Violence by and to young people - despite recent decreases, still among the most pressing health problems facing the nation's cities - is being targeted by a variety of programs, yet little scientific evidence exists to assess what works and what doesn't, a scientist is warning.
Michael B. Greene, PhD, director of research and evaluation at Hunter College Center on AIDS, Drugs, and Community Health in New York City, writes in the April issue of the journal, Health Education and Behavior : "Even a small percentage reduction in youth violence can substantially reduce health care costs.... Unfortunately, we have not been terribly successful in figuring out how to engage...schools, hospital centers, the juvenile justice system, and youth advocacy programs in collaborative and synergistic efforts."
This is the second of two special issues the journal has focused on community-based health education for urban populations, to help develop an urban health agenda for the next century.
In his review of violence-reduction strategies, Greene examines four basic educational approaches and the evidence related to their effectiveness:
Greene also notes that "it is not clear how and to what extent conflict management programs can be integrated into an overall violence reduction effort, and the few efforts that have been undertaken have not been described in sufficient detail to replicate."
"Youth-operated programs," Greene writes, "establish an avenue for young people to create cohesion and pride in their neighborhoods, to enhance their sense of belonging, and to make friends based on mutually shared, goal-oriented projects."
Dr. Greene notes that most authorities urge "comprehensive and integrated approaches that incorporate aspects of each strategy." The variations of conditions from neighborhood to neighborhood also need to be assessed, he writes, but understanding how and whether programs can be adapted to specific local conditions remains limited. "Even programs that have stood the test of rigorous evaluation in one setting," he says, "may not 'travel' well" and need additional research.
Health Education & Behavior