A Multi-level Approach to Violence Prevention Among African American Adolescents
Condition: Violence in Adolescence
Study type: Interventional

Summary: 
      The overall goal of this study is to advance the science of youth violence prevention and the
      social determinants of health by using a community-driven approach to implement a
      comprehensive intervention. The objective of the proposed project is to assess the
      feasibility, acceptability, and preliminary efficacy of an innovative, multi-level
      intervention that promotes adolescent protective factors and reduces risk behaviors among
      African American youth residing in Birmingham. Alabama.
    

Detailed description: 
      Perceived neighborhood violence, hearing about violence in one's community, and being a
      victim of violence contributes to adverse psychological conditions such as anxiety,
      depression, and stress, which may have cascading negative effects physically and be the start
      of a vicious cycle. Among children, the prevalence of neighborhood violent crime is linked to
      symptoms of post-traumatic stress disorder (PTSD), aggressive behavior, school attendance
      problems, sexual risk taking, and the use of alcohol, tobacco, and other drugs.

      Since childhood is a critical and fragile time with respect to developmental trajectories and
      relationship building, it is an important time to intervene. Previous research used a deficit
      model focusing on risks as opposed to an asset model, which focuses on protective factors
      related to prosocial and positive traits. Building the protective factors (e.g., involvement
      in prosocial activities, intolerant attitude toward deviance, connectedness to adults outside
      the family) of youth can promote well-being and reduce the risks of negative outcomes.
      Social-emotional learning (SEL) programming targeting adolescents is thus becoming
      increasingly funded because of its documented success, such as higher levels of prosocial
      behavior, more favorable attitudes toward school and others, and better academic achievement.

      The overall goal of this study is to advance the science of youth violence prevention and the
      social determinants of health by using a community-driven approach to implement a
      comprehensive intervention. The objective of the proposed project is to assess the
      feasibility, acceptability, and preliminary efficacy of an innovative, multi-level
      intervention that promotes adolescent protective factors and reduces risk behaviors among
      African American youth residing in Birmingham. Alabama. According to data from the FBI's 2015
      Uniform Crime Report, Birmingham is ranked as the nation's 3rd most violent city with high
      levels of violent crime occurring in the a neighborhood located in Northeast Birmingham,
      Alabama. By partnering with national and local community partners, this study proposes to
      design a comprehensive intervention that integrates an evidence-based, individual-level SEL
      program with a relationship-level mentoring component and a community-level environmental
      improvement component. The proposed pilot project is building on recently established
      community relationships. Through community capacity development funds, the investigators
      helped establish a community coalition in Spring of 2016 to identify and address the
      underlying causes of health disparities in the community. The coalition has identified
      violence and safety as issues that community members most desire to be addressed and has
      recommended strategies, such as establishing a mentoring program, providing activities for
      children, and organizing community improvement activities. The proposed project addresses
      several of these issues and our community partners have expressed enthusiastic support of the
      project.

      The proposed project will be achieved through the following specific aims:

      Aim 1: Conduct a 4-month multi-level youth violence prevention intervention that includes an
      individual-level social-emotional learning program with a relationship-level mentoring
      component and a community-level environmental improvement component. The intervention will
      include 20 African American male adolescents residing in a community in Birmingham, AL.

      Aim 2: Assess the feasibility and acceptability of the multi-level intervention.

        1. Feasibility and Acceptability (Primary Outcome): Detailed process data will be collected
           to assess recruitment, retention, and acceptance. It is hypothesized that 20 African
           American adolescents (6th-8th grade) will be recruited, >80% of the participants will be
           retained, and >80%will accept the intervention.

        2. Efficacy (Secondary Outcome): To determine the effects of the intervention on aggressive
           behavior and prosocial behavior (protective factors). It is hypothesized that
           participants will have significantly lower levels of aggressive behavior and higher
           levels of prosocial behavior.

      This study will be a significant contribution to the multi-level violence prevention
      literature and lay the foundation for a larger study using an experimental design to examine
      effects of a violence prevention intervention on individual and community health and
      well-being. In addition, lessons learned from this project can serve as a model to address
      violence prevention in similar inner-city communities in the United States.
    

Intervention name(s): Multi-level Violence Prevention Intervention - Boys; Multi-level Violence Prevention Intervention - Caregivers
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Comprehensive, Multi-level Violence Prevention Intervention. The intervention consists of three components: (1) a 15-week after-school program, (2) group mentoring, and (3) community enhancement activities. Adolescents and mentors will attend a 2-hour weekly session at a community center, and will conduct up to four community enhancement activities. At the end of the program, a graduation celebration will be planned, and parents/guardians and stakeholders (e.g., coalition members) will be invited.; This is arm is measuring the Multi-level Violence Prevention Intervention that is administered to the boys, from the perspectives of their caregivers. The caregivers themselves will not receive an intervention, but their perspectives of the impact on the interventions on the boys will be examined
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: The study has 2 groups of participants. Only one group, middle school boys (N=20), will receive the intervention. But, pre- and post-assessments will be conducted with 2 groups: (1) boys, (2) caregivers. Caregivers (N=20) will give their perspectives of boys' behavior pre- and post- intervention.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: violence; adolescence