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. Author manuscript; available in PMC: 2016 Jan 7.
Published in final edited form as: Prev Sci. 2014 Apr;15(2):194–204. doi: 10.1007/s11121-013-0369-7

The Role of Collaboration in Facilitating Policy Change in Youth Violence Prevention: a Review of the Literature

Jeanelle J Sugimoto-Matsuda 1,2,3,✉, Kathryn L Braun 4
PMCID: PMC4704786  NIHMSID: NIHMS747267  PMID: 23430580

Abstract

Youth violence remains a serious public health issue nationally and internationally. The social ecological model has been recommended as a framework to design youth violence prevention initiatives, requiring interventions at the micro-, meso-, exo-, and macro-levels. However, documentation of interventions at the macro-level, particularly those that address policy issues, is limited. This study examines a recommendation in the literature that formalized collaborations play a vital role in stimulating macro-level policy change. The purpose of this systematic literature review is to examine existing youth violence prevention collaborations and evaluate their policy-related outcomes. The search found 23 unique collaborations focused on youth violence prevention. These were organized into three groups based on the “catalyst” for action for the collaboration—internal (momentum began with-in the community), external (sparked by an external agency), or policy (mandated by law). Findings suggest that internally catalyzed collaborations were most successful at changing laws to address youth violence, while both internally and externally catalyzed collaborations successfully attained policy change at the organizational level. A conceptual model is proposed, describing a potential pathway for achieving macro-level change via collaboration. Recommendations for future research and practice are suggested, including expansion of this study to capture additional collaborations, investigation of macro-level changes with a primary prevention focus, and improvement of evaluation, dissemination, and translation of macro-level initiatives.

Keywords: Youth violence, Policy, Collaboration, Social ecological, Literature review

Introduction

Youth violence is a serious public health problem, with the United States (US) having the highest rate of serious youth violence among developed nations (Thornton et al. 2002; U.S. Department of Health and Human Services [DHHS] 2001; World Health Organization [WHO] 2002). In the US, homicide is the second leading cause of death for youth 15 to 19 years old (National Center for Health Statistics 2005). Of 1.1 million juvenile arrests yearly, more than 350,000 are for violent crimes (Federal Bureau of Investigation 2008).

Youth violence is defined as the intentional use of physical force or power which results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation (Centers for Disease Control and Prevention [CDC] 2010). Major risk factors are prior history of or exposure to violence, substance use, poor academic performance, poor social relationships, and poverty in the community (CDC 2010). Consequences include physical harm, decreased sense of wellbeing, increased health care costs, and disruption of social services (Mercy et al. 2002).

The complex nature of youth violence dictates a comprehensive approach that integrates complementary interventions within an ecological context (Goebert et al. 2010; Thornton et al. 2002; WHO 2002). The social ecological framework drives interventions to address the micro-systems the individual interacts with, the meso-system (linkages between microsystem domains), the exo-system (institutional regulations that shape relationships between individuals and micro-systems), and the macro-system context of cultural history and social/political influences (Brach and Fraserirector 2000; Bronfenbrenner 1979).

Macro-level policy change is an important aspect of a comprehensive approach (Figueroa et al. 2002). Policy action can include changes in law (e.g., legislation creating punishments for perpetrators), agency policy (e.g., a school system mandating violence prevention training for teachers), and organizational policy (e.g., an individual school adopting a violence prevention program). Many violence prevention efforts focus on the individual and his/her immediate relationships, and macro-level interventions are less-often attempted (Limbos et al. 2007; U.S. DHHS 2001). Although intra- and interpersonal level interventions can yield positive behavior changes, macro-level interventions are more likely to have broad-reaching impact across communities (Szapocznik and Coatsworth 1999).

Broadly defined, collaboration brings together multiple organizations to accomplish some form of systems change (Backer 2003). While collaborations develop for different purposes, they have been proposed as a valuable facilitator of macro-level change. Formalized coordination is especially critical for youth violence prevention, as this issue suffers from the “many homes” and “no home” syndromes, i.e., responsibility to address youth violence is typically fragmented across agencies or falls through the cracks between them (Saul et al. 2008).

Collaboration is beneficial because it can focus attention on an issue and “braid together” efforts of separate organizations (Spoth and Greenberg 2011). Public health has a strong history of using coalitions to catalyze improvements in community health. For example, Communities that Care (Hawkins et al. 2012) and PROSPER (Spoth et al. 2011) were multi-site interventions that included collaboration as a key element of a larger process to reduce substance abuse and other problem behaviors in youth.

Because the current study focused on collaborations specific to youth violence, we used the “Integrated Model of Communication for Social Change (IMCSC)” as a framework (Figueroa et al. 2002). The IMCSC details steps to achieve macro-level impact through collaboration, and has been successfully applied in youth violence prevention. Thus, it was deemed to provide the best fit to guide our review of collaborations, from how each collaboration was “catalyzed” to its specific processes, outputs, and short- and long-term outcomes (Fig. 1).

Fig. 1.

Fig. 1

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Conceptual model for reduction and prevention of youth violence through collaborative systems and policy change. Adapted from Figueroa et al. (2002) Integrated Model for Communication for Social Change

The IMCSC model posits several “catalysts” for cross-partner dialog. For example, collaborations can be internally catalyzed (i.e., momentum to form the collaboration begins within the community), externally catalyzed (i.e., the collaboration is sparked by an external agency, like a funder), or policy catalyzed (i.e., the collaboration is mandated by law) (Mirabal et al. 2008). Collaborations engage stakeholders in an iterative process of dialog and action. Dialog yields activities, such as problem recognition, leadership, and clarification of interests and objectives to create an action plan. Collective action outputs follow dialog (e.g., a program is implemented and evaluated). Collective action leads to short-term outcomes of social change, evidenced by improvements in leadership, collective self-efficacy, sense of ownership, and social cohesion. The long-term outcome of the model is societal impact. This was undefined by Figueroa et al. (2002), so we operationalized it as changes in law, agency policy, or organizational policy. These long-term outcomes should lead to the prevention and reduction of youth violence.

We conducted a systematic literature review to examine youth violence prevention collaborations in relation to achievement of policy change. Guided by the IMCSC, we assessed each group’s catalyst and membership, its activities around community dialog (problem recognition, identification of leaders, and creation of an action plan), outputs from collective action (project completion, group visibility), and outcomes of macro-level policy impact at the legislative, agency, or organizational level.

Methods

PsycInfo (American Psychological Association) and Pubmed (National Institutes of Health) were searched using the keyword “youth violence” in combination with collaboration(s), coalition(s), network(s), partnership(s), system(s), and policy. Duplicates were omitted. Remaining abstracts were reviewed and items systematically excluded if they were not in English, dated prior to 1980, unrelated to youth violence, or not peer-reviewed. Books and book chapters were retained because these are common sources for case studies of collaborations. Secondary exclusion criteria then were applied. Omitted were: (1) research studies unrelated to coalitions, including evaluations, risk-protective studies, prevalence studies, theory testing, and psychometric studies; and (2) general recommendations for coalition development.

Initial searches yielded 581 articles. Removed were 191 duplicate items, as were items that did not meet primary (107) and secondary (255) inclusion criteria (Fig. 2). The 28 remaining articles represented 23 unique collaborations related to youth violence. Five collaborations were described in more than one article, and in these cases, the contents of all articles were considered in our review. Each of the 23 unique collaborations was categorized according to its catalyst: nine were internally catalyzed (from within the community), 12 were externally catalyzed (by an outside organization, typically a school board or a university in partnership with a school or community), and two were policy catalyzed (by legislative mandate).

Fig. 2.

Fig. 2

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Initial searches yielded 581 articles. After removal of 191 duplicate items, 390 documents remained. A total of 107 and 255 items, respectively, were excluded using primary and secondary criteria. The 28 remaining articles represented 23 unique collaborations related to youth violence. Five collaborations were described in more than one article, and in these cases, the contents of all articles were considered in our review

Results

Collaborations at a Glance

Shown in Table 1 are the 23 unique collaborations by catalyst, group name, location, year initiated, brief description, and article authors/years. An example of an internally catalyzed group, initiated from within the community, was the Virginia Youth Violence Project which coalesced in response to a series of weapon-possession incidents at several schools (Sheras et al. 1996). An example of an externally catalyzed group, initiated by an outside agency or partner, was the Chicago Schools’ Board of Trustees which mobilized all of the schools under its purview (Bell et al. 2001). An example of a policy-catalyzed group, initiated through mandate, was Virginia’s City Initiative on Youth which coalesced following a mandate from city council (Payne et al. 2008). On average, the reviewed articles were published 6 years after the collaboration was established, but the range varied from 0 to 15 years.

Table 1.

Summary of the 23 collaborations found in this literature search

Name of collaboration (location; approximate
year established)		 Description Article citation
Internal catalyst (n=9)
    Virginia Youth Violence Project
(Virginia Beach, VA; 1993)		 Grassroots group founded after series of weapons
possession incidents at several schools.		 Sheras et al. 1996
    North Philadelphia Firearms Reduction
Initiative (Philadelphia, PA; 1997)		 Group began with a Rapid Participatory Appraisal
in response to firearm-related homicides. Led to
adoption of Olweus Bullying Prevention Program.		 Hausman et al. 2000; Black et al. 2010
    Youth Homicide Committee (Philadelphia,
PA; 1996)		 Interdisciplinary group formed to better understand
the murders of children, and see if event was
preventable.		 Fink 2001
    Boston Gun Project’s “Operation Ceasefire”
(Boston, MA; 1996)		 Formed in response to youth firearms-related homicides,
and pushed for problem-oriented policing.		 Braga et al. 2001
    Milwaukee Youth Violence Prevention
Coalition (Milwaukee, WI; 2002)		 Multidisciplinary group that developed to address youth
violence, mainly through raising awareness of the issue.		 Heuermann and Melzer-Lange 2002
    Baltimore Youth Ammunition Initiative
(Baltimore, MD; 2002)		 Began as collaboration among health department,
law enforcement, and researchers, to address youth
gun violence.		 Lewin et al. 2005
    Safe School Task Force (Kailua, HI; 2005) Youth group emerged out of community concerns about
school safety.		 Adler et al. 2008
    Ethnic Studies Model of Community
Mobilization (Sacramento, CA; 2001)		 Resulted as a response to violence stemming from
diversity issues. Led to adoption of high school
Ethnic Studies Course.		 Sobredo et al. 2008
    VIP (Violence Intervention and Prevention)
Team (Haverhill, MA; 2005)		 Began as one-time training, but integrated into high
school curriculum after insistence of community
personnel.		 Rothman et al. 2010
Policy catalyst (n=2)
    City Initiative on Youth (Suffolk, VA; 2006) Began as collaboration with local university to conduct
planning process to utilize existing resources and
stakeholders to understand youth violence phenomenon
in the city.		 Payne et al. 2008; Payne and Button 2009
    Safe Schools/Healthy Students Initiative
(Cicero, IL; 1999)		 Aim was to provide services to district schools which
addressed all levels of the social ecological framework.		 Telleen et al. 2006, 2009
External catalyst (n=12)
    Chicago Public Schools (Chicago, IL; 1995) Reform initiative spearheaded by the Chicago Public
Schools’ Board of Trustees. Included interventions
such as mentorship programs, support for teen mothers,
and a truancy hotline.		 Bell et al. 2001
    Safe Schools Project of the Pittsburgh Public
Schools (Pittsburgh, PA; 2002)		 Multidisciplinary violence prevention coalition which
created an action plan grounded in a theoretical
framework.		 Prothrow-Stith 2002
    Multisite Violence Prevention Project (MVPP)
Collaboration (Various; 2004)		 Arose in response to the lack of large-scale scope and
implementation of violence prevention work.		 Henry et al. 2004; MVPP 2004
    Michigan Youth Violence Prevention Center
(Ann Arbor, MI; 2000)		 Spearheaded by the University of Michigan, mission
was to utilize community-based participatory research
principles to address youth violence prevention.		 Griffith et al. 2008
    Asian/Pacific Islander Youth Violence
Prevention Center (Honolulu, HI and
Oakland, CA; 2000)		 Began as dual-site youth violence prevention center.
Outcomes included institutionalization of a high
school Ethnic Studies course.		 Lai 2008; Umemoto et al. 2009
    Center for the Study and Prevention of Youth
Violence (Richmond, VA; 1999)		 Established at Virginia Commonwealth University through
federal funding. Resulted in several initiatives, such as a
community advisory council.		 Meyer et al. 2008
    Center for Hispanic Youth Violence
Prevention (Puerto Rico; 2000)		 Spearheaded by the University of Puerto Rico to facilitate
community mobilization to reduce youth violence in a
high-risk Latino community.		 Mirabal et al. 2008
    SAFER (Seguridad, Apoyo, Familia,
Educaction, y Recursos) Latinos (Langley
Park, MD; 2007)		 Multi-level youth violence prevention effort to address
factors within the social ecology of an immigrant
Latino community.		 Edberg et al. 2010
    Philadelphia Collaborative Violence
Prevention Center (Philadelphia, PA; 2005)		 Collaborative aimed to use a community-based participatory
model to address the needs of urban youth, their families,
and their community.		 Leff et al. 2011
    Harvard Youth Violence Prevention Center
(Boston, MA; 2000)		 Center aimed to utilize research-practice collaborations
to foster adoption of program planning, development,
implementation, and evaluation processes.		 Azrael and Hemenway 2011
    Center on Culture, Immigration, and Youth
Violence Prevention (Oakland, CA; 2005)		 Housed in the University of California at Berkeley,
the center spearheaded community mobilization activities
that brought the issue of youth violence to the forefront
of the public agenda.		 Le et al. 2011
    Nashville Urban Partnership Academic
Center of Excellence (Nashville, TN; 2005)		 Center identifies community initiation and collaboration as
distinct approaches to community engaged youth violence
prevention research.		 Nation et al. 2011
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The disciplines of collaboration members (e.g., business, community-based organization [CBO], law enforcement, media, and university) are summarized in Table 2. Asterisks indicate that 75 % or more of collaborations in the respective category included a representative from a specific discipline. Across all groups, CBOs, schools, and universities were most frequently represented. Less than half of the collaborations engaged law enforcement agencies. Only six collaborations engaged youth, and even fewer included business and media sectors.

Table 2.

Summary of membership, base, and reach of the 23 coalitions found in this literature search

Internal catalyst
(n=9)		 Policy catalyst
(n=2)		 External catalyst
(n=12)		 Total (n=23)
Membership
  Businesses 1 0 1 2
  Community-based organizations 7* 2* 10* 19*
  Community members 5 1 7 13
  Faith-based organizations 2 2* 6 10
  Health professionals 3 1 6 10
  Law enforcement 7* 2* 5 14
  Media 2 1 1 4
  Policymakers 2 2* 4 8
  Schools 8* 2* 8 18*
  State agencies 5 2* 9* 16
  Universities 6 2* 11* 19*
  Youth 3 0 3 6
Base
  Community 3 0 0 3
  State or local government 2 2* 0 4
  University 1 0 10* 11
  Other 3 (health, law, school) 0 2 (school) 5
Reach
  Statewide 4 1 9* 14
  Citywide 4 1 3 8
  Community-wide 1 0 0 1
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Asterisks indicate that 75 % or more of groups fell within that category. For example, greater than 75 % (seven out of nine) of internally catalyzed collaborations included community-based organizations in their memberships

Also shown in Table 2 are the home base and reach for collaborations by catalyst. Again, asterisks indicate that 75 % or more of groups fell into that category. While the internally catalyzed groups were based in a variety of locations, both groups catalyzed by policy or law were housed within state/local government, and all 12 of the externally catalyzed groups were based at a school or university. The majority of groups across all categories reported having statewide reach.

Activities, Outputs, and Policy-Related Outcomes

The activities, outputs, and policy-related outcomes are summarized in Table 3. The most common activity of the reviewed collaborations was facilitating problem recognition at the community level, achieved by 14 of the 23 collaborations. Only seven collaborations developed action plans, but among these were both of the policy catalyzed groups. Looking at outputs, 18 of the 23 collaborations completed a project, and 15 achieved visibility for their collaboration. These outputs were achieved by 75 % or more of the externally catalyzed groups, and by lesser proportions of the internally and policy-catalyzed groups. Regarding outcomes, eight groups were successful at changing organizational policy, and two achieved passage of new law. None of the groups reported success at changing an agency policy related to youth violence. More detail by type of collaboration catalyst follows.

Table 3.

Summary of activities, outputs, and outcomes of the 23 coalitions found in this literature search (categories have been adapted from Figueroa et al.’s [2002] Integrated Model for Communication for Social Change)

Internal catalyst
(n=9)		 Policy catalyst
(n=2)		 External catalyst
(n=12)		 Total (n=23)
Activities
  Problem recognition 8* 1 5 14
  Identification of leaders 4 1 5 10
  Action plan 1 2* 4 7
Outputs
  Project/assessment completion 6 1 11* 18*
  Group visibility 5 0 10* 15
Outcomes
  Organizational policy 5 0 3 8
  Agency policy 0 0 0 0
  Law/legislation 2 0 0 2
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Asterisks indicate that 75 % or more of groups within the category achieved that particular outcome. For example, greater than 75 % (eight out of nine) of internally catalyzed collaborations achieved problem recognition

Collaborations Catalyzed Internally

As shown in the first column of Table 3, eight of the nine internally catalyzed collaborations groups achieved problem recognition, four identified leaders, and one created an action plan. Under outputs, six completed some type of project, and five increased the visibility of their respective collaboration.

When examining outcomes, five of the groups succeeded in changing organizational-level policy. Specifically, Hausman et al. (2000) and Black et al. (2010) describe the North Philadelphia Firearms Reduction Initiative. After evolving its tertiary prevention focus to one that was more primary prevention focused, the group worked with local schools to implement and adopt the Olweus Bullying Prevention Program. Sobredo et al. (2008) describe the adoption of an Ethnic Studies course in a California high school as a response to violence stemming from diversity issues. Rothman et al. (2010) describe adoption of the Violence Intervention and Prevention (VIP) program in a Massachusetts high school. Adler et al. (2008) describe the development and adoption of a “Safe School Task Force” at a high school in Hawai‘i. Finally, Fink (2001) describes Pennsylvania’s Youth Homicide Committee that achieved a number of outcomes, including summits where multi-disciplinary teams create individualized treatment plans for at-risk youth.

Two of the internally catalyzed collaborations were successful in achieving the passage of legislation. Braga et al. (2001) describe the Boston Gun Project, also known as “Operation Ceasefire.” The initiative revolved around problem-oriented policing, which operates with a “pulling levers” approach where every legal “lever” is pulled when violence occurs. Lewin et al. (2005) describe the Baltimore Youth Ammunition Initiative. The group achieved passage of two pieces of legislation: (1) Bill 02–0854 limited the number of businesses permitted to sell firearms and ammunition within certain distances from schools and places of public assembly; and (2) Bill 02–0855 instituted new accountability measures for ammunition vendors.

Two internally catalyzed groups did not report achievement of policy change outcomes. The goals of the Milwaukee Youth Violence Prevention Coalition primarily focused on raising awareness around youth violence prevention (Heuermann and Melzer-Lange 2002). The Virginia Youth Violence Project’s objectives were aimed at educating professionals in a variety of disciplines (Sheras et al. 1996).

Collaborations Catalyzed by Policy/Law

The second column of Table 3 summarizes the two groups catalyzed by policy/law. Both collaborations were government-based and engaged law enforcement agencies as members. Virginia’s City Initiative on Youth achieved problem recognition, identified leaders, and created an action plan (Payne and Button 2009; Payne et al. 2008). The Safe Schools/Healthy Students Initiative in Illinois completed an action plan and a project/assessment (Telleen et al. 2009; 2006). However, neither group described achievement of policy changes.

Collaborations Catalyzed Externally

Shown in the third column of Table 3 are the 12 externally catalyzed collaborations. Five groups achieved problem recognition and identified leaders, and four created an action plan. For outputs, 11 completed a project or assessment, and ten increased visibility of their collaboration.

Regarding outcomes, three of the groups changed organizational policy. Bell et al. (2001) discussed the reform initiative tackled by the Chicago Public Schools’ Board of Trustees. Lai (2008) and Umemoto et al. (2009) described the work of the Asian/Pacific Islander Youth Violence Prevention Center operating in Hawai‘i and California. Lai describes the group’s history, including formation via CDC’s Academic Centers of Excellence (ACE) on Youth Violence Prevention program. Umemoto and colleagues detail the Center’s work in Hawai‘i, including adoption of a high school Ethnic Studies course adapted from the version implemented in Sacramento (Sobredo et al. 2008). Meyer et al. (2008) describe the Virginia Commonwealth University’s Center for Academic Excellence in Youth Violence Prevention, also CDC-funded. The university adopted a community advisory council to coordinate among university departments and the external community. Six other externally catalyzed collaborations also were funded through CDC’s ACE initiative, but did not report policy changes (see Azrael and Hemenway 2011; Griffith et al. 2008; Le et al. 2011; Leff et al. 2011; Mirabal et al. 2008; and Nation et al. 2011).

Although not part of the ACE program, the SAFER (Seguridad, Apoyo, Familia, Educaction, y Recursos) Latinos group in Maryland also was started through CDC funding, and this group implemented a youth violence prevention initiative for immigrant communities (Edberg et al. 2010). The Multisite Violence Prevention Project (MVPP) achieved completion of a large-scale data collection project (Henry et al. 2004; MVPP 2004). Finally, the Safe Schools Project of the Pittsburgh Public Schools created a “Blueprint” for violence reduction (Prothrow-Stith 2002).

Discussion

Given the multi-faceted nature of youth violence, it must be addressed in a strategic and comprehensive manner from all levels of the social ecological model, in other words at the micro-, meso-, exo-, and macro-levels. The purpose of this study was to examine the role of collaboration in facilitating macro-level interventions for youth violence prevention. The scientific literature confirms the benefits of collaboration, as well as its process-related outcomes (e.g., capacity building, collective self-efficacy). However, our study focused on the potential of the collaborations to facilitate macro-level outcomes, specifically those related to policy.

Utility of a Conceptual Model

We found Figueroa et al.’s (2002) IMCSC to be an excellent conceptual framework for analyzing the literature in relation to our research question. Although there are other conceptual models of collaboration in the literature, the IMCSC has been used in the youth violence prevention community. We streamlined the model to highlight items most salient among the collaborations studied (Fig. 1). The adapted model begins with catalysts, as described by Figueroa’s group, but with an added input of coalition membership, which allowed us to examine membership differences by type of catalyst. The construct of community dialog retained three of Figueroa’s proposed activities—problem recognition, identification of leaders, and creation of an action plan. The collective action construct is comprised of two outputs—implementation/evaluation (retained from the original model) and group visibility (added based on our review of the literature). Short-term outcomes (social change per the IMCSC) will occur first, succeeded by long-term outcomes (policy change, as operationalized through this study), and ultimately the prevention and reduction of youth violence.

Contextual conditions, broadened from Figueroa and colleagues’ notation that not all steps of the process would be appropriate in all situations, refer to considerations such as culture, political climate, leadership, length and history of relationships among agencies, health and service gaps, and socioeconomic conditions. This study confirms that such external factors play an important role in the collaborative process, given that groups with similar catalysts showed such varied outcomes. In addition, groups with similar years of establishment also produced a variety of outcomes. Contextual conditions must be considered throughout the collaborative process, and this study confirms the need to examine these in further detail. In addition, these data support the use of a conceptual framework, such as Figueroa and colleagues’ IMCSC, to report collaboration activities, outputs, and outcomes. Organizing these data on an appropriate model made it possible to examine the various factors that contributed to group outcomes in a standardized manner, as well as seek answers regarding the contextual conditions discussed above. Consistent use of such frameworks may facilitate these types of comparisons of groups, and thus better inform the existing best practices for collaborating on youth violence prevention.

Influence of Collaboration Catalyst

Several noteworthy patterns can be tentatively gleaned from the data as presented. Overall, we found that the internally catalyzed collaborations noted the most success in achieving macro-level outcomes. Five of the nine collaborations (56 %) that “grew” out of the community were successful in changing organizational policies at the high schools in their communities. In contrast, only three of the 12 externally catalyzed groups (25 %) achieved success in affecting organizational policy. Not surprisingly, of the eight total collaborations that changed organizational policy, seven were aimed at youth in high schools. Educational settings are ideal locations for developing, testing, and institutionalizing youth violence prevention programs (Cortina et al. 2008) because of the open access to youth as well as existing infrastructure to support new programs.

Adding to the successes of the internally catalyzed groups, the only two collaborations that were successful in changing laws related to youth violence fell into this category (Boston’s “Operation Ceasefire” and Baltimore’s Youth Ammunition Initiative). Both of these collaborations resulted in new or heightened legislation in response to youth firearms-related homicide. Both achieved increased visibility of the issue, as well as their groups, which may have facilitated work with policymakers to codify new provisions into state statutes. It may be that these groups had more “freedom” to campaign for legislative changes than the externally and policy-catalyzed groups. Most of the externally catalyzed groups were federally funded programs, which cannot engage in lobbying activities and have limits on their role in advocating for policy change. The policy-catalyzed groups were established to carry out a legislative mandate, whose history was not elaborated upon in the articles. They focused on assessment and planning rather than more legislative change. Perhaps if the context behind the policies were examined, it might be seen that previous action by a group led to the policy outcome that created the group.

In terms of membership, all 12 externally catalyzed collaborations were based in school or university settings, and nine set out to achieve statewide reach. Eight of ten were catalyzed by funding from CDC’s ACE program, and all of these were based in universities. Founded in 2000, the ACEs aim to build scientific infrastructure, promote interdisciplinary research, foster collaboration, and empower communities around youth violence prevention (Vivolo et al. 2011). University faculty must conduct research and publish findings; thus it is not surprising that our review included literature about the work of these initiatives. Among all collaborations, CBOs and universities were most frequently represented. Law enforcement agencies participated in fewer than half of the collaborations, and business and media were rarely included despite recommendations in the literature to increase partnership with these disciplines (Webb et al. 2010).

Thus, it can be concluded that while contextual conditions affect the collaborative process, it is equally as important to consider the type of catalyst. A group’s initiation process is usually not considered in traditional reviews, or in organizational strategic planning (e.g., building of logic models and program planning) and evaluation. Although internally catalyzed groups have no limitations on their lobbying and advocacy efforts, they may not have the benefit of a single strong partner to organize efforts and ensure momentum continues. Externally catalyzed groups may include one very powerful partner that brings resources, funds, and research capacity to the table. However, with such resources and funding comes governmental limitations on the extent to which the group can conduct policy work. Policy-catalyzed groups grow out of governmental mandates, and thus may have the greatest potential for sustainability. However, group momentum may not be as strong as with internally and externally catalyzed groups, given there may not be a strong sense of ownership since the process began as a mandate.

Future Directions

It is reassuring to see that formalized collaborations across the country have developed and are documenting their efforts to curb youth violence. For the most part, macro-level change has manifested in organizational policy, rather than agency policy or legislation. It should be noted that the two legislative changes found through this study focused on reducing youth access to firearms and ammunition, rather than on more primary prevention approaches such as preventative training for teachers and other adults that interface with youth. A shift in youth violence prevention is needed at the legislative level, to examine how policies can be designed and implemented from a more primary prevention focus. The CDC’s initiatives in youth violence prevention show movement at the federal level to highlight the public health approach, as well as viewing youth violence as a phenomenon that can be controlled, reduced, and prevented (Tomes 1995). The nationwide ACE program is one example. As noted, however, federally funded programs cannot engage in lobbying activities and have limits on their role in advocating for policy change.

A gap that cuts across all aspects of this study is the lack of comprehensive evaluation, dissemination, and translational strategies for macro-level prevention efforts. Policy-related interventions are difficult to design, evaluate, and disseminate. But this means that investigators must examine different methods of evaluation and surveillance, as well as utilize multiple data sources to monitor trends (Sugimoto-Matsuda et al. 2012). Monitoring of macro-level changes also necessitates longitudinal data, as societal-level effects may not be seen until years after implementation. In addition, there is a dearth of dissemination on collaboration processes and outcomes in peer-reviewed and academic literature, given the strong bias towards university faculty and entities with funding sources that mandate publication. Indeed, the majority of articles reviewed in this study were sponsored by an academic or university partner. It is possible that the articles may be part of larger efforts, but unfortunately dissemination of results is often done in a piecemeal fashion given the nature of scientific reporting and publications.

The limitations of this study are typical of those that rely on existing databases and scientific literature. First, we limited ourselves to the search terms and databases used, and also limited the study to collaborations focused on preventing youth violence. “Youth violence” was chosen as the primary term as it is the most common verbiage used in the field, and Pubmed and PsycInfo (which includes book chapters) were searched as they are the most popular databases for youth violence research. However, these choices may have caused us to miss some important reports. Citation chasing was attempted but did not yield many additional resources. Second, exclusion of articles was determined by abstract only, and thus we may have excluded key reports that addressed policy change but did not refer to it in the abstract. A future review could also search websites or contact collaborations directly to inquire about their policy impacts. It is possible that policy impacts have been achieved but not published, especially in collaborations without an academic partner. Third, the overall sample size of the study (23 collaborations) is small. This is a common challenge faced in studies where the organization or community is the level of analysis (MVPP 2004). However, given that this is a novel study which bridges two key components of a comprehensive violence prevention strategy—policy and collaboration—the strength of findings outweighs this limitation. Finally, additional details of the 23 collaborations and their activities could not be ascertained simply by reviewing the selected articles. For example, many groups embarked on scientifically rigorous research as part of their collaborative efforts, yet results of such studies would need to be sought through additional searches of the literature. Also, some articles were published the same year as the collaboration was founded, and some were published 15 years later, which influences the amount of reportable information on the collaborations’ activities, outputs, and outcomes. For the purposes of this study, only information that was reported in the articles retrieved were reported and utilized to determine a collaboration’s catalyst and outcomes. Again, a future review could be done to gather additional information on these groups’ activities and outcomes.

Conclusion

To address a complex and multi-faceted issue such as youth violence, a comprehensive and multi-disciplinary approach must be taken. Best practices in the field of youth violence prevention recommend the use of the social ecological model that dictates action at the micro-, meso-, exo-, and macro-levels. Individual interventions can be designed, but they must be surrounded by an external infrastructure and policy environment that can support efforts at the individual, relationship, and organizational/community levels (Crall et al. 2009). This study demonstrates that, in certain contexts, the formation of collaborations may produce macro-level outputs and outcomes related to youth violence. However, the ability of a collaboration to demonstrate these impacts depends upon the goals of the group, as well as the circumstances of its formation and its surrounding contextual conditions. Further research is needed to elucidate additional details on the groups that were successful in achieving policy changes, and how these efforts can be replicated and generalized.

Footnotes

Disclosures The authors have no financial disclosures or conflicts of interest.

Contributor Information

Jeanelle J. Sugimoto-Matsuda, John A. Burns School of Medicine, Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, HI, USA John A. Burns School of Medicine, Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI, USA; Department of Psychiatry, University of Hawai‘i, 1441 Kapi‘olani Boulevard, Suite 1802, Honolulu, HI 96814, USA, sugimotoj@dop.hawaii.edu.

Kathryn L. Braun, John A. Burns School of Medicine, Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI, USA

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