A Multi-level Approach to Violence Prevention Among African American Adolescents

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 Kingston community at 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 Kingston neighborhood, which
is 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 Kingston 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 Kingston.

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.

Boys Inclusion Criteria:

- Male

- Identify as African American or Black

- Be in 6th to 8th grade (aged 11-14 years at the time of the study enrollment)

- Be a current student at the Hayes K-8 school at the time of the study enrollment

- Reside in the Kingston community

- Be able to meet after school once a week for 4-months.

Boys Exclusion Criteria:

- Not English speaking

Caregivers Inclusion Criteria:

- Identify as the primary caregiver of a boy enrolled in the study

Caregivers Exclusion Criteria:

- Not English speaking