a community-based systems learning approach to ... community... · a community-based systems...

9
67 pchp.press.jhu.edu © 2011 e Johns Hopkins University Press THEORY & METHODS A Community-Based Systems Learning Approach to Understanding Youth Violence in Boston Khary Bridgewater, BS 1 , Steve Peterson, MS 2 , John McDevitt, PhD 3 , David Hemenway, PhD 4 , Jeffrey Bass, BSE 5 , Paul Bothwell, MDiv 6 , and Ros Everdell, MS 7 (1) Emmanuel Gospel Center; (2) Lexidyne, LLC; (3) Northeastern University College of Criminal Justice; (4) Harvard School of Public Health (5) Emmanuel Gospel Center, (6) Dudley Street Neighborhood Initiative; (7) Dudley Street Neighborhood Initiative; Submitted 14 May 2010; revised 8 October 2010; accepted 21 October 2010. This work was financially supported by the Barr Foundation, State Street Foundation and other local funders. Y outh violence in general and gang violence in par- ticular continues to be a pernicious problem facing the majority of large U.S. cities. 1 Although levels of youth violence have declined since peaking in the mid 1990s, 2 the percentage of homicides involving a gun has increased since 2000. 3 e problem is more pronounced for black males who have experienced a 54% increase in homicides between 2002 and 2007, 3 making homicide the leading cause of death for black males ages 10 to 24. 4 Abstract Background: Youth violence in general and gang violence in particular continues to be a pernicious problem facing the majority of large U.S. cities. Attempts to reduce youth violence are hindered by the absence of a shared framework that crosses multiple disciplines. Objective: e goal of the Youth Violence Systems Project (YVSP) is to help communities strategize for and achieve sustained reductions in youth violence in Boston. Methods: A distinction of YVSP is the engagement of community residents in a group model building process to develop a conceptual framework and create a system dynamics computer model of youth violence in Boston. Community residents including youth participated in the design, execution, and evaluation of the project. We also partnered with community agencies to gain insight from individuals with a history of gang involvement or violent offense. e computer model highlights the dynamics of movement into and out of gangs, and the relationships that influence violent inter- actions among individuals and gangs. e model serves as a simulation-based laboratory for examining initiatives aimed at reducing youth violence within a community. It considers the positive feedback between traumatic stress and violence; as violence levels rise in the community, this increases individual traumatic stress, which further increases violent responses by community members. Conclusion: The project’s community-based approach coupled with its system dynamics methodology produced a new understanding of youth violence in Boston. is under- standing undergirds the model’s logic, making it more useful to community residents and more accurate in describing the behavior of youth in high-violence neighborhoods. Keywords Youth violence, systems theory, system dynamics, computer modeling, gang culture, community-based participatory research Most initiatives to reduce youth violence continue to oper- ate in isolation, 5 despite findings that cities that employ more coordinated efforts have lower rates of youth violence. 1 Although numerous youth violence task forces have been established, they seldom include noncriminal justice partners. Some in the public health community have suggested the use of a multidisciplinary approach to engage health, justice, mental health, and education in addressing this youth violence epidemic, 5,6 but attempts at col- laboration are hindered by the absence of a shared framework.

Upload: doanminh

Post on 06-May-2018

219 views

Category:

Documents


2 download

TRANSCRIPT

Page 1: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

67

pchp.press.jhu.edu © 2011 The Johns Hopkins University Press

ThEORy & METhOdS

A Community-Based Systems Learning Approach to Understanding Youth Violence in Boston

Khary Bridgewater, BS1, Steve Peterson, MS2, John McDevitt, PhD3, David Hemenway, PhD4, Jeffrey Bass, BSE5, Paul Bothwell, MDiv6, and

Ros Everdell, MS7

(1) Emmanuel Gospel Center; (2) Lexidyne, LLC; (3) Northeastern University College of Criminal Justice; (4) Harvard School of Public Health (5) Emmanuel Gospel Center, (6) Dudley Street Neighborhood Initiative; (7) Dudley Street Neighborhood Initiative;

Submitted 14 May 2010; revised 8 October 2010; accepted 21 October 2010. This work was financially supported by the Barr Foundation, State Street Foundation and other local funders.

Youth violence in general and gang violence in par-ticular continues to be a pernicious problem facing the majority of large U.S. cities.1 Although levels of

youth violence have declined since peaking in the mid 1990s,2 the percentage of homicides involving a gun has increased since 2000.3 The problem is more pronounced for black males who have experienced a 54% increase in homicides between 2002 and 2007,3 making homicide the leading cause of death for black males ages 10 to 24.4

Abstract

Background: Youth violence in general and gang violence in particular continues to be a pernicious problem facing the majority of large U.S. cities. Attempts to reduce youth violence are hindered by the absence of a shared framework that crosses multiple disciplines.

Objective: The goal of the Youth Violence Systems Project (YVSP) is to help communities strategize for and achieve sustained reductions in youth violence in Boston.

Methods: A distinction of YVSP is the engagement of community residents in a group model building process to develop a conceptual framework and create a system dynamics computer model of youth violence in Boston. Community residents including youth participated in the design, execution, and evaluation of the project. We also partnered with community agencies to gain insight from individuals with a history of gang involvement or violent offense. The computer model highlights the dynamics of movement into and out of gangs, and the relationships that influence violent inter-

actions among individuals and gangs. The model serves as a simulation-based laboratory for examining initiatives aimed at reducing youth violence within a community. It considers the positive feedback between traumatic stress and violence; as violence levels rise in the community, this increases individual traumatic stress, which further increases violent responses by community members.

Conclusion: The project’s community-based approach coupled with its system dynamics methodology produced a new understanding of youth violence in Boston. This under-standing undergirds the model’s logic, making it more useful to community residents and more accurate in describing the behavior of youth in high-violence neighborhoods.

KeywordsYouth violence, systems theory, system dynamics, computer modeling, gang culture, community-based participatory research

Most initiatives to reduce youth violence continue to oper-ate in isolation,5 despite findings that cities that employ more coordinated efforts have lower rates of youth violence.1 Although numerous youth violence task forces have been established, they seldom include noncriminal justice partners. Some in the public health community have suggested the use of a multidisciplinary approach to engage health, justice, mental health, and education in addressing this youth violence epidemic,5,6 but attempts at col-laboration are hindered by the absence of a shared framework.

Page 2: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

68

Progress in Community Health Partnerships: Research, Education, and Action Spring 2011 • vol 5.1

In an effort to explore the root causes of youth violence in Boston, the Emmanuel Gospel Center and the Boston Capacity Tank convened the YVSP to develop a multidisci-plinary framework that can be used by multiple stakeholders. The project steering committee includes representatives from the Emmanuel Gospel Center, the Black Ministerial Alliance of Greater Boston, the Dudley Street Neighborhood Initiative, and project consultants. Academic partners include the Harvard School of Public Health’s Youth Violence Prevention Center and Northeastern University’s Institute on Race and Justice.

oBjECTIvESThe goal of the YVSP is to improve the understanding of

youth violence in Boston, and ultimately to help communities strategize for and achieve sustained reductions in violence. This article describes the process used by YVSP to integrate academic, institutional and community perspectives into an organizing framework using socio-ecological theory,7 and to build a system dynamics computer model to examine the efficacy of violence-reducing strategies in Boston.

METHodSComputer modeling is common in engineering, econom-

ics, and many other disciplines. Although computer modeling has been used to evaluate youth violence in Boston,8 a distinc-tion of YVSP is the engagement of community residents in a group model building process9 to create a system dynamics computer model. The system dynamics modeling methodol-ogy explores the dynamic behavior of complex systems by modeling the accumulation and flow of discrete variables over time. This process was chosen by the project steering commit-tee because of its ability to facilitate community learning and develop a systems-level, conceptual framework.10

Formative Research

We sought to ensure the project would be informed by the literature, culturally relevant, communicated effectively, and respectful of existing community power structures.11 We conducted a review of literature in criminology, psychology, human development, and mental health on youth violence.12 We then created four neighborhood briefing documents,13–16 and assembled an academic–community advisory board.

Copies of the literature review and the briefing documents were distributed to the community, and published online12,17 at the YVSP website.

Additionally, we conducted 45 in-depth interviews with key community, academic, and public institution stakehold-ers; 4 focus groups with gang experts, family mental health experts, and survivors of gang violence; and 12 project brief-ings with community residents, community-based agencies, and academic and institutional stakeholders. Each stakeholder was identified by multiple community members as having a respectful, long-term relationship with neighborhood resi-dents. This input was essential in helping to design a process that was acceptable to both community residents and the institutional and academic partners.

Although we recognized that external risk factors2 (such as diminished economic opportunities or high concentrations of poor residents) can be associated with higher rates of violence within a community, youth violence in Boston is known to occur in hotspot neighborhoods—distinct multi-block areas that have a higher than average number of criminal violent events.18 This led us to focus on the processes within a neigh-borhood that affect violent behavior.

Theories like social disorganization, social efficacy, broken windows theory, and crime opportunity theories have sought to explain differing neighborhood crime levels.18 Discussions with Boston police officers confirmed findings that most seri-ous youth violence occurred among a small number of gang members who “were constantly on watch for each other and, as a result, carried guns, used guns, and acted tough.”19 We therefore chose to view youth violence as a systems problem,20 driven by the dynamic interplay of multiple actors with dis-parate goals and priorities.

The Group Model Building Approach

Understanding that community residents have local knowl edge and expertise about neighborhood dynamics and violence prevention, we concluded that input from commu-nity residents was needed to understand community-based youth violence. We created a process to help residents capture this knowledge by participating in the design, execution, and evaluation of the project. This approach was welcomed, with one participant declaring, “You’re asking me what I think creates the violence cycle? Now that’s a first. Usually outsiders

Page 3: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

69

Bridgewater et al. Understanding Youth Violence in Boston

come and tell us what they think, and then leave, and we never see them again!”

Concept maps21 were used to represent the relationships that drive youth violence within a community and to provide a visual record of corporate thinking. Maps were developed in conversation with community members to describe con-nections between youth violence behavior, the context in which this violence occurs, the institutions that influence this context, and potential catalysts that may drive behavior.

Figure 1 describes residents’ understanding that:

• the violent behavior of youth could be attributed to gang violence (accounting for the vast majority of serious violence including youth homicides) and other, less serious non-gang violence;

• this violence is contextualized to the community, culture, and personal predisposition of youth;

• the context in which violence occurs is influenced by social institutions, family, peers, and public institutions; and

• traumatic stress serves as catalyst, which may drive behavior in the system.

By providing a value-neutral focal point for discussion, the diagrams helped community members to effectively commu-nicate their understanding of the forces that drive violence.

Vennix10 describes the group model building process as a way to facilitate team learning using system dynamics model-ing. We adapted this approach to integrate the perspectives of community residents with academic research and institutional data.

Design teams were convened in 3 neighborhoods (Uphams Corner, Grove Hall, and Bowdoin-Geneva) to oversee the development of the core logic and framework. They worked in close collaboration with a computer model builder to translate findings into visual diagrams and into a computer model. Each design team regularly reviewed, tested, and approved the computer simulation model throughout its development.

Each design team was assembled with the assistance of 3 community partners. Each partnering agency selected 4

figure 1. Concept map: factors affecting youth Violence

Page 4: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

70

Progress in Community Health Partnerships: Research, Education, and Action Spring 2011 • vol 5.1

individuals to participate in the design team (2 adults and 2 youth who were community residents) for a total of 6 adults and 6 youth on each team.

The inclusion of youth in the design teams was an impor-tant part of the process. This provided tremendous insight into the behaviors and motivations of community youth. The process was also perceived as respectful to the community because a significant amount of effort was invested in develop-ing trusting relationships. Furthermore, it provided account-ability, which is crucial in leading sustainable22,23 community transformation.

Hard-to-Reach Focus Groups

During the group model building process, community residents expressed sentiments that—despite their proximity and familiarity with community violence—they knew very little about the behavior and motivations of those perpetrating violence. As a result, we realized the necessity of conducting primary research with gang members and violent offenders.

We partnered with community-based agencies experi-

enced with gang work to identify and engage key individuals in the project. It was decided that it was necessary to talk with young, active gang members as well as older and in some instances founding gang leaders to get a comprehensive pic-ture of the structure and dynamic behavior of gang members. Two focus groups were formed, the first consisting of gang members ages 18 to 23, and the second consisting of men ages 22 to 40 with a history of gang involvement or violent offense. Participants were hired as consultants and tasked with providing information about the methods and rationale for youth violence based on their own experiences.

Group reflective listening along with individual and group observations24 were used to gather information in the form of verbatim quotations and observation notes. In addition to co-facilitating the sessions, partner agency staff and consultants assisted in evaluating and interpreting the data.

description of the Framework and Inputs Into the Model

Stock/flow diagrams* were used to develop a framework for youth violence, which describes the dynamic movement of

figure 2. the model showing “slippery slope” dynamics

* In the language of systems dynamics, “stocks” are the places where items accumulate (in this model, number of youth) and “flows” are the mechanisms by which stocks are increased or depleted. See, for example, “An Introduction to Systems Thinking, iThink” (Barry Richmond, isee systems, 2004).

Page 5: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

71

Bridgewater et al. Understanding Youth Violence in Boston

youth in their involvement with community based violence. Design teams discussed and reviewed the diagrams, modifying them as needed to more accurately reflect team members’ understanding of how violence occurs in their neighborhoods. Through the use of these diagrams, multiple stakeholders were able to communicate with one another in sophisticated ways about youth violence, regardless of age, culture, background, or discipline.

Figure 2 shows the stock/flow diagram for youth violence with the youth population in a community is segmented into a set of 13 categories. Each category represents a sub-set of the youth population as it relates to gang subculture. “Uninvolved,” “associate,” and “on the edge” constitute non-gang categories. The 3 × 3 category matrix represents gang subculture categories.† “Incarcerated” describes those youth who are in jail, prison, or a detention program.

Over time, there is potential for youth to move between the different categories (e.g., from “uninvolved” to “on the edge”). Specific pathways of movement were identified through dis-cussions with project participants. Each pathway represents a potential place for system intervention. The process by which youth move downward into violence is described as “slippery slope” dynamics.

The framework considers the shifting identities and behav iors of youth as they become involved in violence. It provides the core logic for the computer model which serves as a simulation-based laboratory for examining initiatives aimed at reducing youth violence within a community.

The findings of the gang member focus groups suggest that gang involvement represents a radical shift in identity. Gang members describe a subculture in which identity and belonging are reinforced with violence, making it extremely difficult for certain youth to leave gang membership.

This violent subculture displays an abnormal relationship with violence in which gang members report using violence as a dominant mechanism for managing emotional well-being.25 Gang members also describe trauma experienced as a result of their own acts of violence against others. Individuals recounted experiencing extreme fear, uncontrollable shaking, flashbacks,

and in some cases blacking out associated with the first time they personally shot at someone. This suggests that initial acts of violence may lead youth down a path of increasingly violent behavior that is reinforced by self-induced traumatization.

At the beginning of the project it was assumed that the majority of youth in high-violence neighborhoods were uninvolved with gang violence because research showed that community violence was being committed by a “small number of chronically offending gang-involved youth.”26 Discussions with youth from high-violence neighborhoods revealed, however, that most identified themselves and their peers as having a significant number of conspicuous relationships with gang members. This suggests that a complex network of relationships exists between violent and nonviolent youth in high-violence neighborhoods.

Rich and Grey discuss how high levels of traumatic stress for victims of violence may contribute to recurrent interper-sonal violence for victims.27 Community residents, however, describe how the ever-widening ripples of impact from each violent event contribute to heightened levels of traumatic stress for non-victims as well. It seems, then, that the violent behavior of youth in Boston is a place-based phenomenon that is driven in part by higher than normal levels of traumatic stress in high-violence neighborhoods.

The Computer Model

The isee systems STELLA system thinking software pack-age (Lebanon, NH) was used to build the computer model. The model seeks to provide a physical basis for the generation of violence among youth. Focal areas within the model include slippery slope dynamics, community trauma, and youth affin-

figure 3. Community trauma and affinity for Violence feedback loops

† Rogue, less organized, and more organized represent increasing levels of gang organization and structure. For example, rogue represents youth who are regularly involved in non–gang-related violence. Rookie, non-shooter, shooter/leader represent increasing levels of leadership and likelihood to be involved in violent activity.

Page 6: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

72

Progress in Community Health Partnerships: Research, Education, and Action Spring 2011 • vol 5.1

ity for violence. The model uses these focal areas to determine the frequency of high risk interactions and violent activity within and across the 13 categories. Figure 3 provides a highly simplified representation of the model’s logic.

Slippery Slope Dynamics. The model treats in detail the dynamics of movement into gangs and the relationships that influence violent interactions among individuals and gangs. Default movement rates are reflective of macro-system influ-ences such as job availability and levels of neighborhood poverty. These rates can be calibrated to model the effects that different social influences may have on communities of interest. By speeding up or slowing movement between categories, it is possible to capture the impact of real-world initiatives that alter the long-term distribution of youth along the slippery slope. The distribution of youth across the different categories determines how the annual frequency of high-risk interactions is calculated, the likelihood that an interaction will result in violence, and the likelihood that a violent interaction will involve guns.

Community Trauma. Traumatic stress is both a result of and a precursor to violence, and is experienced as violence levels rise

within a community. The model uses the concept of community trauma to model the positive feedback between traumatic stress and violence. As violence levels rise in the community, this increases individual traumatic stress, which increases the fre-quency of high-risk interactions between community members, leading to further increases in violent behavior.

Affinity for Violence. The model uses the concept of “affinity for violence” to capture the impacts of individual trauma that accrues to those engaged in violence. For these individuals, violence drives the growth in affinity for violence, which subsequently increases the likelihood that a high-risk interaction will result in violence.

The model interface enables exploration of initiatives focused on slippery slope dynamics, the generation of violence, as well as on trauma dynamics. In the current version of the model (v. 1.09), configuration of experiments is accomplished through a set of switches. Figure 4 illustrates the modeling of a 4-year initiative aimed at reducing the rate that “on the edge” youth are recruited into gangs and increasing the rate of incar-ceration of gang members by 20% compared with baseline.

figure 4. illustrative interventionIn this model run the following intervention strategies (represented by the switches in the up position) are selected: (1) Reduce rogue entry; (2) reduce less organized gang recruiting; (3) reduce more organized gang recruiting; and (4) clear the streets.

Page 7: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

73

Bridgewater et al. Understanding Youth Violence in Boston

This configuration is then tested through a 12-year simula-tion run.‡ Results can be viewed in isolation on a simulation dashboard, or as a set of comparative graphs and tables of key output metrics. The model projects the distribution of youth among the 13 behavioral categories over time. This distribution is used to calculate an estimation of community trauma, youth related gun violence, and youth related other violence over the simulation run.

Figure 5 shows a drop in community trauma after a 3-year delay and an increase corresponding to community violence in year 6. It also shows a drop in youth gun violence and other violence after a 2-year delay that bottoms out in year 6 and begins to rise and eventually settles at a lower baseline by year 12. By analyzing different scenarios through multiple model runs, the model provides a tool to focus discussions among stakeholders around the relative efficacy of prevention, mitigation, and intervention strategies.

lESSoNS lEARNEd

Community-Based Participatory Research Acknowledges and learns From the Past

It should be understood that all community-based initia-tives occur within the context of the community’s historic relationship with similar projects. In addition to developing critical analytical skills, community residents develop a clear perspective regarding what types of collaborative relationships are useful for their communities. This project benefited from listening carefully to these perspectives and respecting the diversity of skill and motivation within the community. The

project avoided a number of potential pitfalls by listening closely to community residents and learning from their assess-ment of previous initiatives.

When a complaint was raised by residents regarding a previous initiative’s failure to respect community opinions, we decided to place the final model design authorization with community-led learning teams instead of the model builder or project steering committee. This helped to establish credibility early on within the community and helped to overcome the resistance to “outside-in” approaches.28

We also learned from the failure of a previous project to “go deeper with gang members.” Upon partner consultation, the project team adopted a very direct, interpersonal approach to inquiry design that increased our ability to generate primary data about the rules, norms, behaviors, and motivations of gang members. For example, based on this input we asked gang members to describe their initial and ongoing experi-ences perpetrating gun violence. They described their use of violence to “release tension” associated with grief or abating generalized anger, “forcing” conflict with others for personal reasons, and feeling a “rush” and sense of time slowing down during initial experiences with gun violence. This suggests that the presence of a subculture with fundamentally dif-ferent behavioral norms may explain why some initiatives have results that differ from expectations when attempting to modify the violent behavior of gang members. Practitioners with extensive gang expertise (such as law enforcement and youth workers) may have unique insight into the behavior of this subculture and should be consulted to help design the most effective interventions.

‡ A 12-year simulation run was selected to evaluate long-term behavior and optimize the calculation and display behavior of the software application.

figure 5. a 12-year simulation run

Page 8: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

74

Progress in Community Health Partnerships: Research, Education, and Action Spring 2011 • vol 5.1

Successful Partnership Require Considerable Effort

As trust grew over the course of the project, community residents became more open in sharing their unique, valuable insights into youth violence. In many cases, residents had devoted significant thought to the problem; however, draw-ing out these insights required the use of effective listening methods. Ultimately, it must be understood that respectful treatment of community residents requires acknowledging that they are capable of participating in problem definition, analysis, and solution creation. And that this understanding is rooted in the awareness that communities do not exist as monoliths, but contain a diversity of perspective, capacity, ability, and motivation. This is especially true of the deep and meaningful insights that can be gained by understanding the opinions of youth.

Successful partnership treats each partner with respect and allows each participant to contribute from their area of expertise. In this process, we have tried to meet the definition of successful partnerships by including a broad array of agen-cies in the development of the model. Although the commit-ment to develop a sustainable relationship with community residents took twice as long as originally planned, this type of partnership is more fulfilling for groups who often serve as a source of information for academic research but are seldom included in what information is analyzed or presented.

CoNClUSIoNThis project employed a community-based participatory

research process in which residents participated in the design, execution, and evaluation of a detailed, system dynamics computer model of youth violence in Boston. Community residents, from agency leaders to youth to gang members, provided unique insights into the behavior of violent youth in Boston. Their empowerment and engagement in a commu-nity-driven process fostered a collaborative environment in which the logic of community residents could be articulated and explored.

The use of a group model-building process to codify this logic into a system dynamics model created enthusiasm from community residents because they saw their own logic reflected in the evaluation of violence-reducing initiatives. The

project’s community-based approach coupled with its system dynamics methodology produced a new understanding of youth violence in Boston. This understanding undergirds the model’s logic, making it more useful to community residents and more accurate in describing the behavior of youth in high-violence neighborhoods.

Sterman29 notes that the process of model testing and improvement is iterative. The current phase of the project (April 2010 through December 2011) will deepen our rela-tionships with current participants and expand to a broader community as we continue to test and develop the model as a useful tool for facilitating the reduction of youth violence in Boston. Specific activities in this phase include:

• refine the model based on community input;

• train and support 50 community agencies to apply the model to their situation and interests;

• partner with 3 to 5 community agencies to foster ongoing learning about the system of youth violence;

• train and support 200 youth workers to understand and use the model;

• convene 2 community and 1 academic forums; and

• tailor the model to describe a typical high-violence neighborhood in Boston.

Our goals for this phase are to gain deeper insight into the root causes of youth violence, create a broader conversa-tion about these root causes, help people to see where they fit into the framework, discern what is missing, and increase the dialogue about what strategies are needed.

ACKNoWlEdGMENTS The authors thank the following community partners:

Boston TenPoint Coalition, Black Ministerial Alliance of Greater Boston, High-Risk Youth Network, Dudley Street Neighborhood Initiative, Bird Street Community Center, Dorchester Bay Economic Development Corporation, Project R.I.G.H.T., Freedom House, Charles Street AME Church, College Bound Dorchester, Bowdoin Street Health Center, the Teen Center at St. Peter’s, and United Way of Massachusetts Bay and Merrimack Valley. We also thank our project advi-sors: Deborah Prothrow-Stith, Ray Hammond, Jeffrey Brown, Jack McDevitt, and Dean Borgman.

Page 9: A Community-Based Systems Learning Approach to ... Community... · A Community-Based Systems Learning Approach to Understanding ... approach to engage health, ... * In the language

75

Bridgewater et al. Understanding Youth Violence in Boston

REFERENCES1. Weiss B. An assessment of youth violence prevention ac-

tivities in USA cities. Los Angeles: Southern California Injury Prevention Research Center UCLA School of Public Health; 2008.

2. Elliot D, Hatot NJ, Sirovatka P, eds. Youth violence: A report of the Surgeon General. Washington (DC): Department of Health and Human Services; 2001.

3. Fox J, Swatt A, Swatt M. The recent surge in homicides involv-ing young black males and guns: time to reinvest in prevention and crime control. Boston: Northeastern University; 2008.

4. Web-based Injury Statistics Query and Reporting System (WISQARS), Centers for Disease Control and Prevention, [updated 2010 Mar 4]. Available from: http://www.cdc.gov/injury/wisqars/index.html

5. Cohen L, Davis R, Franchak S, Prothrow-Stith D, Quaday S, Swift S, et al. Shifting the focus: an interdisciplinary framework for advancing violence prevention. Prevention Institute Web site [updated 2006 Jul 27; accessed 2010 Jan 6. Available from: http://www.thrive.preventioninstitute.org/shifting.html

6. Cook P, Laub J. The unprecedented epidemic in youth violence. Crime and Justice. 1998;24:27-64.

7. Dahlberg LL, Krug EG. Violence—A global public health problem. In: Krug E, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. World report on violence and health. Geneva, Switzerland: World Health Organization; 2002. p. 1-56.

8. Kennedy D, Braga A, Piehl A. The (un)known universe: map-ping gangs and gang violence in Boston. Crime Prevention Studies. 1998:8:240

9. Richardson GP, Andersen DF. Teamwork in group model building. System Dynamics Review. 1995;11:113-37.

10. Vennix J. Group model building: facilitating team learning using system dynamics. Journal of Organizational Behavior. 1998;19:215-6.

11. Shiu-Thornton S. Addressing cultural competency in research: integrating a community-based participatory research ap-proach. Alcoholism: Clinical And Experimental Research. 2003;27:1361-4.

12. Youth Violence Systems Project [homepage on the Internet]. Literature review. Available from: http://gettingtotheroots.org/gettingtotheroots/literature_review

13. Mitchell R. The Uphams Corner neighborhood briefing docu-ment. Boston: Youth Violence Systems Project; 2008.

14. Mitchell R. The Bowdoin/Geneva neighborhood briefing docu-ment. Boston: Youth Violence Systems Project; 2009.

15. Mitchell R. The Grove Hall neighborhood briefing document. Boston: Youth Violence Systems Project; 2009.

16. Mitchell R. The South End/Lower Roxbury neighborhood briefing document. Boston: Youth Violence Systems Project; 2009.

17. Youth Violence Systems Project [homepage on the Internet] Neighborhood briefing documents. Available from: http://www.gettingtotheroots.org/gettingtotheroots/nbds

18. Eck J, Chainey S, Cameron J, Leitner M, Wilson R. Mapping crime: understanding hot spots. Washington (DC): U.S. Department of Justice, National Institute of Justice; 2005.

19. Kennedy D, Braga A, Piehl A. Reducing gun violence: develop-ing and implementing operation ceasefire. Washington (DC): U.S. Department of Justice, National Institute of Justice; 2001. p. 16-8.

20. Forrester J. System dynamics and the lessons of 35 years. Cambridge: Massachusetts Institute of Technology; 1991.

21. Trochim W. Concept mapping for evaluation and planning. New York: Pergamon Press; 1989.

22. Altman D. Sustaining interventions in community systems: on the relationship between researchers and communities. Health Psychol. 1995;14:526-36.

23. Shediac-Rizkallah MC, Bone LR. Planning for the sustainability of community-based health programs: conceptual frameworks and future directions for research, practice and policy. Health Education Research Theory & Practice. 1998;13:87-108.

24. Patton M. Qualitative research and evaluation methods. Thousand Oaks (CA): Sage; 2002.

25. Hodge J, Hollin CR, McMurran M. Addicted to crime? Hoboken (NJ): John Wiley & Sons Ltd.; 1997.

26. Kennedy D. Pulling levers: chronic offenders, high-crime settings, and a theory of prevention. Valparaiso University Law Review. 1997;31:449-84.

27. Rich J, Grey C. Pathways to recurrent trauma among young black men: traumatic stress, substance use, and the “code of the street.” Am J Public Health. 2005;95:816-24.

28. Minkler M. Ethical challenges for the “outside” researcher in community-based participatory research. Health Educ Behav. 2004;31:684-97.

29. Sterman, J. Learning from evidence in a complex world. Am J Public Health. 2006;96:505-14.