Challenging Dogma - Fall 2008

Monday, December 15, 2008

A Critique and a Proposed Alternative Intervention to Boston’s Youth Violence Prevention Programs-Elizabeth Gonzalez Suarez

In the mid 1990’s Boston began a concerted multi-agency effort to address youth violence, which had increased by 230% from 22 victims in 1987 to 73 victims in 1990. (1) This alarming rate of youth violence brought city officials, and violence prevention experts to create a menu of programs with the goal of reducing youth violence in the city.

One of the leading programs was the Boston Gun Project initiated by the Boston Police Department. The goal of this program was to analyze and determine best strategies to prevent and control the spread of youth violence in the city. To accomplish this goal, the Boston Gun Project formed a working group of law enforcement personnel, youth workers, and researchers to analyze the nature of Boston’s youth violence. The working group concluded that youth violence in Boston “was largely the result of patterned, largely vendetta-like hostility among a small population of highly active criminal offenders –particularly those involved in about 60 loose, informal, mostly neighborhood-based gangs.” (2)

As a result of this analysis, the Boston Police Department’s Youth Violence Strike Force (YVSF) developed a strategy named Operation Ceasefire. Operation Ceasefire “is a problem-oriented policing intervention aimed at reducing youth homicide and youth firearms violence in Boston”.(3)

The YVSF, an elite unit of 40 officer and detectives, convened an interagency working group, comprised of law enforcement personnel, youth workers, and members of Boston’s Ten Point Coalition of black activist clergy to collaborate in the implementation of “Ceasefire”. The group developed a “pulling levers” strategy, which consisted in reaching out directly to gangs clearly stating that violence will no longer be tolerated. The anti-violence and deterrence message was communicated directly to gang members in formal meetings or indirectly through meetings with inmates or gang outreach workers. The message was backed up by “pulling every lever” legally available when violence occurred. (2, 3)

Another component of Ceasefire was to partner with social service agencies to provide services and opportunities to gang members who wanted to step away from violence.

One of the biggest accomplishments of the Boston Gun Project’s Operation Ceasefire has been to bring law enforcement agencies to work together in a coordinated fashion. Historically, Boston’s criminal justice agencies have worked independently, competing for scarce resources without much coordination amongst them. After Ceasefire, these agencies have worked in collaboration to fund, equip, and carry out complex strategies for controlling and preventing youth violence. (2)

Furthermore, the Boston Gun Project’s Operation Ceasefire invited a Black community faith-based organization, Ten Point Coalition, to work in collaboration with the Boston Police. The process to engage the Ten Point Coalition in this initiative was not easy, since historically the Ten Point Coalition leadership was highly and publicly critical of police efforts to prevent youth violence.(2)

Operation Ceasefire dramatically decreased youth homicides in Boston from 73 cases in 1990 to 15 to 18 cases per year from 1997 until 2000. This represents a decrease of 58 cases from 1990 to 2000. After 5 successful years, since the year 2000 youth violence in Boston has begun to escalate seriously and consistently from 15 cases in 2000 to 67 in 2007 (see Table 1- omitted from blog, contact author). The average youth homicide rate in Boston was about 44 per year between 1991 and 1995. From 2004 through September 2008, the average rate is 57 youth homicides per year. (1, 5)

What happened? Why the Boston Gun Project’s Operation Ceasefire did not keep youth homicide rate from escalating again. I believe that the short-term success of this well-intentioned initiative is due to several factors: (1) the top-down approach to design and planning; (2) the failure to develop a comprehensive intervention to reduce the flow of illegal guns; and (3) the failure to use an ecological model to design and implement the program.

Argument 1: Top-down approach

Operation Ceasefire was designed and implemented by the Boston Police Department’s Youth Violence Strike Force with support from academia. Once the program was developed, it engaged a community faith-based organization, the Ten Point Coalition, and other community-based agencies. The people most affected by the violence, Boston minority residents, were not involved in the planning or designing of the program. There were not focus groups, key informat interveiews or participant observation conducted with the affected community to inform the design and development of the Initiative.

Community input was sought after the program was implemented by the creation of the Safe Neighborhood Initiative (SNI), with one major limitation, -this network of governmental, private and nonprofit agencies was invited to problem-solve around crime-related issues in the Boston area, and not to inform or adapt the program to the culture of the community. (4, 5)

Basically, the Boston Police agency, an agency not trusted historically by minority communities, designed the youth violence prevention program to be implemented in Boston minority community. (2)

As illustrated above, one of the failures of the Boston Gun Project’s Operation Ceasefire was its top-down approach to designing and implementing the program. Furthermore, many of the factors incorporated in the Boston’s Youth Violence programs are derived from research conducted predominatly in white American, middle-class populations, and none of the approaches where tested via formative research or adapated to work in the intended population.(6)

Operation Ceasefire should have conducted a thorough formative research, including a community assessment of needs and strength of the neighborhood, school or community which would have identified community culture, capacity, potential acceptance, as well as its willingness to participate in the program. Through the needs assessment it could have determined what keeps gangs going, the why and how many of our youth are carrying guns, how easy is to get a gun in Boston, and so on. This work would have allowed Ceasefire to understand contextual factors necessary to develop community capacity for the program to work beyond law enforcement, and work toward a more equitable community where crime it is less likely to proliferate.

Argument 2: Failed to develop a comprehensive intervention to reduce the flow of illegal guns

In 2006, the Harvard Youth Violence Prevention Survey found that 65% of the 1,244 students surveyed in schools across the city reported witnessing one or more acts of violence in the past year, 30% did not feel safe in their neighborhood, 31% carried a knife in the previous 12 months, and 6% carried a gun. Forty two percent believed it was easy to get a gun, and 28% reported not feeling safe on the bus or train. (7)

Based on survey results, Maria Vriniotis, a research specialist from the HYVPC concludes that the “underlying cause of the shootings and student’s fear of them is the accessibility of guns”. (8)

When comparing the U.S. to other developed nations, “the United States has, per capita, the most guns (particularly handguns), the most permissive gun control laws, and the most death by guns.(10) Miller et al.(2006) found that in states with more guns, a greater percentage of the population living in urbanized areas, higher robbery and assault rates, and poverty have higher rates of gun-related homicides. The authors concluded that a strong predictor of high gun homicide is easy access to guns. (11)

One component of Operation Ceasefire was to prevent illegal firearms trafficking by systematically addressing the pattern of firearms trafficking, for example, interstate trafficking in Massachusetts. Unfortunately, the impact of these efforts was minimal and “did nothing to reduce the existing stockpile of illegally acquired and possessed firearms in Boston”. (3).

To have a greater, long-term impact, Ceasefire should have gone beyond addressing illegal firearms trafficking. It should have conducted focus groups and key informant interviews with gang members, community and law enforcement leaders to understand how youth gain access to fire arms, where the guns used in a crime come from, and what needs to be done to effectively affect the flow of illegal guns in Boston.

Ceasefire could have worked with law enforcement agencies to develop stricter policies to reduce the flow of illegal guns. For example, it could have worked with local gun dealers to enforce what Wal-Mart just announced as part of its policy for selling firearms. Wal-Mart will be videotaping all firearms purchases, conducting background checks of employees, and creating a record and alert system for guns sold that were later used in crime. In addition, it could have worked with police to develop better tracking systems, destroy guns that come into police possession, and report all lost and stolen guns. (9)

In neighborhoods where 30% of our youth do not feel safe, and 42% believe that is very easy to get a gun, it is not surprising that a higher number of kids are carrying knife and guns around. As reported by Kim-Ju, et al (2008) “gang formation is not simply a product of greed and irrational deviant behavior, but rather of youth member seeking protection from harassment and discrimination.” (11)

Ceasefire recognized that youth violence is in part a self-protective behavior, especially for youth living in high-risk neighborhood. For this youth having a gun and using it, as well as being part of a gang has a functional meaning, -keeping them alive, and belonging to a group that can protect them. Although, Ceasefire acknowledged these contextual factors it failed to address them in the intervention. The intervention was focus in using deterrence to keep gangs from committing criminal acts, but there was very little done to increase safety level in high-risk neighborhoods, and decrease poverty. Spiegle (1995) outlines a comprehensive gang intervention model that “views the presence of gangs as largely related to a lack of socioeconomic opportunities, social disorganization, poverty, institutional racism, social policy deficiencies, and lack of misdirected social controls”. (12)

Argument 3: Failed to address contextual issues

Youth Violence is a complex public health issue which requires an ecologic and interdisciplinary approach. Youth Violence programs must understand and address the social-ecological context where youth violence occurs. Part of this approach requieres developing partnership with leaders and agencies serving in the high crime neighborhoods. It will also requiere a significant amount of qualitative researh to understand the community’s perception, needs, and capacity to address the problem. (13,14)

Operation Ceasefire failed to address broader contextual factors that influence youth-violence behavior, like poverty, discrimination and people feeling unsafe in their neighborhood. It failed because it did not use an ecological approach to understand, design, and implement the program. It failed because it focus on gangs individual behaviors and not on social, environmental, and policy factors which influence youth violence behavior.

Feeling unsafe and high rates of youth homicides are real issue in Boston’s low-income minority communities. A recent Blue Cross/Blue Shield Survey found that Boston residents living in poorer neighborhood “were three times more likely to say they are worried about neighborhood violence, compared to those in more affluent towns.” (15) Yet, Boston Youth Violence Prevention Program still develops interventions to address youth individual behaviors, not changing the social environment where the homicides occur.

In Boston, there is very little being done to systematically address poverty, institutional racism, and social policy deficiencies as it relates to high rates of youth homicides.

Interventions have been developed to work with social services agencies to provide at-risk youth with job training, leadership skills, summer programs, and so on but no intervention has been developed to address social and environmental factors influencing youth violence behavior.

For a Youth Violence Prevention program to be effective long-term issues like lack of socioeconomic opportunities, poverty, institutional racism, and social policy deficiencies would need to be addressed systematically by a comprehensive, multilevel intervention designed based on ecological model principles.

Boston Youth Violence Prevention: An Alternative Approach.

Using an ecological model(13) to develop a comprehensive, multi-component intervention will result in a more effective and sustainable Youth Violence Prevention program that will address the three flaws identified above.

In an ecological model youth violence is conceptualized as an outcome of a complex system of influences in several domains (e.g., policy and regulations, sociocultural factors, the physical environment, and individual factors). (13) In this framework, an intervention which works at different levels from the individual to the policy level needs to be developed for behavior change to occur.

The proposed intervention will use a grassroots approach (12) , in which leading community-based organizations recognized by their leadership and capacity in working with youth will coordinate the youth violence prevention initiative.

The leading community-based organizations (CBOs) will begin the Initiative by conducting a thorough assessment which will involve: (1) identifying and developing partnerships with coalitions, agencies and organizations located in Boston high crime neighborhoods; (2) working with these coalitions and organizations to conduct qualitative research to understand the community’s perception of the issue, needs, and capacity to address the problem; and (3) in close collaboration with partners, developing an intervention to address youth violence at several levels, home, school and public policy.

This Initiative will work at the neighborhood level, and its intended to reach out the youth and community systems beloging to the defined neighborhood. The idea behind developing an intervention for each community is to facilitate the development of a culturally appropriate and sensitive intervention.(12) Boston is not one community, but it is a city with many neighborhoods with unique characteristics, which need to be taken into account if a successful youth violence prevention intervention is to be developed.

The intervention will be developed using the evidence presented in the CDC Community Guide (17) under Youth Violence Prevention. The interventions identified by the Task Force on Community Preventive Services as having sufficient or strong evidence will be used, after adapting them to our intended community by using findings from the qualitative research.

The evaluation impact will be measure through out the duration of the program using neighborhood data provided by the Boston Public Health Commission(18), and reports from the Boston police.

I. Grassroot Aprroach

In this phase, the leading CBOs, in collaboration with other community coalitions, agencies and organizations located in the identified high crime rate neighborhood (e.g. Jamaica Plain or South End) will conduct the formative research.

In each identified neighborhood, leading CBOs will meet with neighborhood coalitions, tenants’ associations, school boards, faith-based organization, community youth agencies, and representative from the Boston Public Health Commission. During these meetings, partnership and collaboration will be sought through exploring how concern they are about youth violence and how they would like to work on addressing the violence.

Once community organizations are invested and committed to addressing the violence, a series of focus group, key informant interviews and participant observations will be conducted. Community leaders, residents, teachers, and youth (including gangs and non-gang members) will be involved in the qualitative research phase of the program. During this assessment, information such as what they think keeps a high rate of youth violence in their community, what they have done to try to address the issue, what they would like to do stop the violence, and what they think the community has or needs to reduce the violence, will be explored. The qualitative research will be conducted focusing on identifying what community thinks will work in the eighborhood, and who and how should be involved.

II. Intervention Development: Using an Ecological Framework.

Once the qualitative research has been completed, the findings will be presented to the CBOs involved in the Initiative. Intervention plans will be discussed and a menu of programs will be offered based on the formative research findings, the CDC Community Guide and the Harvard Violence Prevention Center recommendations.

Following an ecological framework the proposed intervention will be multi-component, and it will include: (1) an early childhood home visitation program; (2) a universal school-based violence prevention program; and (3) an advocacy group to work with city officials to change social policies that are perpetuating youth violence in Boston, such as easy access to gun in Boston’s neighborhoods. (10)

  1. Early Childhood Home Visitation Program: Children who grow up observing violence or being mistreated by parents or guardiansat home are more likely to engage in aggressive behavior and violence later in life.(19) There are sufficient evidence demonstrating the effectiveness of using an early childhood home visitation program to prevent child maltreatment. As a result, the leading CBOs will partner with the MDPH Early Intervention Program to train the Early Intervention Workers (EIW) to address the following areas with parents during their home visits: infant care, parenting, child abuse and neglect prevention, developmental interaction with infants/toddlers, development of problem solving and life skills for parents, assistance with educational and work opportunities and linkage with community resources. (20) Based on the Community Guide recommendations, the program will target high risk families and will be implemented for more than two years to produce lager effects. If the assessment identified other agencies in the community providing home visitation programs to family and children, these agencies will also be invited to attend the training, thus they can be involved in delivering the program.
  2. Universal School-Based Violence Prevention Programs: Based on the evidence, the Task Force on Community Preventive Services recommends the implementation of universal, school-based program to prevent violence behavior. This will include working with elementary, middle and high-schools located in the neighborhood. School boards and teachers will identify resources and time to bring the universal curriculum to the classroom. This Universal program is intended to be brought to the classroom to all children not only to the kids with behavioral problems. The curriculum is adapted to each grade level and includes: emotional self-awareness, emotional control, self-esteem, positive social skills, social problem solving, conflict resolution and team work.

The curriculum will be enhanced by the findings from the formative research, particularly the findings coming from the focus groups conducted with youth (gangs and non-gangs members). The goal will be to tailor the universal program to respond to the community’s unique charateristics, consequetly creating more salient messages.

  1. Advocacy: The advocacy group will be formed by members from the leading CBOs and community coalitions. The group will focus on the following: (1) advocating with city official to bring more resources to high risk neighborhood, like employment, high qulatiy daycare and aferschool programs that low-income people can afford: (2) advocating to develop a comprehensive plan to reduce poverty and increase safety in high risks areas, for example improving the quality of housing communities, increasing green areas, bringing more business and employment to the neighborhood; and (3) advocating to stop illegal guns by working with the Boston Police to enforce better tracking systems, destroy guns that come into police possession, report all lost and stolen guns, and effectively affect the flow of illegal guns in Boston.

This intervention works in many levels to address the contextual factors influencing youth violence prevention. It does not only focus in changing gangs individual behaviors but works towards changing the environment (home and school) and policy factors which influence youth violence behavior.

Ideally, this type of Initiative will be funded by private foundations and will be carried out by community-based organizations with a clear track record of serving youth. In addition, the community-based organization will need to have the organizational capacity to run a program that requires working in collaboration and partnership with many other community agencies. Lastly, using an ecological framework for program designed and a grassroots approach to mobilize community around this issue will result in sustainable changes in communities systems, as well as increase in social capital, and change in social norms resulting in long term changes. (12,13,15)


1. Kennedy School of Government, Harvard University. Operation Ceasefire/Boston Gun Project. Cambridge, MA. Program in Criminal Justice Policy and Management.

2. Kennedy School of Government, Harvard University. Creating an Effective Foundation to Prevent Youth Violence: Lessons Learned from Boston in the 1990s by A. Braga and C. Winship. Cambridge, MA. RAPPAPORT Institute for Greater Boston.

3. Braga, A.A., Kennedy, D.M., et al. Problem-Oriented Policing, Deterrence, and Yoth Violence: An Evaluation of Boston’s Operation Ceasefire. Journal of Research in Crime and Delinquency 2001; 38 (3): 195-225.

4. NCJRS. Youth Violence: A Community-Based Response. One City’s Success Story.

5. NCJRS. Boston Strategy to Prevent Youth Violence.


7. Kerns, Suzanne E. U., Prinz, R.J. Critical Issues in the Prevention of Violence-Related Behavior in Youth. Clinical Child and Family Psychology Review, 2002; 5 (2):133-160

8. The Boston Data Project: Fact Sheet. What Kind of World Do You Want to Live in? Results on Weapon Carrying from the Boston Youth Survey. Boston, MA: Harvard Youth Violence Prevention Center.

9. The Boston Globe. Youth no Longer a Refuge.

10. Hemenway, D. Protecting Children from Firearm Violence. Big Ideas for Children: Investing in Our Nation’s Future

11. Miller, M., Hemenway, D., & Azrael, D. State-level Homicide Victimization Rates in the US in Relation to Survey Measures of Household Firearm Ownership, 2001-2003. Social Science and Medicine 2007; 64: 656-664

12. Kim-Ju, G. Mark, G.Y. Community Mobilization and Its Application to Youth Violence Prevention. American Journal of Preventive Medicine 2008; 34 (3S): S5-S12.

13. Spiegel, I. The Youth Gang Problem: A Community Approach. New York, NY: Oxford University Press, 1995.

14. Mark Edberg. Essentials of Health Behavior: Social and Behavioral theory in Public Health. Sudbury, MA: Jones and Barlett Publishers, 2007.

15. Watson-Thompson, J. Fawcett, S.B. et al. A Framework for Community Mobilization to Promote Healthy Youth Development. American Journal of Preventive Medicine 2008; 34 (3s): S72-S81.

16. The Boston Globe. Concern Over Safety oaring in HubArea: Study Finds Link Between Health, Fear of Violence.

17. Guide to Community Preventive Services: Systematic Reviews and Evidence Based Recommendations. Violence Prevention.

18. Boston Public Health Commission. Health Status of Youth 2007.

19. Guide to Community Preventive Services: Systematic Reviews and Evidence Based Recommendations. Violence Prevention. Chapter 9. Violence.

20. Guide to Community Preventive Services: Systematic Reviews and Evidence Based Recommendations. Violence Prevention. New Findings Demonstrate Early Childhood Visitation Prevent Child Maltreatment.

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