwork and 

monitoring to be done. At times, project directors spent time managing trainings or direct 

services. At the tribal sites, the paperwork required to get tribal council approval to spend 

funds was significant. Funders should encourage organizations responding to reportingheavy request for proposals should budget for at least a part-time administrative assistant. 

7. Ensure that sites budget for a local research partner. It is critical for each site to have a 

local data and evaluation partner on board from the beginning. With such a large 

initiative, where each site is choosing a different package of strategies to address 

children’s exposure to violence, the cross-site evaluator cannot do evaluation at the 

individual level. 

8. Ensure that original RFP fully discloses funding sources and their implications. When 

sites originally developed their strategic plans, they were unaware that part of their 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 46

funding would be coming from the Office of Violence Against Women (OVW). They 

were informed of this after their plans had been developed through a long, collaborative 

local process. The OVW money had specific requirements about funding domestic 

violence direct services, which some sites had not planned for. Additionally, this 

requirement helped to rebuild the community violence/domestic violence silos the sites 

had worked hard to break down during the initial strategic planning phase. 

Improve Internal and External Coordination 

There were multiple players involved with the Defending Childhood Demonstration Program. 

There was the programmatic funder (OJJDP), the program sites, the research funder (National 

Institute of Justice), the research and evaluation partner (Center for Court Innovation), and the 

technical assistance provider (Futures Without Violence). While each had a unique role, there 

could have been better synchronization. Funders should: 

9. Minimize the number of transitions. Over the course of the initiative, there was a change 

in technical assistance provider and a change in the grant mangers for each site. Funders 

should recognize that this disrupts relationships and that when new players are brought 

in, historical knowledge—about the initiative, about the sites’ program models, about 

why certain decisions were made—is often lost. Whenever possible, funders should try to 

reduce the number of these transitions and only make them if absolutely necessary. 

10. Improve coordination among key partners. Although there were phone meetings 

involving the funders, the technical assistance team, and the evaluation team, these often 

did not address challenges of coordination. These meetings could be used to discuss how 

best to work as a team to make things easier for demonstration sites. Additionally, 

funders should coordinate a streamlined reporting process so that the sites do not have to 

do multiple reports for the different partners. 

11. Connect new sites with original demonstration sites. Federal funders that plan to fund 

similar initiatives or new sites under the same initiative should pair new sites with one of 

the six sites evaluated under the Defending Childhood Demonstration Program. Existing 

sites could serve as mentor sites to new ones that are similar in jurisdiction or strategy. 

This could help new sites avoid errors in the early stages of planning and implementation, 

and help facilitate decision making. 

Hasten Approval Process for Public Messaging 

Many of the sites struggled with the level of regulation and restriction over printed material and 

the length of time it took to receive OJJDP approval for all public messaging. This also applied 

to many events, conferences, trainings, and site visits. This problem led to delays in awareness 

campaigns and professional and community trainings, frustrating those working in the sites. It 

also led to higher costs since planning and travel arrangements could not be initiated until 

approval was received. In some cases it took over six months to receive approval. Given this, 

funders should: 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 47

12. Set realistic and reasonable timeframes for approval. Funders should be required to 

approve materials submitted by sites for review within a set time frame, and that time 

frame should be communicated to the sites at the start of the initiative. 

13. Create a policy for social media. In an age of social media where much communication 

and promotion is done immediately on websites such as Facebook and Twitter, sites 

cannot submit every message for approval. Sites must be given flexibility to tweet or post 

about events, especially when they are in response to something that has happened (e.g., 

an immediate response to a shooting). Additionally, funders should create a list of trusted 

organizations that sites could share or “repost” materials from without prior approval. 

Allow for More Flexibility 

14. Allow grant funds to be used for food. Across all cultures and geographic locations, and 

especially in impoverished communities, providing food at community events is an 

important tool. Federal restrictions on the reasonable spending of grant monies on food 

for initiative-sponsored events can lead to staff spending their own money out-of-pocket 

or lower attendance rates. 

15. Encourage research partners to incorporate non-western research practices. Federal 

funders such as the National Institute of Justice often encourage their grantees to develop 

research designs that are based on western social science and the scientific method, with 

an emphasis on random assignment and quasi-experiments. These designs may not be 

applicable in tribal communities or, at minimum, may need to be supplemented. Funders 

of evaluation should highlight in their RFPs the role that alternative evaluation models, 

such as case studies and storytelling, might play in helping to document work in tribal 

communities. 

16. Support both evidence-based and non-evidence-based programming. All sites expressed 

concern that the federal government’s emphasis on evidence-based programming limited 

their options. Evidence-based programming may be too lengthy for some families to 

complete. Sites felt restricted in developing new and innovative practices, or adopting 

good programs that have not been evaluated. Funders should encourage a combination of 

both evidence-based and non-evidence based programming—while promoting rigorous 

local research and evaluation plans where novel approaches are tried. 

Understand Tribal Communities 

Funders working with tribal reservations need to have a strong understanding of the needs of 

these communities, as well as the historical role that federal funding has played there. 

17. Understand that the spending processes may be more complex for tribal sites. Tribal 

leadership is the signatory for the federal grant management system (GMS), and when 

tribal leaders change, new ones may not know how to make adjustments and submissions 

in GMS. When a report is not submitted or submitted late, the tribes cannot drawn down 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 48

funding, and, due to local politics, this can lead to jobs being threatened. Grant managers 

must play a more active role than they might with non-tribal sites.

18. Be mindful of tribal politics. Like many state and local communities, there is a certain 

degree of “politics” on tribal reservations, where jobs are perceived as a form of payback 

for political support. Often, local tribal officials see grants as “job creators.” Given the 

high unemployment rates, grant-funded positions can become a contested political issue. 

In addition, because of the intensity of politics on the reservations, staff members are 

often nervous that they will lose their jobs for reasons that are unrelated to job 

performance. And when the federal government was shut down in the fall of 2013, staff 

were threatened with termination because the tribe could not draw down money to pay 

their salaries. Grant managers must pay close attention to how local politics is affecting 

staffing and morale. 

19. Provide support for evaluation and technical assistance grantees. Research and technical 

assistance grantees should be connected to other federal grantees that are doing 

evaluation and technical assistance work with tribal communities in order to facilitate 

discussion of best practices and alternative research designs. Tribal communities can also 

be encouraged to bring in local evaluators, if they have existing relationships, to partner 

with national evaluators. 

Recommendations for Technical Assistance Providers 

In general, the Defending Childhood Demonstration Program sites had positive impressions of 

the technical assistance (TA) providers, and the tribal sites in particular were thankful for the 

inclusion of a native TA provider. 

1. Help sites understand relevant laws. TA providers should help sites understand the full 

implications of laws such as the Affordable Care Act, the Violence Against Women Act, 

the Health Insurance Portability and Accountability Act, and the Family Educational 

Rights and Privacy Act that may potentially affect programming. 

2. Focus on the science of implementation. At the start of the implementation phase, many 

of the sites did not need help in choosing strategies to address children’s exposure to 

violence, but rather needed help moving their initiatives from paper to reality. TA 

providers should focus on helping sites through the logistics of implementation and 

provide “on the ground” assistance. 

3. Provide onsite TA. Bringing the sites together on an annual basis is important, but often 

project staff have a hard time translating what they learned into practice when they return 

to their sites. After all-site meetings, TA providers should visit sites to help them adapt 

some of what was discussed to their local programming. TA providers should budget for 

multiple site visits to each site. They should also cater their work to the individual sites. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 49

4. Be mindful of differences between urban and rural populations. Sites in urban areas tend 

to have more resources than rural communities. When convening all-sites meetings, TA 

providers should include specific components that address these unique challenges. 

5. Work with a native TA provider. If working with tribal sites, it may be important, or even 

imperative, for the TA provider to partner with a native-run organization that can help 

provide culturally appropriate assistance to tribal sites. This step will help make the 

assistance more accepted and more relevant. 

6. Provide webcasts. Because sites have limited travel funds, all-sites meetings are usually 

restricted to a handful of participants from each location. However, many of the topics 

covered would be useful for other team members as well. TA providers should live 

stream or archive videos of the speakers so that others can learn from the meetings—and 

those who are there can go back to refresh their memories. 

7. Host podcasts that highlight unique strategies. To highlight success stories and unique 

strategies, the TA provider could host regular podcasts or events where local initiatives 

can discuss their approach.

8. Reduce the number of meetings sites as time goes on. Once sites have been up and 

running for multiple years, biweekly phone calls that were helpful at the start may 

become burdensome. Consider hosting them on an ad-hoc basis. 

9. Provide both proactive and reactive technical assistance. TA providers should react to the 

needs of the sites as they work to implement their strategies, but should also work to 

identify trends and missing knowledge and to plan for emerging issues. Proactive TA 

provision may require the use of affinity groups or more peer-to-peer learning 

opportunities that can help TA providers identify important issues early on, while also 

provide important learning opportunities for sites. 

Recommendations for Researchers and Evaluators 

Evaluating a multisite, comprehensive initiative where sites employ different activities can be 

challenging. The evaluation of the Defending Childhood Demonstration Program included both 

a process and outcome evaluation. (The outcome evaluation report is forthcoming later in 2015.) 

The following recommendations emerged for future large-scale evaluations: 

1. Develop local knowledge. Researchers should take time to get to know the sites. This 

means not only forming and maintaining relationships with local staff members, but 

immersing themselves in the geographic and historical context of the communities. To 

accomplish this task, it is essential to make multiple site visits. Additionally, research 

teams should invest time in learning about tribal history relevant to the particular tribal 

sites. 

2. As much as possible, streamline reports. Collecting implementation data on a regular 

basis is important to both funders and evaluators. Whenever possible, reports should be 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 50

streamlined. Before creating any new reporting requirements, researchers should obtain 

the report formats that funders require. Federal funders and evaluators are often seeking 

different information. However, it is important for researchers to make a good faith effort 

to streamline reporting. 

3. Give back. Because reporting requirements can be burdensome, it is important for 

researchers to “give back” to the sites (at least to the extent that doing so is feasible). 

Examples include: helping design local evaluations, adding questions to data collection 

tools or surveys, offering to present key evaluation findings, and providing access to data 

(e.g., to run their own analyses and incorporate into future grant proposals). Researchers 

should also present interim findings to staff at the sites so that they can see how the data 

they submit is being used and what story it is telling. 

4. Ask the sites for their input. And then ask again. Sites should be involved at various 

stages of the evaluation process. Early on, researchers should ask the sites for their input 

on tools and instruments and the terminology and language used to discuss the initiative. 

Sites should also be asked to help design the outline for any reports that will be publicly 

available. Finally, sites should be given the opportunity to review and provide feedback 

on any reports produced. Transparency is absolutely critical to conducting effective 

research. 

5. Conduct a process evaluation. With initiatives like Defending Childhood that seek to 

address complicated issues in a relatively short period of time, a process evaluation may 

provide more lessons than an outcome evaluation. 

6. Employ a mixed-methods study. Evaluations must use a combination of quantitative and 

qualitative data in order to fully understand the effects programs have had on 

communities. When possible, qualitative interviews or focus groups with program 

participants should be considered. 

7. Embrace non-western approaches when working with tribal sites. There is a long history 

of distrust in many tribal communities that feel they have been the subject of (and 

subjected to) studies that harmed their people. Given this history, tribes may be hesitant 

to participate in an evaluation by outside researchers. Therefore, to the extent feasible, 

researchers should embrace non-western methods (e.g., storytelling) that acknowledge 

and respect tribal values, history, and social structures. These methods can supplement 

researchers’ standard tools. No matter what methodology is selected, researchers should 

seek local input. In implementing a telephone survey, for example, researchers could ask 

for feedback on language and response categories, in addition to getting tribal councils’ 

permission to administer the survey. Seeking tribal approval of evaluation and research 

projects is an important way to recognize tribal sovereignty. In any approach, findings 

must be interpreted in ways that incorporate cultural and contextual factors. 

8. Be mindful. Evaluation reports can have positive and negative impacts on sites and their 

ability to sustain their work. Outcome and impact evaluations, although ideal, should only be 

done for sites that are ready to be evaluated. Process evaluations are important, and need to 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Chapter 3. Recommendations Page 51

be candid about barriers and shortcomings; yet, humility on the part of evaluators is also 

important in acknowledging the daunting challenge of successfully implementing numerous 

strategies, involving multiple agencies and individuals, to address a serious social problem. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix A. Aggregate Program Outputs by Year Page 52

Appendix A

Aggregate Program Outputs by Year 

(October 1, 2011 – September 30, 2014) 

Number of Collaborative Body Meetings

YEAR 1 YEAR 2 YEAR 3 TOTAL

56 64 38 158

Number of Professional Trainings Number of Individuals Trained

YEAR 1 YEAR 2 YEAR 3 TOTAL YEAR 1 YEAR 2 YEAR 3 TOTAL

93 299 241 633 2,406 3,757 3,575 9,738

Number of Community Awareness/ 

Education Events

Number of Audience Members66

YEAR 1 YEAR 2 YEAR 3 TOTAL YEAR 1 YEAR 2 YEAR 3 TOTAL

138 343 242 723 7,185 22,258 121,283 150,726

Number of Individuals Receiving Treatment/Healing or 

Prevention Services

YEAR 1 YEAR 2 YEAR 3 TOTAL

5,104 10,759 10,463 26,326

Number of 

Publications/Advertisements

Number of Recipients67

YEAR 1 YEAR 2 YEAR 3 TOTAL YEAR 1 YEAR 2 YEAR 3 TOTAL

90 222 235 538 41,294 3,357,986 4,392,023 7,791,303

 

66 The much larger number in Year 2 can be explained with the increase in community awareness activities, and, for 

some sites, many of these activities were presentations to audiences over 1,000 people. 

67 If a publication was a television or radio PSA or a billboard advertisement, for example, the number of recipients 

represents the potential viewing audience.

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix A. Aggregate Program Outputs by Year Page 53

Publication/Advertisement Types

Year 1 Year 2 Year 3 Total

Handouts/Flyers/Brochures 24 69 82 175

Newsletters 2 16 6 24

Curriculum Guides 11 7 1 19

Surveys 5 3 0 8

Email/Mailer/Website/Social media 4 41 95 140

Awareness Item (e.g. bracelets) 0 18 2 20

Journal Article 0 1 0 1

Press Release/Newspaper Article 7 19 5 31

Newspaper Ad 0 0 6 6

Radio PSA/News Story 7 10 10 27

TV PSA/News Story 1 3 0 4

Web PSA 0 3 2 5

Banners/Billboards 0 12 3 15

Miscellaneous 17 14 14 45

Total 78 216 226 520

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix B. Process Evaluation Stakeholder Interview Protocol Page 54

Appendix B 

Process Evaluation Stakeholder Interview Protocol

Process Evaluation Interview Protocol

Name: _________________________________________________________________

Agency: ________________________________________________________________

Title: ___________________________________________________________________

Job Responsibilities: ______________________________________________________

Role within the Initiative: __________________________________________________

---------------------------------------------------------------------------------------------------------------

1. How are you involved with the Defending Childhood Initiative?

a. Are you on the core management team?

b. Are you a member of a subcommittee? If so, which one?

c. Are you your organization’s representative to the collaborative?

d. How often do you attend Defending Childhood-related meetings?

2. What has been the role of the collaborative body in Phase II?

a. How often does it meet, and where?

b. Has the makeup of the collaborative changed since Phase I? Who has left and who 

has joined?

c. What types of decisions are being made by the collaborative? How would you 

describe the process by which the collaborative makes decisions? Is it efficient and 

effective? How could it be improved? Can you give a specific example of such a 

decision?

d. Are there any key agencies that aren’t collaborating, and if so, how do you think this 

might affect project implementation?

e. Are there currently subcommittees? If so, how often do they meet and what have 

they been working on? If not, why not?

3. What has been the staffing of the local Defending Childhood Initiative?

a. Who is part of the core management team?

b. What new staff have you hired, and what are their roles?

c. Has there been any turnover in coordinators, researchers, etc.?

d. Have staffing issues affected the initiative? If so, in what ways?

4. How has implementation been going so far?

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix B. Process Evaluation Stakeholder Interview Protocol Page 55

a. What parts of your strategic plan have already been implemented?

b. What have been some of the barriers/challenges to implementation? Have you 

overcome those barriers, and if so, how? If not, what do you think you might need to 

overcome them?

c. Have you had to abandon any of your planned activities or change your target 

populations in any way? Why?

d. Have the assumptions you made about target population and needs Phase I have been 

confirmed? 

5. What have been some of the identified successes thus far?

a. Why do you think they were successful?

b. Aside from Defending Childhood resources, what additional money/staff/political 

capital were involved?

6. Tell me your community awareness activities or campaigns.

a. Who has been involved in these activities? (organizations, PR companies) 

b. What are its primary messages, and how were those messages chosen? How have 

you gotten those messages out?

c. Who has been your target audience so far, and do you feel like you’ve been reaching 

that audience? If so, how have you done so? If not, what have the challenges been to 

reaching them?

d. Does the collaborative track how many people have been reached by various 

community awareness activities? If so, how?

e. How many people have you reached so far? How do you know that? How many 

times do you want your target to see/hear the message? How many times has the 

message been broadcast/printed/aired/etc.? 

f. What have been some additional challenges to getting your message out?

g. Do you have a sense of how the messaging is being received? Is it having its 

intended effect on its audience?

h. How will the messaging or strategies change or continue in the next future?

i. Can I have a copy of any campaign materials (e.g., brochures, photos of billboards, 

PSAs, cds of radio spots, etc.)?

7. Tell me about your professional training activities.

a. How many trainings have you held, where were they held, and what were the topics? 

Who ran the trainings? How long did they last?

b. How did you reach out to people to invite them to attend? How was the attendance? 

Who was your target audience and who came? What were challenges in recruitment?

c. What has the feedback on the trainings been? If it has been positive, what made them 

successful? If it has been negative, what made them unsuccessful?

d. Now that you’ve implemented some trainings, do you feel like there are additional 

groups that weren’t previously identified that you want to reach out to for training? 

Additional topics?

e. Can I have a copy of any training materials you’ve distributed?

8. Has the collaborative created universal screening or assessment instruments and protocols?

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix B. Process Evaluation Stakeholder Interview Protocol Page 56

a. What was the process of creating these? Who was involved?

b. Can I get a copy of the final/latest draft?

c. Have you been successful in getting agencies to use these new instruments/protocols? 

How many organizations have adopted them? What is your goal for number of 

agencies that use them?

d. What is the timeline for getting these agencies to be using these instruments?

e. What have been some of the challenges related to screening and assessment thus far?

f. Are the agencies sending their data to a central location for analysis/reporting? What 

are you doing with the data collected? Have there been any findings from these tools 

that could be useful to the field in terms of better understanding children who have 

been exposed to violence?

g. What about other policy or protocol changes? (probe on data sharing, systems 

response, etc.)

9. What prevention programs have been implemented to date? By prevention programs, I mean 

direct primary or tertiary prevention programs designed to prevent children’s exposure to 

violence. 

a. Where are these programs taking place, and who is running them?

b. What is the role of the Defending Childhood Initiative in these programs (e.g., funder, 

provide other support, running it, etc.)?

c. If you were able to get schools involved, how were you able to do so? If you weren’t, 

what have the challenges been? Are they able to be addressed?

d. What are these programs? Are they evidence-based? What are the topics they are 

addressing?

e. What are the goals and how is success defined?

f. Are you doing any local evaluation of these programs? If so, how are you evaluating 

them, and what have been some of the results?

g. What have been some successes of implementing these programs? What have been 

some challenges?

(Question 10 is more for the actual organizations running the prevention programs.)

10. I’d like to know more about these prevention programs.

a. How often do the programs meet, for how long each time, and for how long will the 

program run?

b. Who is the population being reached? How are participants being recruited? What 

are the eligibility requirements and how are they screened?

c. How many did you intend to serve, and how many are actually being served? If there 

is a gap in the program’s intended and actual reach, why do you think this is? Is there 

a plan to recruit more program participants?

d. How many people have dropped out? Why did they leave the program?

e. Have you had people decline participation? Why?

f. How many staff members are involved, and what qualifications do they need to run 

these programs?

g. How have participants reacted to the program? How about the staff?

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix B. Process Evaluation Stakeholder Interview Protocol Page 57

11. What intervention programs or services have been implemented through the Defending 

Childhood Initiative to date? By intervention, I mean direct intervention services or programs 

for children who have been exposed to violence. 

a. Where are these programs/services taking place, and who is running them?

b. Is this location accessible to the target audience (i.e., does public transportation 

access the facility and is parking available?)?

c. What is the role of the Defending Childhood Initiative in these programs (e.g., funder, 

provide other support, running it, etc.)?

d. What are these programs/services? Are they evidence-based? What are the goals and 

how is success defined?

e. Are you doing any local evaluation of these programs? If so, how are you evaluating 

them, and what have been some of the results?

f. What have been some successes of implementing these programs? What have been 

some challenges?

(Question 12 is more for the actual organizations running the intervention programs.)

12. I’d like to know more about these interventions.

a. How long do these interventions last, and how often does the child/family participate?

b. Who is the population being reached? How are participants being recruited? What 

are the eligibility requirements and how are they screened?

c. How is confidentiality maintained?

d. What factors do the clients have in common?

e. What types of violence have the clients been exposed to?

f. How many did you intend to serve, and how many are actually being served? If there 

is a gap in the program’s intended and actual reach, why do you think this is? Is there 

a plan to recruit more program participants?

g. How many people have dropped out? Why did they leave the program?

h. Have you had people refuse services? Why do you think they refused?

i. How many staff members are involved, and what qualifications do they need to run 

these programs?

j. How have participants reacted to the program? How about the staff?

13. What are the next steps in the implementation plan?

a. What is the timeline for implementing the other parts of your plan?

14. What have been additional obstacles your local Defending Childhood Initiative has 

encountered?

a. Where are there still major gaps in prevention, intervention, awareness?

b. What additional challenges have you faced? (probe on each of the following: 

political will, resources, organizational support, agency turf battles, interagency data 

sharing and collaboration, etc.?

c. How has the move from being a 3-year initiative to a 2-year one changed your 

strategies, target population, etc.?

15. Have you asked for help from the technical assistance provider, Futures Without Violence?

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix B. Process Evaluation Stakeholder Interview Protocol Page 58

a. If so, what types of assistance have you requested? (probes: guest speakers, help 

designing professional training, help regarding media campaigning, technical 

information about the effects of violence exposure on children, facilitation, etc.)

b. What has the response been to your requests? (probes: responsiveness, timeliness, 

helpfulness)

c. What types of assistance do you think you may ask of them in the future?

16. Have you asked for help from the technical assistance provider, Futures Without Violence?

a. If so, what types of assistance have you requested? (probes: guest speakers, help 

designing professional training, help regarding media campaigning, technical 

information about the effects of violence exposure on children, facilitation, etc.)

b. What has the response been to your requests? (probes: responsiveness, timeliness, 

helpfulness)

c. What types of assistance do you think you may ask of them in the future?

17. What are your plans for sustainability past the 2-year grant period?

a. What parts of the initiative do you think are sustainable without additional funding?

b. What parts of the initiative do you think are not sustainable or will likely go away?

c. Have you been looking for funding elsewhere to support the initiative? If so, where?

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix C. Sample Quarterly Implementation Report Page 59

Appendix C 

Sample Quarterly Implementation Report 

THE DEFENDING CHILDHOOD INITIATIVE: QUARTERLY IMPLEMENTATION REPORT

[QUARTER DATE]

INSTRUCTIONS: Fill in the information below for all Defending Childhood activities from October 1-December 31, 2013. 

Please submit electronically by January 15, 2014.

COLLABORATIVE BODY MEETINGS: 

List the date, time, and number of participants for all collaborative meetings during this quarter. 

If no meetings took place, type "None."

Group/ Committee Name

Meeting 

Date Meeting Time

# of 

Participants

Example 1 Full Collaborative Body 10/15/2011 1:00 p.m.-3:00 p.m. 15

Example 2 Prevention Committee 12/1/2011 9:00 a.m.-11:00 a.m. 5

PROFESSIONAL TRAININGS: 

List the date, time, number of participants, audience, topic, and description for all trainings during this quarter. If no trainings took place, type "None."

Training Name Event Date Event Time

# of 

Participants Audience Event Topic Description

Example 1

Identifying the Effects of 

Children’s Exposure to 

Violence (CEV) 11/2/2011 9:00 a.m.-12:00 p.m. 30

Home Visiting 

Nurses Effects of CEV

Home visiting nurses were trained on 

how to identify the effects of CEV.

Example 2 TFCBT Provider Training 12/1/2011 10:00 a.m.-4:00 p.m. 12

Mental Health 

Providers TFCBT

Mental health care providers were 

trained in TFCBT techniques. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix C. Sample Quarterly Implementation Report Page 60

COMMUNITY AWARENESS/EDUCATION EVENTS:

List the date, time, number of participants, audience, topic, and description for all community events during this quarter. If none, type "None."

Event Name Event Date Event Time

# of

Participants Audience Event Topic Description

Example 1 City Council Meeting 11/15/2011 6:00 p.m.-6:15 p.m. 25

City Council 

Members

Defending Childhood

Initiative

City Council Members were given a 

brief description of DCI and how it will 

be implemented in the community.

Example 2 Community Summit 12/15/2011 12:00 p.m.-2:00 p.m. 150

Adult Community

Members

Community 

Violence

Community members discussed results 

of the community needs assessment.

PUBLICATIONS/MATERIALS:

List the type, topic, number distributed, and audience for all publications and materials distributed this quarter. If 

none, type "None." 

Publication Name Type Topic

# 

Distributed Audience

Example 1

Teen Dating Violence Fact 

Sheet Brochure

Teen Dating 

Violence Prevention 30 Teenagers

Example 2

Defending Childhood 

Newsletter Newsletter

Update on 

program activities 250

School staff and 

parents

DIRECT SERVICES:

List the type, total number of hours provided, recipients, and number of recipients for all direct 

services provided during this quarter. If none, type "None."

Type

Total # of 

Hours

Provided

Recipients # of 

Recipients Total # of individuals screened

for services (if applicable)

Example 1

Cognitive Behavioral 

Therapy 10 hours Children, Ages 8-12 5

Example 2

DV Crisis Intervention 

Services 2 hours Adult victims of DV 30

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.
Appendix C. Sample Quarterly Implementation Report Page 61

POLICIES, PROTOCOL, AND PROCEDURE CHANGES:

Please describe any policies, protocol, and procedure changes. Include the type of change, when the change was implemented, and who or 

what was affected. If none, type "None."

Example 1 Beginning in January, the local law enforcement was required to report when a child witnessed a violent crime.

Example 2 In December, all agencies represented on the collaborative adopted a universal screening tool for CEV. 

OTHER:

Please describe any other activities or events not listed above. Includes date, time, number of participants, and audience where applicable.

Example 1 During October we held a poster contest for public high school youth. The winning poster was disseminated to 50 public high 

schools. 

Example 2 During December we issued an RFP for a public relations firm to design the community awareness campaign. 

This document is a research report submitted to the U.S. Department of Justice. This report has not 

been published by the Department. Opinions or points of view expressed are those of the author(s) 

and do not necessarily reflect the official position or policies of the U.S. Department of Justice.