Cure Violence

Cure Violence, formerly Chicago CeaseFire, aims to reduce youth gun possession and violence in Chicago. It focuses on three key elements: interrupting violence, changing high-risk individuals’ behavior, and altering community norms around violence.

The Cure Violence model does not have threats of punishment. It works by assuming that violent behaviour responds to structures, incentives and norms. The program also functions separately from law enforcement while aiming not to subvert their work.

The staffing model is rather unique, requiring a mix of staff members to reflect the program’s needs. The program requires violence interrupters (VIs) who are meant to stop violence through direct intervention. A key to their selection is their relatability due to their personal experiences with violence or crime. This allows them to speak more intimately to at-risk youth and establish a relationship. VIs tend to be young men between the ages of 15 and 30. In particular, the program prefers reformed, reputable gang members because their voices carry weight. These are often individuals who are not judgmental or outsiders.

Through a fostered relationship VIs can monitor street conflict and proactively intervene before there is a retaliation or escalation. Knowing that the victim’s associates are the likely retaliators after an attack, they seek out these people to convince them not to engage in violence given there are personal, familial, and community consequences.

The staffing model also includes Outreach Workers (OWs) who are case managers. They are trusted individuals in the community and may have had past run-ins with law enforcement. They are responsible for connecting participants to opportunities and resources in the community, including employment, housing, and recreational activities. Their ultimate purpose is to facilitate the growth of participants by getting them to change their behaviour and thoughts of conflict resolution.

Information gathered from VIs and OWs is shared during team meetings. Observations of participants are shared through case-planning sessions and updated in a database with very little identifiers. In meetings, participants are described using pseudonyms (e.g., person A, person B) to maintain anonymity and their cooperation. The team collaborates with neighbourhood partners to transform the social environment and connect with faith and community-based organizations, neighbourhood associations, and tenant councils to gain community support.

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Program Results

Being first piloted in Chicago, some of the measures for the study included site selection, staff training, service by participants, and the capabilities and quality of the host organization. Using 16 years of shooting and attempted shooting data, the first thing the analysis assessed was neighbourhood-level change in gun violence in seven locations. The evaluation found that the program significantly decreased shootings in five of the seven analysis sites, and that trends in these areas generally outperformed those in similar neighbourhoods. The second thing assessed was the overall impact on the community. Here, the study concluded that the overall impact was mixed as only some locations had positive changes.

Although the results were determined to be mixed, there were considerable obstacles during implementation. The early buy-in from the community was limited, they struggled to create new programs in neighbourhoods that lacked community leaders and were not united, funding was inconsistent, and they had complications with hiring high-risk individuals as staff members. Still, participants believed that the program was important and that it reached its intended population.

Since its initiation, the Cure Violence model has been extended to Baltimore, Brooklyn, and Phoenix.

Safe Streets (Baltimore, Maryland)

In 2007, the Baltimore City Health Department launched the Safe Streets program in East Baltimore, based on the Cure Violence model. An evaluation showed significant positive effects in one neighbourhood, with a 56% reduction in homicides and a 34% reduction in nonfatal shootings. Other communities on the border saw a 48% reduction in homicides. One of the sites saw a 26% decrease in homicide incidents but a 22% increase in nonfatal shootings. Subsequently the researchers suggested that the findings were mixed.

Despite the varied effects, in three of the four intervention neighbourhoods researchers stated that there were “relatively large program-related reductions in at least one measure of gun violence without also having a statistically significant increase in another measure of gun violence.”

In another study of the same program, researchers found that the program was correlated to the prevention of approximately 35 nonfatal shootings and a minimum of five homicides during the program’s implementation across the four sites. Some things to consider with respect to the program’s implementation is consistency across all sites. Researchers stated the following:

The sites with large reductions in homicides had about three times as many conflict mediations as the other two sites, and the 22-month period without a homicide in McElderry Park occurred when Safe Streets’ outreach workers conducted 16 mediations—many involving large numbers of gang members—within the first 4 months of full program implementation. Cherry Hill’s program may have also benefited from having to contend with little violence caused by outsiders because it is geographically isolated from most of the rest of the city.

Safe Over Streets (Brooklyn, New York, New York)

Safe Over Streets (SOS) was a Brooklyn based program that had 96 participants, most of whom were considered high risk. Reports indicate that VIs mediated more than 100 potentially violent situations involving more than 1,000 people. Researchers found that gun violence decreased in the program neighbourhood while increasing in proximate comparison neighbourhoods, although the size of the reduction was not statistically significant.

Despite this, survey results showed that community residents didn’t feel any safer, and post-intervention survey respondents still supported the right to carry a gun if they had witnessed a gun-related crime in the past.

TRUCE Project (Phoenix, Arizona)

In the TRUCE Project they found that the intervention was associated with an overall decrease in violent events, with an average of 16 fewer per month. Although, the decline in violence events was due to the decline in assaults. In fact, TRUE was associated with an increase in shootings, an average of 3.2 calls for shootings or shots fired per month in the target area.

Creating a Tailored Violence Reduction Strategy

In all studies the researchers found that the program results were mixed, largely because the results did not demonstrate a consistent and positive impact in each site studied. However, this characterization is inaccurate given that gun violence reduced in over 60% of the neighbourhoods assessed in Chicago and Baltimore, while in Brooklyn, the treatment location saw decreases in gun crime while non-treatment locations saw increases. Agreeably, it can be said that although a higher percentage of neighbourhoods realized positive effects, it’s impossible to know how scalable this model is and where it will work. In turn, this could equate to a wasted investment and time. However, it could also be the remedy municipalities are looking for. It simply depends on how palatable the risk is, and what the impact of current violent reduction approaches is. At large this simply shows that there is no one size fits all approach using this model, indicating that every iteration of a public-health based approach requires place-based tweaks.

Based on the research we see that any public health-based approach to violence reduction requires VIs and OWs who are engrained in their communities. Overall, the intervention must mediate conflict, build relationships with youth, connect high-risk individuals to programs, resources, and opportunities for employment, educational or skill growth, and work with community stakeholders to educate and bring together the wider community. It’s also important to consider funding, staff capacity, community buy-in. For evaluations, in-depth analysis on individual-level is also required.

Despite these elements being considered the essential aspects to public-health based violence reduction programs, there are some gaps that need to be addressed that may allow for more consistent results. More research needs to be done in this area. However, in this regard, researchers have determined some pressing questions to develop stronger programs. I found these particularly important:

• Does the community only realize the effects of the program after a significant number of individuals are directly influenced by the program to stop shooting, or are community residents in general affected by hearing or seeing the program’s message?
• How many conflict mediations are sufficient to effect change? Does the people who attend the mediations (a high-risk program participants, high-risk nonparticipants, or random bystanders) matter?
• Do social norms only change after high-risk participants are treated and reformed? Or can disapproval and reformed perspectives from the larger community influence high-risk individuals to change?
• How long does it take for a neighbourhood to change before it can be reliably measured?

Assessing the gaps we have before us, some adjustments can be made to see if it yields positive results. Based on the community, two things can be done to tailor the Cure Violence model.

1. Engage the community on a larger scale to get their buy-in and understand what community groups and leaders can be leveraged.
   • The Cure Violence model engaged the community to get their buy-in. However, the model remained inflexible, pushing the community to adapt to the model as opposed to the model adapting to the community. Indeed, it’s important to maintain the framework of the model to replicate its results; however, community-based tweaks are always necessary, particularly given that the results of the model itself were mixed. As such, facilitate town hall meetings, focus groups, and community forums to gather input from residents on an ongoing basis. It’s also important to empower community leaders to actively participate in decision-making processes, ensuring interventions are community-driven.
2. Create trauma-informed community centers and groups.
   • We often focus so heavily on the likely perpetrators of gun violence and fail to offer sufficient support to community members either live in fear or are grieving due to the loss of a loved one due to gun violence. Here, it’s important to establish trauma-informed community centers offering mental health resources, counseling, and support groups tailored to address historical and systemic trauma. In many cases people need an outlet to grieve, but also support in understanding how to grieve while normalizing it. This may include community healing circles or other culturally relevant practices,
3. Provide ongoing cultural competency training.
   • indeed, community members with lived experiences that are trained to support their community as part of the program is important. However, it is important to recognize that the program leverages community talent largely based on their experience with law enforcement or gang activity so to establish broad credibility. It may be the case that these individuals are relatable and driven to do this type of work but may require ongoing training and support to nuance their approaches and enhance their experiences. Lived experience is invaluable and cannot be replicated; however, lived experience supported by the right training and education is a powerful combination. It equips individuals with the ability to speak on their experience, trauma, or past decisions not just in reflective ways, but also from a diagnostic and analytical perspective which can help others understand why they are making certain decisions and pinpoint what help they need.
4. Establish baseline data prior to the program’s implementation and measure post-implementation data against violent crime data in local police databases.
   • It is often that case that evaluations only take place after the program has been running for length of time that might yield result. In these cases, it is impossible to fully understand the program’s impact because it cannot be compared to pre-treatment evaluations. Establishing a baseline for the program through analyses that reveal the homicide rate, shooting and non-shooting related deaths and injuries, community perceptions on crime, the program, accessing support, and dealing with trauma among other things is important to in creating a holistic picture of how the program is impacting the community.

Implementing these changes can help municipalities better understand the impact of public health-based violence reduction models. While evaluating these programs, it is crucial to continue exploring and refining alternative approaches, rather than reverting to traditional methods, to foster safer and more resilient communities.