Violence is the threatened or actual use of physical force against another person, against oneself, or against a group or community that results in or has a high likelihood of resulting in injury, death, or deprivation. Interpersonal violence encompasses the many forms of violence that take place between and against people, including child and elder abuse, intimate partner violence, sexual assault, and homicide. Individuals and families rarely experience violence as an isolated incident. Different forms of violence often coexist within the same home or community. Violence not only takes a toll on victims, but it also has effects on family, friends, and community members. At the community level, violence can undermine business prosperity and property values and can reduce neighborhood vitality. Preventing violence improves quality of life by reducing risk of injury, improving health outcomes, reducing further deterioration of communities, empowering residents, and acting as a cost-saving measure for communities over the long term.
Interpersonal violence is a learned behavior that can be unlearned or not learned in the first place. Violence has multiple and complex underlying factors that include but are not limited to poverty, unemployment, discrimination, substance abuse, educational failure, fragmented families, internalized shame, and felt powerlessness. Violence prevention is a comprehensive and multifaceted effort to address these underlying factors. Efforts build on resiliency in individuals, families, and communities. Violence prevention is distinct from violence containment or suppression. Violence prevention efforts contribute to empowerment, educational and economic progress, and improved life management skills while fostering healthy communities in which people can grow in dignity and safety. Prevention efforts realign institutions to be more inclusive and receptive in responding to community needs.
Despite its preventable nature, interpersonal violence is often seen as intractable because its prevention is rarely approached with the level of commitment and attention required for long-term success. No single program can address the magnitude or all the causes of violence, but effective programs can contribute to an overall solution. As a complex problem, violence requires a comprehensive solution involving the participation of multiple stakeholders.
Prevention AS A Systemic Process
Effective prevention is comprehensive and is designed to address conditions that may lead to violence before it occurs, rather than waiting to intervene after violent situations arise. This method is known as primary prevention. The goal of primary prevention in interpersonal violence is to create environments in which people do not have to question whether or not they are safe. Primary prevention is distinct from other forms of prevention because it explicitly focuses on taking action before violence develops. In contrast, a secondary prevention response takes place shortly after violence has developed and/or is recognized, such as developing a safety plan for a woman who has experienced intimate partner violence. Tertiary prevention refers to addressing the long-term effects of violence to prevent further negative consequences, such as mental health services for victims or the rehabilitation of a community affected by violence. Prevention programs working at all three levels are important and can be mutually supportive and reinforcing.
To be effective, it is critical that prevention efforts work to change the social norms that contribute to violence. Norms are among the most powerful societal and community influences that shape behavior. Norms are often based in culture and tradition, representing the attitudes, beliefs, and standards of a group of people. If violence is seen as typical and is reinforced by the media, family, or community, it will occur with greater frequency. Alternatively, in communities that demonstrate consistently high levels of support and consistently model nonviolence more positive outcomes can be expected.
Risk and resilience factors also influence the likelihood and frequency of violence. Prevention efforts reduce the factors that put individuals and communities at risk of violence and bolster factors that are protective against violence. Risk factors are those characteristics or circumstances that increase the likelihood of violence. Examples of risk factors include poverty, school failure or truancy, substance abuse, and discrimination. In contrast, resilience factors are those influences that increase the capacity of an individual, family, or community to develop positively, despite harmful environments and experiences. Resilience factors include positive attachments and relationships, social capital, and ethnic or intergroup relationships.
The Development Of Effective Prevention Programs
Risk and resilience factors do not develop over a short period of time and cannot be changed immediately. Addressing them requires a multifaceted approach. Therefore, effective initiatives include attention not only to strengthening individual knowledge and skills and community education, but also to training providers, fostering coalitions and networks, changing organizational practices, and influencing policy and legislation. Strategies at each of these levels can be designed to reduce risk factors and bolster resilience factors. Such comprehensive approaches can foster systemic change and change norms. It is this comprehensive approach that can provide current health practitioners, community members, and policymakers with an effective strategy for preventing interpersonal violence.
Communities and providers often encounter significant barriers to success. These barriers include, though are not limited to, a lack of a focused, shared vision; lack of knowledge and skills to change community environments and norms; challenges related to building multidisciplinary partnerships and collaborations; and challenges to developing a shared context. Prevention programs can be developed in a variety of ways to best address an identified need, overcome barriers to effectiveness, and ensure success that is sustainable over the long term.
Strategy Development Ensures Maximum Efficacy
A strategic approach is the key to determining priorities and maximizing discrete efforts, ensuring that each effort builds on the previous in order to address the complexities of interpersonal violence. Such an approach provides an analysis of the issue, delineates a final goal, and defines what steps are necessary to execute the plan. Strategy development leads to better outcomes by promoting approaches that are well coordinated, responsive to local needs and concerns, and built on best practices. Further, the process of strategy development builds shared understanding and commitment, enabling participants to create relationships needed for success.
Infrastructure Facilitates Coordination And Effectiveness
Violence prevention efforts should include all segments of the community, beginning with the individual and involving education, community action, social support, and competency building. No single prevention program can be all-encompassing, and there is great value in multicomponent initiatives. Multicomponent initiatives require the appropriate infrastructure: support for staffing, ongoing coordination and collaboration, and improved data systems. Such organization will enhance access and will facilitate communication and effectiveness.
Training Initiatives Enhance Violence Prevention Skills
Practitioners, service providers, and elected officials must be able to draw upon specific skills and knowledge to adequately address violence prevention. Training and staff development are critical to these efforts. Specific training may include the value of a public health approach to violence prevention, risk and resilience factors, interdisciplinary collaboration, behavioral norms, promising practices, advocacy skill development, public relations skill building, engaging youth and communities, leadership development, and those issues specific to the particular area of program focus. Cross-disciplinary training builds a common language, fosters understanding about different roles, and builds skills for collaboration and communication.
Appropriate Evaluation Ensures The Identified Need Is Addressed
Evaluation is a critical component of ensuring that programs are effective in addressing the identified need. Evaluation increases the viability of programs by demonstrating effectiveness and establishing credibility, especially when the appropriate level of assessment is also determined. For example, proven programs need to be evaluated only for fidelity and fiscal management, while new programs need more scrutiny to ensure they are achieving the desired outcomes. To the extent possible, evaluation should also consider the overall context of the program.
To influence current trends in interpersonal violence, effective prevention programs must be able to sustain their efforts in a community over the long term. This need is one of the biggest challenges affecting violence prevention programs at present and is mainly due to the instability of funding for such efforts. Nonetheless, collaboration with multiple stakeholders can facilitate the establishment of effective programs and will ensure that interpersonal violence prevention becomes integral to communities nationwide.
Bibliography:
- Cohen, L., & Swift, S. (1993). A public health approach to the violence epidemic in the United States. Environment and Urbanization, 5, 50–66.
- Davis, R., Nageer, S., Cohen, L., Tepperman, J., Biderman, F., & Henkle, G. (2002). First steps: Taking action early to prevent violence. Oakland, CA: Prevention Institute. Available at https://www.preventioninstitute.org/publications/first-steps-taking-action-early-to-prevent-violence
- Murphy, G. (2002). Beyond surviving: Toward a movement to prevent child sexual abuse. New York: Ms. Foundation for Women.
- S. Department of Health and Human Services. (2001). Youth violence: A report of the surgeon general. Rockville, MD: Author.
- World Health Organization. (2004). Preventing violence: A guide to implementing the recommendations of the World Report on Violence and Health. Geneva: Author. Available at http://www.who.int/violence_injury_prevention/media/news/08_09_2004/en/
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