Challenging Dogma - Spring 2008

...Using social sciences to improve the practice of public health

Wednesday, April 23, 2008

The Limited Impact of Violence Intervention and Prevention (VIP) Among Target Neighborhoods in the City of Boston - Yuanyu(Emily)Lo

Nationwide, we are seeing a surge in violence among the younger population, and youth violence has become a very important public health problem in recent years. Around the country, gang violence has spread to communities throughout the United States. At last count, there were more than 24,500 different youth gangs around the country, and more than 772,500 teens and young adults were members of gangs(1). From 1999 to 2000, youth-gang related homicides in Massachusetts rose more than 50 % (2), and the number of shootings started to climb: 268 in 2004 and 341 in 2005. Statistics show that Suffolk County Juvenile Courts handles approximately 2,275 cases annually for youths under 18 (3). According to the Massachusetts Youth Risk Behavior Survey, 2005: 10% of high school students were involved in a gang in 2004.

In 2007, Boston Mayor, Thomas Menino launched a Violence Intervention and Prevention (VIP) public health campaign in an effort to decrease the increasing violence in Boston neighboring communities. VIP used a canvassing approached and had volunteer go to four specific neighborhoods and knock on in order to distribute educational materials and survey the residents about violence concerns in their neighborhood. The volunteers worked in pairs knocking on residents’ doors and walked on the street in teams of six people per group. In addition the intervention put in place public safety officers (police and EMS) in each neighborhood to support the door-knocking team. Education materials were given in backpacks to each family filled with school supplies, giveaways for kids, and key information regarding city benefits and services such as educational flyers, youth service agencies and violence prevention agencies. When residents opened the door, VIP volunteers would ask the permission from the residents and spent 30 minute to an hour using the standardize survey to discuss about their concern in the neighborhoods. The goal of this campaign is to improve the safety of Boston residents living in high risk neighborhoods and to provide youths, and their families with the tools and strategies to address and resolve violence.

Failure of addressing social network issues
This campaign did not use social network to make it successful. According to the Greater Vancouver Street Gang Study, there are three types of gangs: criminal business organizations, street gangs and wannabe groups (4). These types of gangs must be distinguished in order to be able to tackle the major issues pertinent to the type of gang or gangs in these communities. Neighborhood implemented interventions need to understand this kind of range of gang difference in order to have a successful intervention. The VIP campaign had a good approach to visit residents in high risk neighborhoods between 4-8 pm however, most likely elderly and children would be home. The VIP intervention therefore needed to canvass the neighbourhoods and talk to community members that would know the difference between the kinds of gangs in their community to be able to get more information about what kinds of violence interventions the neighbourhood needs. Also, the educational materials did not offer the information that target different youth population, therefore, it may not deliverer the violence prevention message.

Most of the VIP volunteers were health educators and public health advocates, and most importantly members outside of the neighborhoods that were being canvassed. If we took social network perspective, neighborhood youth may think that talking to the volunteer is not “cool” since the volunteers do not belong to their peer group. Also, volunteers accompanied by EMT’s or the police. This may attract unwanted attention in the neighborhoods, and residents may feel intimidated talking to the volunteers because they don’t want to be associated with the police. According to social network theory, people’s behaviors are based on their social network. Using youth gang behaviors as an example, youth used violence to resolve conflict or seek revenge against their rivals. Failure to recognize the social network issue will lead to the inability to alter group behavior.

Failure to use “McGuire’s Communication Model”
Violence prevention interventions need to look at effective strategies that help people change behavior, like persuasive communication theory. Over the years, William J. McGuire has done extensive research in the area of attitude change and persuasive communication (5-8). He states when an individual is exposed to a message the information will be processed based on their individual personality and demographic (6,8). According to McGuire, there are several steps needed to alter the behavior including exposure, perception, comprehension, agreement, decision making, and action.

From the McGuire, it is critical to know who deliver the message. VIP campaign, messages were instituted by City Hall and delivered by public health advocates. Historically, young people tend to rebel against authority and do not like to be told what to do. They may rebel against their parents, teachers and public officials and do not want to listen to them. Who delivers the message and what messages are delivered are critical.

Even with exposure, attention is not guaranteed. The human brain can only process a small portion of the information it receives. When VIP volunteer handed over educational flyers and asking survey questions, it might overwhelm the residents with too many information which did not apply to them. It would be very helpful to select certain key messages to disseminate among the population with the hope that certain portions of the message will be retained. Personally, I think a backpack full of information will overwhelm residents. The backpacks would surely deliver the message, but it was not really a comprehensive means by which to do it. One thing to consider was that the residents might be less educated or limited in their English speaking skills. It might be hard for them to understand the message from the volunteers. Also, how they interpret the information might be very different from the message put forth by the campaign.

Self-efficacy issue
Self-efficacy is a person’s belief in his or her ability to succeed in a particular situation. Bandura described these beliefs as determinants of how people think, behave, and feel (9-12). Everyone can identify the goals and that which they wish to change to achieve these goal. However, young people who lack self-efficacy will believe that these tasks are too difficult or impossible to achieve. Therefore, they may just give up, or not follow through at all. Using adults showing up at their doors and telling youth the risk of street violence would not give them enough of a reason to change their behavior. Young people knew the risks of being in a gang and the amount of violence on the street. However, sometimes they believed that they had to join a gang to survive or to be part of the community. They had grown up in a gang culture, and it might be the only way of life that they knew. Gangs was a part of their lives and part of neighborhood culture. Failure to address these behaviors that were a direct result of their background would result in not being able to target the intended group.

Another obstacle young people might face is the inability to break away from the group or gang. Handing out surveys and fliers would not achieve the goal of preventing violence in the neighborhood. There needs to be tools and guidance to teach them how to break away or not join a street gang in the first place. Eventually, they will have to learn how to say “no” to the violence.

In order to have an effective public health campaign, we first have to identify and focus on our target population. One way to win over young people that we might consider is to use a previous gang member who could speaks their language. Other outreach methods that might influence young people are rap/pop concerts, basketball games or commercials to deliver the message rather than adults knocking on doors. For high risk neighborhoods, we should understand the culture of the communities and let youth know that there is another way to solve the problem besides violence. By understanding their background and the environment that they live in, we will be able to design a comprehensive plan to help residents and prevent future violence in the city.

1. Howell, J.C. (1998). Youth Gangs: An Overview. Washington, D.C.: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.
2. “Caught in the Crossfire: Arresting Gang Violence by Investing in Kids,” Fight Crime: Invest in Kids 9/14/04, available at
3. Boston High-Risk Youth Network, “Needs Assessment of High-Risk Youth in Boston,” Sept. 2005.
4. Youth Justice in Canada Excerpt on “Youth Gangs”, 2003
5. McGuire, W. J. (1968). Personality and attitude change: An information-processing theory. In Greenwald, A.G., Brock, T.C., & Ostrom, T.M (Eds.), Psychological foundations of attitudes (pp.171-196). New York: Academic Press.
6. McGuire, W. J. (1976). Some internal psychological factors influencing consumer choice. Journal of Consumer Research, 2, 302-319.
7. McGuire, W. J. (1989). Theoretical foundations of campaigns. In Rice, R. E., & Atkin, C. K. (Eds.), Public Communication Campaigns (2nd ed.) (pp. 43-65). Newbury Park, CA: Sage Publications.
8. McGuire, W. J. (1999). Constructing social psychology: Creative and critical processes. Cambridge: Cambridge University Press.
9. Bandura, A. (1982). Self-efficacy mechanisms in human agency. American Psychology, 37, 122-147
10. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
11. Bandura, A. (1982). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.
12. Bandura, A. (1997). Self-Efficacy: The exercise of control. New York, NY: W. H. Freeman.

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