CDC Advances Violence Prevention Research
CDC’s Injury Center Research Priorities helps identify and encourage innovative research. Research is fundamental to helping states and communities prevent violence. The Division of Violence Prevention (DVP) conducts research on the factors that put people at risk or protect them from violence, creates and evaluates the effectiveness of prevention strategies, and examines how to adopt and disseminate prevention strategies.
- Adapting and Testing the myPlan App to Prevent Dating Violence with Adolescents
Institution – Johns Hopkins University; Principal Investigator – Dr. Nancy Glass
Sexual and physical dating violence among adolescents are common, can result in serious injury, and increase the risk for violence and other health problems in adulthood. The myPlan app is a web-based resource for young adults about dating relationships and safety planning. The myPlan app will be adapted for use by adolescents living in urban and rural communities and rigorously evaluated using a longitudinal, randomized study. Relative to other information resources, the myPlan app’s impact on victimization and perpetration of sexual and dating violence as well as safety, bystander behavior, and mental health will be examined. Results could inform ways to use technology to strengthen community approaches to preventing dating violence.
- Experimental Evidence on Reducing Youth Violence and Improving Life Outcomes in Chicago
Institution – University of Chicago; Principal Investigator – Dr. Jens Ludwig
Youth violence is a chronic problem in the United States, with homicide being a leading cause of death among African American and Hispanic youth. Although effective school-based prevention programs are available, little is known about how to successfully engage and maintain youth at highest risk for violence in programs administered outside of institutional settings. Choose to Change (C2C) is an intensive mentoring program for high-risk youth that incorporates trauma-informed cognitive behavioral therapy. Using a randomized controlled trial, the impact of C2C on violent crime among participants and their peers and the cost-effectiveness of the program will be evaluated. The manual for the program will be developed to enable other communities to replicate the program. The findings could help communities prevent youth violence and improve the safety and life outcomes of some of the most vulnerable young people.
- Expect Respect Middle School: Preventing Serious and Lethal Violence Among Youth with Prior Violence Exposure
Institution – University of Pittsburgh at Pittsburgh; Principal Investigator – Dr. Elizabeth Miller
Adverse childhood experiences, such as witnessing domestic violence, loss of a loved one to homicide, and violence victimization, are common and increase the risk for future health and social difficulties. Expect Respect is a gender-specific support group for middle school students with a history of exposure to violence. This program modifies beliefs about violence, gender expectations that foster violence perpetration, and bystander behavior. A longitudinal, cluster-randomized study with 36 middle schools will examine the impact of Expect Respect on dating violence, sexual violence, weapon carrying, physical fighting, sexual harassment, bystander behaviors, and suicidal behaviors relative to usual services. This research can inform ways to efficiently and effectively prevent multiple forms of serious and lethal violence by addressing common risk and protective factors.
- A National Evaluation of Medicaid Expansion on the Prevention of Child Abuse and Neglect, Youth Violence, and Intimate Partner Violence
Institution – John Hopkins University; Principal Investigator – Dr. Elizabeth Letourneau
Low-income communities are disproportionately affected by violence and other public health challenges. Policies and programs, such as those supported by Medicaid, can have positive impacts on child and family well-being, including reducing risk factors for violence. This research is the first longitudinal evaluation of the impacts of the Medicaid expansion adopted by 32 states relative to states that did not expand coverage on child abuse and neglect, youth violence, and intimate partner violence. The results from this study can inform how communities use policies, in combination with other support services, to prevent multiple forms of violence.
- Evaluation of State Earned Income Tax Credit Policies for the Primary Prevention of Multiple Forms of Violence: A Natural Experiment
Institution – University of Washington; Principal Investigator – Dr. Ali Rowhani-Rahbar
Poverty has profound adverse effects on health, including increasing the risk for violence. Earned income tax credits (EITCs) reduce this risk by helping low-income families increase their income while incentivizing work or offsetting the costs of child rearing. The 29 states and the District of Columbia with EITCs vary in their administration. Three decades of data will be used to examine how EITCs and their variability impact child abuse and neglect, youth violence, intimate partner violence, sexual violence, and suicide as well as other factors impacting health such as stress, parenting practices, and well-being. The findings may provide actionable evidence about how policy implementation can prevent violence and improve public health.
- Anti-Bullying Laws and Youth Violence in the United States: A Longitudinal Evaluation of Efficacy and Implementation
Institution – University of Minnesota; Principal Investigator – Dr. Marizen Ramirez
Bullying is a common form of youth violence in the United States. Although all 50 states have enacted anti-bullying legislation, limited research is available about whether, why, and for whom these strategies are effective. Longitudinal and quasi-experimental data will be used to assess the effectiveness of anti-bullying laws in reducing multiple forms of violent behaviors among youth, including bullying, cyberbullying, school fighting and assaults, weapons carrying, teen dating violence, and suicidal behavior. School climate, identification of specific higher risk groups, and varying implementation approaches will also be examined for their influence in reducing youth violence. Results from this research project could inform ways for communities to strengthen their comprehensive approaches to prevent bullying and other forms of violence impacting youth.
- Evaluating the Prevention Effects of Men of Strength (MOST) Clubs on Sexual Violence and Teen Dating Violence Perpetration
Institution – Research Triangle Institute; Principal Investigator – Dr. Marni Kan
Sexual violence and dating violence among high school students are significant public health problems, and increasing the availability of evidence-based primary prevention strategies is critical. The MOST Club is an after-school positive youth development program that encourages high school males to become “change agents” by promoting healthy masculinity and peer leadership within their school community. This promising sexual violence prevention strategy will be evaluated using a randomized controlled trial with 16 high schools. Examined program impacts will include changes in the perpetration of sexual violence, teen dating violence, other forms of interpersonal violence, and bystander behaviors at six-month and one-year follow-ups. This research can inform ways to efficiently and effectively prevent multiple forms of violence by addressing common risk and protective factors.
- A Comprehensive Parent-Child Prevention Program for Youth Violence: The YEA/MADRES Program
Institution – University of California, Irvine; Principal Investigator – Dr. Nancy Guerra
Youth violence disproportionately affects Latino youth, yet few prevention programs have been rigorously evaluated with Latino adolescents, families, and communities. Building on an existing network of promotoras (lay health workers), this research will develop, implement, and evaluate an approach that combines the Youth Engaged for Action (YEA) program and Madres a Madres family program. The integrated YEA/Madres Program will build skills among youth and parents, promote anti-violence norms, and engage youth and their caregivers in community violence prevention projects. The impact of the YEA/Madres Program on youth violence and dating violence will be examined using a randomized controlled trial in six urban Latino communities with violence rates approximately six times the national average. The findings from this research will inform community strategies to prevent multiple forms of violence and highlight ways to deliver prevention strategies using innovative, cost-effective, and culturally-appropriate designs.
- The Denver National Center of Excellence in Youth Violence Prevention: The Denver Community-Level Collaborative
Institution – University of Colorado; Principal Investigator – Dr. Beverly Kingston
An infrastructure to support coordinated, comprehensive youth violence prevention is critical but often lacking particularly in high-burden urban communities. The Denver Youth Violence Prevention Center will address this gap by collaborating with partners in two communities to implement Communities That Care (CTC). CTC is an evidence-based, community-level prevention system that uses data to help communities understand how to best prevent violence. The Center will evaluate the impact of its activities on the communities’ readiness and capacity to implement prevention activities and decreases in rates of youth violence. An implementation roadmap will be developed so that other communities can replicate and benefit from Denver’s successes.
- Clark-Hill Institute for Positive Youth Development: Evaluation of a Comprehensive Community-Level Approach to Youth Violence Prevention
Institution – Virginia Commonwealth University; Principal Investigators – Drs. Saba Masho and Terri Sullivan
Effective youth violence prevention programs are available but underutilized, and more needs to be learned about approaches that change community-level risks for violence. The Clark-Hill Institute will implement and evaluate Communities that Care (CTC) PLUS, an enhancement of CTC with Walker-Talker community outreach that strengthens awareness, capacity, and collaboration to use evidence-based strategies. CTC PLUS will be evaluated in three Richmond, Virginia neighborhoods for associated changes in rates of youth homicide and injury, neighborhood factors that affect the likelihood of violence, and community capacity to implement effective strategies.
- Testing the Efficacy of a Strengths-Based Curriculum to Reduce Risk for Future Sexual Violence Perpetration among Middle School Boys
Institution – New York State Department of Health, Health Research, Inc.; Principal Investigator – Dr. Leah Wentworth
The New York State Department of Health will collaborate with Cornell University to evaluate the efficacy of a strengths-based curriculum called the Council for Boys and Young Men. This program is designed to reduce risk for future sexual violence perpetration among middle school boys aged 12-14 years. The impact of the program on a number of outcomes will be examined, including sexual assault perpetration, bystander behavior, attitudes related to gender roles and acceptability of sexual violence, interpersonal relationships, and youth-adult connectedness. Factors that may impact the implementation of the program will also be assessed, and results will be used to inform future Rape Prevention Education Program activities.
- Preventing Sexual Violence Through a Comprehensive, Peer-Led Initiative: A Process and Outcome Evaluation
Institution – University of New Hampshire; Principal Investigator – Dr. Katie Edwards
This research will be conducted in collaboration by the University of New Hampshire, the South Dakota (SD) Network Against Family Violence and Sexual Assault, the SD Department of Health, and Rapid City, SD Area Schools. A youth-led violence prevention initiative will be implemented and evaluated via a quasi-experimental design in middle and high schools within Rapid City, SD. Examined program effects will include sexual violence perpetration, bystander actions, and other behaviors, such as bullying and suicidality. Information will be collected from youth, school staff, caregivers, and social media to understand how prevention messages are shared. A cost-analysis of implementing the program will be conducted to inform replication, dissemination, scalability, and sustainability efforts.
- The Impact of Sources of Strength, a Primary Prevention Youth Suicide Program, on Sexual Violence Perpetration among Colorado High School Students
Institution – University of Florida; Principal Investigator – Dr. Dorothy Espelage
The University of Florida and the Colorado Department of Public Health & Environment will collaborate on a randomized controlled trial of Sources of Strength (SoS). SoS is a school-based program that builds connections between trained student leaders and adults to strengthen social connectedness, help-seeking, and healthy norms about behavior. Previous program evaluations have shown many benefits, including reducing risks and increasing supports for students with histories of suicidal ideation. The potential broader effects on sexual violence perpetration by 9th-11th grade students will be examined in 24 high schools. This prevention strategy could have substantial public health impact by addressing risk and protective factors for multiple forms of violence.
- A Randomized Trial of Wise Guys: The Next Level
Institution – University of North Carolina-Chapel Hill; Principal Investigator – Dr. Kathryn Beth Moracco
This research will be conducted through a collaboration between the University of North Carolina-Chapel Hill, the Children’s Home Society of North Carolina, and the North Carolina Coalition Against Sexual Assault. The study will rigorously evaluate an ongoing Rape Prevention Education program, Wise Guys: The Next Level. This program seeks to reduce sexual violence perpetration by addressing known risk and protective factors, such as rape culture and unhealthy masculinity, gender stereotyping, communication, and consent in relationships. Using a cluster-randomized design, the study will evaluate the program’s impacts on the perpetration of sexual violence, dating violence, bullying, and harassment as well as sexual risk behavior. The implementation costs will also be assessed to inform future prevention activities.
- Youth Empowerment Solutions for Healthy Relationships: Engaging Youth to Prevent Sexual Violence
Institution – Wayne State University; Principal Investigator – Dr. Poco Kernsmith
Wayne State University, the University of Michigan, and the Michigan Rape Prevention Education Program will collaborate to adapt, implement, and evaluate Youth Empowerment Solutions, a primary prevention strategy focused on influencing community-level change through youth empowerment and positive youth development. A group randomized trial will be used to examine the effects of the strategy on sexual violence and teen dating violence perpetration, youth empowerment, social connectedness, and social norms in six high schools in Wayne County, Michigan.
- Preventing Child Maltreatment with Economic Supports
Institution – University of Wisconsin-Madison; Principal Investigator – Dr. Kristen Shook Slack
Project GAIN (Getting Access to Income Now) is designed to prevent child abuse and neglect by improving family economic resources and reducing financial stressors. Families in the intervention will have assessments of their economic needs, receive assistance in identifying and accessing resources, and get support with financial decision-making. Approximately 800 at-risk families will be randomly assigned to the intervention or control groups. This research will collect information from families over one year and from administrative databases over two years to examine the intervention’s effects on rates of child abuse and neglect. A cost-benefit analysis will be conducted.
- Exploring the Causal Impacts of Economic and Social Safety Net Policies on Child Neglect in the United States: Implications for Primary Prevention
Institution – University of Kansas-Lawrence; Principal Investigator – Dr. Michelle Johnson-Motoyama
This multi-phase study will examine whether economic and social safety net policies impact rates of child abuse and neglect using an integrated, longitudinal database. It will investigate the association between reports of child neglect and changes in multiple state and county programs, such as Temporary Assistance for Needy Families, Earned Income Tax Credits, and Supplemental Nutrition Assistance Programs, which occurred between 1995 and 2014. The effects of state policy changes on rates of child neglect based on children’s age, race/ethnicity, and gender will be examined. A cost analysis platform will be developed to inform prevention strategies.
- A Medical Home-Based Intervention to Prevent Child Neglect in High-Risk Families
Institution – Boston Medical Center; Principal Investigator – Dr. Caroline Kistin
This study is a randomized controlled efficacy trial of Child Abuse Prevention Problem Solving (CAPPS). CAPPS is a targeted intervention designed to address specific stressors faced by low-income parents of children with special health care needs and to enhance family strengths in order to reduce the risk of child abuse and neglect. The program seeks to improve parent functioning by decreasing perceptions of being overwhelmed by daily problems, increasing self-efficacy, and buffering the impact of life stressors on mood. Approximately 250 parents from seven urban patient-centered medical homes will participate in a randomized controlled trial. The study will examine for program effects on referrals to child protective services for neglect, adherence to children’s medical care, and improvements in key parenting skills and overall well-being.
- Prevention at the Outer Layers of the Ecology: GreenDot to Build Collective Efficacy and Change Injunctive Norms
Institution – University of New Hampshire; Principal Investigator – Dr. Victoria Banyard
Community approaches to preventing intimate partner and sexual violence are needed, and promising strategies such as GreenDot bystander training may be an important component. The Green Dot model seeks to engage community members, through awareness, education and skills-practice, in behaviors that result in intolerance of violence as the norm. GreenDot Community will be examined using a quasi-experimental design with communities receiving GreenDot bystander trainings, GreenDot bystander trainings and capacity building for a social marketing campaign and action events, or no intervention. Reductions in rates of intimate partner and sexual violence will be examined as well as changes in community collective efficacy and norms intolerant of gender-based violence.
- Bystander Program Adoption and Efficacy to Reduce Sexual Violence and Intimate Partner Violence in College Community
Institution – University of Kentucky; Principal Investigator – Dr. Ann Coker
Bystander training helps all community members prevent dating, intimate partner, and sexual violence. Publicly-funded colleges and universities are required to implement this promising prevention strategy. A quasi-experimental study involving 24 colleges and universities will compare three bystander approaches: exclusively online training, Green Dot (an in-person, skills-based program), and other skills-based, interactive bystander programs. The impact of these approaches on sexual and intimate partner violence-related attitudes, knowledge, behaviors as well as cost-effectiveness will be examined.
- Community Level Primary Prevention of Dating and Sexual Violence in Middle Schools
Institution – Rhode Island Hospital; Principal Investigator – Dr. Lindsay Orchowski
Changing beliefs and social norms can improve health; however, this promising approach has not been examined for preventing dating and sexual violence. This study, which will take place in middle schools, will look at how effective a social norms marketing campaign can be in affecting misperceptions about the acceptability of dating and sexual violence, gender roles, sexual activity, sexual communication/consent, support for victims, and bystander intervention. Reductions in rates of dating and sexual violence and promoting change in community norms will be examined. Middle school students are a key population for dating and sexual violence interventions as healthy relationship behaviors can have a positive effect on a teens’ emotional development. Prevention efforts that begin early can help promote lifelong health and well-being.
- Implementing Fourth R in U.S. Schools: Feasibility, Fidelity, and Sustainability
Institution – University of Texas Medical Branch at Galveston; Principal Investigator – Dr. Jeffrey Temple
The Fourth R program integrates promotion of healthy relationship skills and prevention of teen dating violence into existing school curricula. Research has demonstrated the effectiveness of Fourth R; however, implementing the program with fidelity and sustainability in real-world settings can be more difficult. This study will identify how factors at the school, teacher, and student levels affect program feasibility, fidelity, and sustainability in order to enhance implementation of this effective program. Teachers will be trained to implement Fourth R with 9th-grade students in 10 ethnically, economically, and geographically diverse high schools in Texas. Implementation barriers at the school, teacher, and student levels will be captured as well as practices that can assist with sustainability of the intervention and how these issues may affect changes in student’s attitudes, knowledge, and behaviors related to teen dating violence.
- Randomized Trial Integrating Substance Abuse with Bystander-Based Violence Prevention
Institution – University of Kentucky; Principal Investigator – Dr. Ann Coker
Rates of sexual violence and dating violence are high among college students. Binge drinking also commonly occurs in undergraduate populations and may be related to violence victimization and perpetration. This study will implement different levels of bystander-based prevention programming at the University of Kentucky to better understand bystander intervention approaches that may reduce not only sexual and dating violence behaviors but also reduce alcohol abuse. The cost-effectiveness of these approaches will also be studied.
- Alcohol Policies to Prevent and Reduce Youth Violence Exposure
Institution – Johns Hopkins University; Principal Investigator – Dr. Debra Furr-Holden
Violence among youth ages 10 to 24 is a leading cause of injury and premature death. Research demonstrates that alcohol can increase the rate of injury and violence among children and adolescents. This study will rigorously evaluate the longitudinal relationship between alcohol outlet density, alcohol policies, and changes in the alcohol environment on rates of youth violence in 10 Alcohol Beverage Control States. An in-depth analysis in one state will examine the mediating roles of policy enforcement and changes in overall community disorder/disadvantage on rates of youth violence.
- Tailored Activation in Primary Care to Reduce Suicide Behaviors in Middle-Aged Men
Institution – University of California at Davis; Principal Investigator – Dr. Anthony Jerant
About half of all middle-aged men who die by suicide are seen by a primary care provider within a month of dying, suggesting the potential of primary care-based suicide prevention. A randomized control trial will evaluate whether suicidal ideation and behaviors are reduced by Multimedia Activation to Prevent Suicide for Men (an interactive computer program addressing suicide risk) linked with telephone evidence-based follow up care.
- Online Screening and Early Intervention to Prevent Suicide among Middle-Aged Men
Institution – University of Maryland at Baltimore; Principal Investigator – Dr. Jodi Jacobson Frey
Increasing identification of middle-aged men at risk for suicide and their help-seeking behavior could reduce suicide. A randomized control trial will evaluate Screening for Mental Health (an online screening program) plus Man Therapy (a comprehensive online screening and referral intervention for men) compared to Man Therapy alone on changes in suicidal behavior, ideation, and help-seeking behavior.
- Michigan Youth Violence Prevention Center: Community Engagement and Revitalization
Institution – University of Michigan; Principal Investigator – Dr. Marc Zimmerman
Improving and sustaining a safe physical environment in communities and creating spaces to strengthen social relationships is a promising youth violence prevention strategy. The Michigan Youth Violence Prevention Center will study the effects of improving vacant properties on violence, property crimes and intentional injuries among youth in Flint, Michigan, Youngstown, Ohio and Camden, New Jersey. A community and youth-engaged approach to maintaining and improving environments will be compared to professional maintenance. Over 100 communities nationwide that have greening programs will be asked to share their experiences and lessons learned to inform an implementation guide.
- Chicago Center for Youth Violence Prevention
Institution – University of Chicago; Principal Investigator – Dr. Deborah Gorman-Smith
Researchers from the Chicago Center for Youth Violence Prevention and a coalition of faith and community leaders will evaluate the process and impact of implementing Communities that Care (CTC) in Bronzeville, Illinois. CTC is a promising, community-level prevention system that provides a data-driven framework for community decision-making and implementation of evidence-based prevention programs that best address community needs, values, and resources. This study will be the first evaluation of CTC’s impact on youth violence and neighborhood social organization in an inner-city community. Additionally, current prevention strategies, such as Chicago’s Green Healthy Neighborhoods Large Lots Program and Safe Passage Program, will be evaluated for their impact on youth violence and results will inform future community and policy strategies.
- University of Louisville Youth Violence Prevention Center: Changing the Narrative by Using Media to Shift Social Norms of Violence
Institution – University of Louisville; Principal Investigator – Dr. Monica Wendel
Changing norms about the acceptability of violence as a way to resolve conflicts is a promising youth violence prevention strategy that requires additional study. Researchers at the University of Louisville and Vanderbilt University will partner to develop, implement and evaluate a mass and social media campaign to change norms about violence and reduce violence among youth in West Louisville, Kentucky relative to youth in East Nashville, Tennessee. The development and implementation of the social norming campaign will be documented to inform replication and scalability in other communities.
- Evaluating a Dating and Sexual Violence Bystander Prevention Program with High School Youth: A Cluster Randomized Control Trial
Institution – University of New Hampshire; Principal Investigator – Dr. Katie Edwards
Dating violence and sexual assault among high school students is a significant public health problem, and the increased availability of evidence-based primary prevention strategies is critical. Bystander approaches are a promising strategy that encourages all community members to be involved in prevention. This research is a cluster randomized control trial of the Bringing in the Bystander-High School Curriculum. The impact of this program on dating and sexual violence-related attitudes, knowledge, and behaviors will be examined by surveying students and school staff in 26 high schools before the program is implemented, at the end of the program, and at five-month and one-year follow-ups.
- A Cluster-Randomized Trial of a Middle School Gender Violence Prevention Program
Institution – University of Pittsburgh; Principal Investigator – Dr. Elizabeth Miller
Although dating and sexual violence can begin early, few evidence-based prevention programs are available for middle school youth. This research will address this gap with a cluster randomized control trial of Coaching Boys into Men, a promising strategy that trains athletic coaches to modify gender norms that contribute to dating and sexual violence and to promote bystander intervention skills. The impact of this program on dating and sexual violence knowledge and perpetration, gender-related views of relationships, and bystander skills will be examined by surveying male athletes in 26 middle schools before the program is implemented, at the end of the sport season, and again one year later.
- Youth Violence Prevention through Environmental Design
Institution – University of Michigan; Principal Investigator – Dr. Mark Zimmerman
Youth violence is a significant public health problem as indicated by youth homicide being the third leading cause of death among 10-24 year-olds. This research will examine the effects of crime prevention through environmental design (CPTED) and other school- and community-based prevention activities on youth violence. CPTED activities include addressing blight and crime hotspots, stabilizing land use, and establishing leisure and recreational areas that are safe. A quasi-experimental design will examine the effects of CPTED activities only, CPTED activities plus other school- and community-based prevention strategies, other school- and community-based prevention strategies only, and no prevention strategies on crime incidents, assault injuries, property conditions, and residents’ perceptions and behaviors.
- Policy Brief: Preventing Sexual Violence Among Young People in the U.S. [245 KB, 2 pages, 508]
- Policy Brief: Preventing Child Abuse and Neglect in the U.S. [249 KB, 2 pages, 508]
- Policy Brief: Preventing Suicide in the U.S. [224 KB, 2 pages, 508]