Associations between land bank ownership and stewardship of vacant properties and crime, violence, and youth victimization in Flint, MI.

Land banks across the United States are managing expanding vacant property inventories. By maintaining vacant properties and engaging residents in the process, land banks facilitate processes integral to building safe neighborhoods and may play a role in violence prevention. Using generalized additive mixed model regression, adjusted for spatial and temporal dependencies, we examined whether land bank ownership and stewardship of vacant properties in Flint, Michigan were associated with trends in serious, violent, and firearm-involved crime, between 2015 and 2018. We tested for differences in trends in crime density between properties owned by the Genesee County Land Bank Authority (GCLBA; n = 7151) and comparison properties not owned by the land bank (n = 6,245). In addition, we tested for differences in crime density trends between vacant properties that received different levels of land bank stewardship, including biannual mowing, GCLBA standard stewardship, and GCLBA-sponsored community-engaged stewardship. We found that GCLBA ownership was associated with net declines in densities of all types of crime and violence, over time, relative to properties not owned by the GCLBA. When we distinguished between levels of stewardship, we found that GCLBA stewardship, both with and without community engagement, was associated with net declines in serious and violent crime relative to comparison properties. Only community-engaged GCLBA stewardship was associated with declines in firearm-involved crime and firearm-involved crime with a youth victim over time, relative to comparison properties. Land bank stewardship of vacant properties may be protective against crime, violence, and youth victimization in legacy cities like Flint, MI that experience high rates of vacant properties and violent crime.

Community identified characteristics related to illegal dumping; a mixed methods study to inform prevention.

Illegal dumping is a public health burden for communities suffering from historical disinvestment. We conducted a mixed methods study to answer: 1) What are stakeholder perspectives on social/environmental determinants of illegal dumping? and 2) Do these or other characteristics predict known locations of illegal dumping? We employed an exploratory sequential design in which we collected and analyzed in-depth interviews (n=12) with service providers and residents and subsequently collected and analyzed data from multiple secondary sources. Stakeholders endorsed nine determinants of illegal dumping: Economic Decline, Scale of Vacancy, Lack of Monitoring, Poor Visibility, Physical Disorder, Illegal Activity, Norms, Accessibility, and Seclusion. Results demonstrate important community-identified, modifiable, social, and environmental characteristics related to illegal dumping with the potential to inform effective prevention.

Community engagement, greening, and violent crime: A test of the greening hypothesis and Busy Streets.

Researchers have documented that vacant lot greening can reduce community-level crime and violence. Busy Streets Theory (BST) suggests that residents who are involved in the greening process can help to improve physical environments and build social connections that deter crime and violence. Yet few researchers have explored how community engagement in the greening process may affect crime and violence outcomes. We applied BST to test the effects of community-engaged vacant lot greening compared to vacant lots that received either professional mowing or no treatment, on the density of violent crime around study lots. Using mixed effects regression models, we analyzed trends in violent crime density over the summer months from 2016 to 2018 at 2102 street segments in Youngstown, OH. These street segments fell within 150 meters of an intervention parcel that was classified as one of three conditions: community-engaged maintenance, professional mowing, or no treatment (control). We found that street segments in areas receiving community-engaged maintenance or professional mowing experienced greater declines in violent crime density than street segments in areas receiving no treatment, and more decline occurred in the community-engaged condition compared to the professional mow condition. Our findings support BST and suggest that community-engaged greening of vacant lots in postindustrial cities with a concentrated vacancy can reduce crime and violence.

Firearm safety counseling among caregivers of high-school age teens: Results from a National Survey.

Firearms are the leading cause of death for high-school age teens. To inform prevention efforts, we characterize the prevalence of healthcare provider (HCP) counseling of caregivers of teens around firearm safety, safety conversation elements, and caregiver receptivity towards counseling. A cross-sectional web survey (6/24/2020-7/22/2020) was conducted among caregivers (n = 2924) of teens (age:14-18). Weights were applied to generate nationally representative estimates. Bivariate analyses and multivariate regressions were examined. Among respondents, 56.0% were women, 75.1% were non-Hispanic White, and mean (SD) age was 47.4. Firearm safety was the least discussed topic among caregivers reporting their teen received HCP preventative counseling (14.9%). For caregivers receiving counseling, the most common issues discussed were household firearms screening (75.7%); storing firearms locked (66.8%); and storing firearms unloaded (53.0%). Only 24.6% of caregivers indicated firearm safety was an important issue for teen HCPs to discuss and only 21.9% trusted teen HCPs to counsel about firearm safety. Female caregivers (aOR = 1.86;95%CI = 1.25-2.78), those trusting their teen's HCP to counsel on firearm safety (aOR = 9.63;95%CI = 6.37-14.56), and those who received teen HCP firearm safety counseling (aOR = 5.14;95%CI = 3.02-8.72) were more likely to favor firearm safety counseling. Caregivers of teens with prior firearm safety training (aOR = 0.50;95%CI = 0.31-0.80) were less likely to agree that firearm safety was an important preventative health topic. In conclusion, few caregivers receive preventive counseling on firearm safety from their teen's HCP, with trust a key barrier to effective intervention delivery. Future research, in addition to understanding barriers and establishing effective strategies to increase safety practices, should focus on increasing provider counseling competency.

Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative study.

This study examined how teachers discuss various factors as impacting their ability to execute with fidelity the Michigan Model for Health (MMH), an evidence-based health universal prevention curriculum widely adopted throughout Michigan. Researchers have found a robust relationship between fidelity and participant outcomes, including in schools. While previous studies have identified barriers that inhibit fidelity, few have focused on identifying key barriers and deepening our understanding of how these factors influence intervention fidelity. We conducted a thematic analysis using the reflexive thematic approach to identify key barriers and facilitators and deepen our understanding of how these factors influence MMH implementation. Guided by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcomes Framework, we conducted semistructured interviews with 23 high school health teachers across Michigan. Teachers identified intervention characteristics (e.g., design quality, packaging, and program adaptability), student needs (e.g., trauma exposure, substances), and the fit between the intervention and the context as factors that contributed to acceptability. They also discussed the curriculum and its alignment with their teaching style and/or experiences as contributing to fidelity. Teachers shared how they would often go "off protocol" to improve intervention-context fit and meet students' needs. Our results identified acceptability, a perceptual implementation outcome, as demonstrating an important role in shaping the relationship between CFIR factors and fidelity. Results provide guidance for systematically designing implementation strategies that address key barriers to improve acceptability, enhance fidelity, and ultimately achieve desired public health objectives.

Why some parents made firearms more accessible during the beginning of the COVID-19 pandemic: results from a national study.

The objective of this study was to assess parents' firearm storage behaviors during the COVID-19 pandemic and characterize reasons why some parents made their firearms more accessible during this time. In June-July 2020, the study team conducted the FACTS National Survey-a cross-sectional, web-based, survey of 2,924 parents and their teens (ages14-18) regarding firearm-related practices. We weighted descriptive analyses to be nationally representative of parents of teens in the United States. We utilized qualitative thematic analysis to identify parents' reasons for making firearms more accessible. Five percent of firearm-owning parents of teens reported making their firearms more accessible during the beginning of the COVID-19 pandemic. Reasons why parents increased the ease of firearm access included: (1) Increased civil unrest and riots; (2) Threat of home invasion and/or crime victimization; (3) Fear of panic and the unknown; and (4) Easier access and greater protection, threat unspecified. Some parents-largely motivated by fear-chose to store firearms in a more accessible manner during the beginning of the COVID-19 pandemic to protect their family against possible external threats. Understanding the fear that motivates parents' decisions regarding storage practices might aid interventions focused on harm reduction and safer storage.

Community-Engaged Neighborhood Revitalization and Empowerment: Busy Streets Theory in Action.

Busy streets theory predicts that engaging residents in physical revitalization of neighborhoods will facilitate community empowerment through the development of sense of community, social cohesion, collective efficacy, social capital, and behavioral action. Establishing safe environments fosters positive street activity, which reinforces neighborhood social relationships. A community-engaged approach to crime prevention through environmental design (CE-CPTED) is one promising approach to creating busy streets because it engages residents in collaborative interactions to promote safer environments. Yet, few researchers have studied how CE-CPTED may be associated with busy streets. We interviewed 18 residents and stakeholders implementing CE-CPTED in Flint, Michigan. We studied three neighborhoods with different levels of resident control over CE-CPTED. Participants described how CE-CPTED implementation affected their neighborhood. Participants from all three neighborhoods reported that CE-CPTED was associated with positive street activity, sense of community, and collective efficacy. Participants from neighborhoods with higher resident control of CE-CPTED reported more social capital and behavioral action than those from neighborhoods with less resident control. Our findings support busy streets theory: Community engagement in neighborhood improvement enhanced community empowerment. CE-CPTED that combines physical revitalization with resident engagement and control creates a potent synergy for promoting safe and healthy neighborhoods.

Prevention of Firearm Injuries Among Children and Adolescents: Consensus-Driven Research Agenda from the Firearm Safety Among Children and Teens (FACTS) Consortium.

IMPORTANCE: Firearm injuries are the second leading cause of death among US children and adolescents. Because of the lack of resources allocated to firearm injury prevention during the past 25 years, research has lagged behind other areas of injury prevention. Identifying timely and important research questions regarding firearm injury prevention is a critical step for reducing pediatric mortality. OBJECTIVE: The Firearm Safety Among Children and Teens (FACTS) Consortium, a National Institute for Child Health and Human Development-funded group of scientists and stakeholders, was formed in 2017 to develop research resources for the field, including a pediatric-specific research agenda for firearm injury prevention to assist future researchers and funders, as well as to inform cross-disciplinary evidence-based research on this critical injury prevention topic. EVIDENCE REVIEW: A nominal group technique process was used, including 4 key steps (idea generation, round-robin, clarification, and voting and consensus). During idea generation, stakeholders and workgroups generated initial research agenda topics after conducting scoping reviews of the literature to identify existing gaps in knowledge. Agenda topics were refined through 6 rounds of discussion and survey feedback (ie, round-robin, and clarification steps). Final voting (using a 5-point Likert scale) was conducted to achieve consensus (≥70% of consortium ranking items at 4 or 5 priority for inclusion) around key research priorities for the next 5 years of research in this field. Final agenda questions were reviewed by both the stakeholder group and an external panel of research experts not affiliated with the FACTS Consortium. Feedback was integrated and the final set of agenda items was ratified by the entire FACTS Consortium. FINDINGS: Overall, 26 priority agenda items with examples of specific research questions were identified across 5 major thematic areas, including epidemiology and risk and protective factors, primary prevention, secondary prevention and sequelae, cross-cutting prevention factors, policy, and data enhancement. CONCLUSIONS AND RELEVANCE: These priority agenda items, when taken together, define a comprehensive pediatric-specific firearm injury prevention research agenda that will guide research resource allocation within this field during the next 5 years.

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.