Measuring the Implementation of Youth Empowerment Solutions.

Scholars have increasingly emphasized the importance of using evidence-based programs to promote health and prevent disease. While theoretically and empirically based programs may be effective in carefully controlled conditions, many fail to achieve desired outcomes when implemented in real-world settings. Ensuring high-quality implementation of health promotion programs is critically important as variation in implementation is closely associated with program effectiveness. The purpose of this article is to present methods used to document and assess the implementation of the Youth Empowerment Solutions (YES) program. We collected process evaluation data on 25 YES groups from 12 schools over a period of 4 years. The evaluation assessed four key aspects of delivery: fidelity, dose delivered, dose received, and program quality. We found wide variations in delivery for some measures, while others were more consistent across groups. These indicators of program delivery provided a strong basis for evaluating program implementation, taking actions to improve it, and ultimately, deepening understanding of program effectiveness. The study suggests a model for using multiple methods to collect and analyze data about aspects of program delivery to guide future implementations.

A Comprehensive Prevention Approach to Reducing Assault Offenses and Assault Injuries among Youth.

Since 2011, the CDC-funded Michigan Youth Violence Prevention Center (MI-YVPC), working with community partners, has implemented a comprehensive prevention approach to reducing youth violence in Flint, MI, based on public health principles. MI-YVPC employed an intervention strategy that capitalizes on existing community resources and application of evidence-based programs using a social-ecological approach to change. We evaluated the combined effect of six programs in reducing assaults and injury among 10-24 year olds in the intervention area relative to a matched comparison community. We used generalized linear mixed models to examine change in the intervention area counts of reported assault offenses and assault injury presentation relative to the comparison area over a period 6 years prior- and 30 months post-intervention. Results indicated that youth victimization and assault injuries fell in the intervention area subsequent to the initiation of the interventions and that these reductions were sustained over time. Our evaluation demonstrated that a comprehensive multi-level approach can be effective for reducing youth violence and injury.

Psychological Empowerment Among Urban Youth: Measurement Model and Associations with Youth Outcomes.

Empowerment-based strategies have become widely used method to address health inequities and promote social change. Few researchers, however, have tested theoretical models of empowerment, including multidimensional, higher-order models. We test empirically a multidimensional, higher-order model of psychological empowerment (PE), guided by Zimmerman's conceptual framework including three components of PE: intrapersonal, interactional, and behavioral. We also investigate if PE is associated with positive and negative outcomes among youth. The sample included 367 middle school youth aged 11-16 (M = 12.71; SD = 0.91); 60% female, 32% (n = 117) white youth, 46% (n = 170) African-American youth, and 22% (n = 80) identifying as mixed race, Asian-American, Latino, Native American, or other ethnic/racial group; schools reported 61-75% free/reduced lunch students. Our results indicated that each of the latent factors for the three PE components demonstrate a good fit with the data. Our results also indicated that these components loaded on to a higher-order PE factor (X2  = 32.68; df: 22; p = .07; RMSEA: 0.04; 95% CI: .00, .06; CFI: 0.99). We found that the second-order PE factor was negatively associated with aggressive behavior and positively associated with prosocial engagement. Our results suggest that empowerment-focused programs would benefit from incorporating components addressing how youth think about themselves in relation to their social contexts (intrapersonal), understanding social and material resources needed to achieve specific goals (interactional), and actions taken to influence outcomes (behavioral). Our results also suggest that integrating the three components and promoting PE may help increase likelihood of positive behaviors (e.g., prosocial involvement); we did not find an association between PE and aggressive behavior. Implications and future directions for empowerment research are discussed.

Community Engagement in Youth Violence Prevention: Crafting Methods to Context.

The purpose of the Youth Violence Prevention Centers (YVPC) Program at the Centers for Disease Control and Prevention is to reduce youth violence in defined high-risk communities through the implementation and evaluation of comprehensive, evidence based prevention strategies. Within this common framework, each YVPC varies in its structure and methods, however all engage communities in multiple ways. We explore aspects of community engagement employed by three centers that operate in very different contexts: a rural county in North Carolina; a suburban area of Denver, Colorado; and an urban setting in Flint, Michigan. While previous research has addressed theories supporting community involvement in youth violence prevention, there has been less attention to the implementation challenges of achieving and sustaining participation. In three case examples, we describe the foci and methods for community engagement in diverse YVPC sites and detail the barriers and facilitating factors that have influenced implementation. Just as intervention programs may need to be adapted in order to meet the needs of specific populations, methods of community engagement must be tailored to the context in which they occur. We discuss case examples of community engagement in areas with varying geographies, histories, and racial and ethnic compositions. Each setting presents distinct challenges and opportunities for conducting collaborative violence prevention initiatives and for adapting engagement methods to diverse communities. Although approaches may vary depending upon local contexts, there are certain principles that appear to be common across cultures and geography: trust, transparency, communication, commitment. We also discuss the importance of flexibility in community engagement efforts.

Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings.

Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have limited guidance on how to prepare their programs for broad dissemination in practice settings. We describe Three Cs of Translation, which are key areas that are essential for developers to translate their EBPs from research to practice settings: (1) Communicate the underlying theory in terms easily understandable to end users, (2) Clarify fidelity and flexibility, and (3) Codify implementation lessons and examples. Program developers are in the best position to describe their interventions, to define intervention core components, to clarify fidelity and flexibility, and to codify implementation lessons from intervention studies. We note several advantages for developers to apply the Three Cs prior to intervention dissemination and provide specific recommendations for translation.

Youth Empowerment Solutions for Peaceful Communities: combining theory and practice in a community-level violence prevention curriculum.

This article describes the development and evaluation of an after-school curriculum designed to prepare adolescents to prevent violence through community change. This curriculum, part of the Youth Empowerment Solutions for Peaceful Communities (YES) program, is guided by empowerment and ecological theories within a positive youth development context. YES is designed to enhance the capacity of adolescents and adults to work together to plan and implement community change projects. The youth curriculum is organized around six themed units: (a) Youth as Leaders, (b) Learning about Our Community, (c) Improving Our Community, (d) Building Intergenerational Partnerships, (e) Planning for Change, and (f) Action and Reflection. The curriculum was developed through an iterative process. Initially, program staff members documented their activities with youth. These outlines were formalized as curriculum sessions. Each session was reviewed by the program and research staff and revised based on underlying theory and practical application. The curriculum process evaluation includes staff and youth feedback. This theoretically based, field-tested curriculum is designed to be easily adapted and implemented in a diverse range of communities.

Developing a cross-site evaluation tool for diverse health interventions.

The Prevention Research Center of Michigan provided technical assistance for the evaluation of 10 projects funded by the Michigan Department of Community Health's (MDCH) Health Disparities Reduction Program. These projects varied considerably in focus, methodology, geographical coverage, and populations served. The authors developed a cross-site evaluation tool to complement the internal evaluations of the projects. The tool contains four sections based on priorities identified by MDCH: evidence-based practice, research-based learning/evaluation (including process, impact, and outcomes indicators), cultural competence, and sustainability. Recognizing the diversity of programmatic efforts and organizational evaluation capacity, the authors sought to enable each project to create the best evaluation possible given the resources and data available. Each section contains a range of components from basic questions to more advanced evaluation techniques. The instrument attempts to use the highest quality of information available for each project. This evaluation tool can be used by programs with diverse goals and methodology.

Community-based organizational capacity building as a strategy to reduce racial health disparities.

One of the biggest challenges facing racial health disparities research is identifying how and where to implement effective, sustainable interventions. Community-based organizations (CBOs) and community-academic partnerships are frequently utilized as vehicles to conduct community health promotion interventions without attending to the viability and sustainability of CBOs or capacity inequities among partners. Utilizing organizational empowerment theory, this paper describes an intervention designed to increase the capacity of CBOs and community-academic partnerships to implement strategies to improve community health. The Capacity Building project illustrates how capacity building interventions can help to identify community health needs, promote community empowerment, and reduce health disparities.

Using a community-based health survey as a tool for informing local health policy.

BACKGROUND: The Speak to Your Health! community survey is a biennial community-based survey designed and implemented by the Prevention Research Center of Michigan whose central mission is to strengthen the capacity of the community to improve health. METHOD: The survey was developed collaboratively by the university and community partners that comprise the Prevention Research Center of Michigan and focuses on health and social issues at the heart of the community of Genesee County, Michigan. FINDINGS: The results of this survey have been used to shape policy changes and strategic planning at the county health department and in local health intervention programs. CONCLUSIONS: This project has demonstrated that useful quantitative data for addressing local public health policy and planning can be collected using the principles of community-based research.

Organizational empowerment in community mobilization to address youth violence.

Community mobilization efforts to address youth violence are often disconnected, uncoordinated, and lacking adequate resources. An organizational empowerment theory for community partnerships provides a useful framework for organizing and evaluating a coalition's community mobilization efforts and benefits for individual organizations, partnerships, and communities. Based on a qualitative analysis of steering committee interviews and other primary data, the results of a case study suggest that the intraorganizational infrastructure; interorganizational membership practices and networking; and extraorganizational research, training, and organizing activities facilitate the community mobilization efforts of the Youth Violence Prevention Center in Flint, Michigan. The organizational empowerment framework, and its focus on organizational structures and processes, illustrates the importance of recognizing and incorporating the organizational systems and structures that provide the foundation on which a community mobilization effort may build. This framework also highlights how organizational structures and processes are central components of multilevel strategies for organizing and mobilizing community efforts to address youth violence.

Youth Empowerment Solutions: Evaluation of an After-School Program to Engage Middle School Students in Community Change.

We report on an effectiveness evaluation of the Youth Empowerment Solutions (YES) program. YES applies empowerment theory to an after-school program for middle school students. YES is an active learning curriculum designed to help youth gain confidence in themselves, think critically about their community, and work with adults to create positive community change. We employed a modified randomized control group design to test the hypothesis that the curriculum would enhance youth empowerment, increase positive developmental outcomes, and decrease problem behaviors. Our sample included 367 youth from 13 urban and suburban middle schools. Controlling for demographic characteristics and pretest outcome measures, we found that youth who received more components of the curriculum reported more psychological empowerment and prosocial outcomes and less antisocial outcomes than youth who received fewer of the intervention components. The results support both empowerment theory and program effectiveness.

From broken windows to busy streets: a community empowerment perspective.

In the present article, we introduce a community empowerment perspective to understanding neighborhoods. A preponderance of literature exists on neighborhood risk factors for crime. Yet less is known about positive factors that make neighborhoods safe and desirable. We propose community empowerment as a conceptual foundation for understanding neighborhood factors that promote social processes, and ultimately, lead to an improvement in structural factors. We suggest that neighborhoods are empowered because they include processes and structures for positive social interactions to emerge and develop. We present busy streets as a mechanism that creates a positive social context, in which social cohesion and social capital thrive. Thus, empowered communities are characterized by climates that promote busy streets. Our article underscores the need to examine both the broader, structural context and social processes operating within this context. Such an integrative perspective is necessary to fully understand how to empower neighborhoods, particularly in the face of structural challenges.

Youth empowerment solutions for violence prevention.

The limited success of youth violence prevention interventions suggests that effective prevention needs to address causes at multiple levels of analysis and empower youth in developing and implementing prevention programs. In this article, we review published studies of youth violence prevention efforts that engage youth in developing or implementing violence prevention activities. The reviewed studies suggest the promise of youth empowerment strategies and the need for systematic outcome studies of empowerment programs. After reviewing empowerment theory applied to youth violence prevention programs, we present a case study of the Youth Empowerment Solutions (YES) for Peaceful Communities program. YES engages middle-school youth in an after-school and summer program that includes a culturally tailored character development curriculum and empowers the youth to plan and implement community improvement projects with assistance from adult neighborhood advocates. The case study focuses on outcome evaluation results and presents evidence of the YES program effects on community-level outcomes (eg, property improvements, violent crime incidents) and on individual-level outcomes (eg, conflict avoidance, victimization). The literature review and the case study suggest the promise of engaging and empowering youth to plan and implement youth violence prevention programs.

Using process evaluation to strengthen intergenerational partnerships in the Youth Empowerment Solutions program.

This study illustrates the utility of process evaluation methods for improving a new violence prevention program, Youth Empowerment Solutions for Peaceful Communities (YES). The YES program empowered young adolescents to plan and complete community improvement projects with neighborhood adult advocates. The process evaluation methods included questionnaires and focus groups with students and interviews with neighborhood advocates. Process evaluation results guided program improvements for the second year. The process evaluation results after the second program year suggested that the program improvements were associated with higher student ratings of program staff and neighborhood advocates. The students and neighborhood advocates reported increased positive experiences after the second program year, but continued to note the challenges of working inter-generationally on community improvement projects.

Challenges and lessons learned in developing a community-based health survey.

BACKGROUND: Collecting community-level data to inform health interventions and monitor health status is critical to improving community health and eliminating health disparities. Ideally, the process for designing and utilizing these data collection tools will include representation from community, service, and academic institutions. The process for incorporating these entities' diverse needs and perspectives, however, can be challenging. OBJECTIVES: This paper describes how a community-academic partnership designed a survey in 2003 and 2005 to examine factors influencing the health of residents in an urban city and surrounding county area. METHODS: The partnership used community-based public health research principles to guide the development of the telephone surveys. LESSONS LEARNED: Through these two survey development processes, we learned three key lessons: To regularly examine our partnership and process; to communicate directly with and obtain the support of each individual partner; and to focus on building the capacity of the partners and partnership.

Flint Photovoice: community building among youths, adults, and policymakers.

Flint Photovoice represents the work of 41 youths and adults recruited to use a participatory-action research approach to photographically document community assets and concerns, critically discuss the resulting images, and communicate with policymakers. At the suggestion of grassroots community leaders, we included policymakers among those asked to take photographs. In accordance with previously established photovoice methodology, we also recruited at the project's outset another group of policymakers and community leaders to provide political will and support for implementing photovoice participants' policy and program recommendations. Flint Photovoice enabled youths to express their concerns about neighborhood violence to policymakers and was instrumental in acquiring funding for local violence prevention. We note salutary outcomes produced by the inclusion of policymakers among adults who took photographs.