Child/Adolescent Health

Intervention programs that focus on already violent youth are more effective than other programs for reducing violent behavior

Tertiary intervention programs are more likely to report effectiveness than primary and secondary programs for reducing youth violent behaviors, concludes a systematic review of studies on the topic. Primary prevention programs aim to reduce risk behaviors associated with subsequent violence, such as substance abuse. Secondary programs focus on youth at increased risk for violence, such as those in impoverished neighborhoods. Tertiary programs focus on youth who have already engaged in violent behavior, explain researchers at the Southern California Evidence-based Practice Center.

Researchers included 41 studies for review, 15 of which were randomized control trials (RCTs). Overall, nearly half (49 percent) of interventions were effective. Of the RCTs, two of six (33 percent) primary interventions, three of seven (43 percent) secondary interventions, and two of two (100 percent) tertiary interventions were effective.

One primary intervention, "Responding in Peaceful and Positive Ways," a skills building and conflict resolution program for 7th graders, reduced violent behavior 1 year later to 11.2 per 100 students compared with 23.1 for the control group. One of the three effective secondary intervention programs was the "Moving To Opportunity (MTO) Project." This demonstration project to relocate families from high- to low-poverty neighborhoods significantly lowered arrests for violent crimes among MTO teens compared with teens on the MTO waiting list.

One tertiary intervention program, "Turning Point: Rethinking Violence," educated male first-time violent crime offenders and their parents about the consequences of violence. The rate of second violent offenses was 0.05 for that group compared with 0.33 for the control group.

The second tertiary intervention program was a multisystemic therapy program for juvenile offenders who met criteria for substance abuse and dependence. The mean 4-year conviction rate for aggressive crimes, such as assaults and strong-armed robbery, was 0.61 compared with 1.36 for the control group.

The study was supported in part by the Agency for Healthcare Research and Quality (Contract No. 290-97-0001 and No. 290-02-0003).

See "Effectiveness of interventions to prevent youth violence: A systematic review," by Mary Ann Limbos, M.D., M.P.H., Linda S. Chan, Ph.D., Curren Warf, M.D., and others, in the July 2007 American Journal of Preventive Medicine 33(1), pp. 65-74.

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