Addressing Crime, Violence, and Other Determinants of Health through Community-Based Participatory Research and Implementation Science.

In this paper, we describe the assessment and planning phase of the Thrive community-based initiative to reduce violence and address other determinants of health in a community in the Southwestern United States. Using community-based participatory research (CBPR) and an implementation science framework, we engaged residents and other key stakeholders as equal partners in the assessment and planning process. The Thrive assessment and planning phase involved collaboration among researchers, residents, law enforcement, nonprofit agencies, public health, local government, and other cross-sector partners. We used implementation science in order to examine the barriers and facilitators to addressing community health and safety, to assess the nature and scope of health and safety issues, to review existing solutions, to assess the acceptability and necessary adaptations of selected interventions, and to assess feasibility and sustainability of the initiative. Through interviews, focus groups, analysis of crime incident data, geomapping, and direct observations, our findings highlighted the presence of an open-air drug market, the high-stress nature of the community, concern for the lack of opportunities for youth, the lack of trust between residents and law enforcement, and a need to address the built environment to promote safety and well-being.

Parenting Wisely Six Months Later: How Implementation Delivery Impacts Program Effects at Follow-Up.

We evaluated the effectiveness of the Parenting Wisely (PW) program 6 months post intervention and assessed differences based on delivery format. Using a quasi-experimental design, parents (N = 311) participated in the PW program in one of five formats (i.e., parents-only intensive workshop, parents-only 5-week group, parents and adolescents 5-week group, parent and adolescent online, and parent-only online format). An additional 53 parents served as a comparison group. We used the McMaster Family Assessment Device, the Child Behavior Checklist, and the Violent Behavior Checklist to measure family functioning, parenting, and adolescent behavior. Relative to the comparison group, at 6 month follow-up parents who participated in PW reported increases in confidence in their parenting skills, decreases in conflicts with their adolescents, and decreases in adolescent externalizing and violent behavior. Mechanisms of change analyses supported the conceptual model that program effects were related to child behavior changes by influencing positive parenting and decreasing negative family dynamics. PW effectiveness did not vary substantially by delivery format, except for the intensive workshop format, which was less effective than other formats. These findings extend research on PW to include evidence of sustained program effects on adolescent externalizing and violent behaviors in an ethnically diverse, socioeconomically disadvantaged sample. Study findings are relevant to agencies and clinicians who are seeking to implement an evidence-based, flexible parent-training program.