The goal of this intervention program is to decrease the number of juvenile arrests in black male youth in Broward County, Florida. Specifically, to identify individuals with a high risk for juvenile arrest (those who have experienced four or more ACEs) early on to allow for protective measures to be put in place for these youth via self-regulation, resilience, and adult presence. The goals for this project are to decrease the negative outcomes related to ACEs in Black male youth, including chronic health problems, mental illness, substance abuse problems, and greater criminal involvement. By equipping these Black male youth with self-regulation tools and through building resilience, this program will ensure a reduction in juvenile arrests in Broward County, Florida and help prevent the negative downstream effects of youth entering the juvenile justice system early on in their lives.
Public Health Framework
Utilizing a public health framework will allow our intervention to have wider-ranging impact than the traditional disease-centric model, which aims to address health only as the absence of illness (Cawley, J. et al., 2016).
Following the public health approach, primary prevention includes efforts to prevent ACEs so that children grow up with less exposure to adversity, decreasing the negative outcomes. At this level, we will intervene by implementing a community advisory board (CAB) which will help increase community stability moving forward (Oral et al., 2016). By implementing the CAB and building a healthier and more resilient community, we will ensure that the future generation of Black male youth in this community will grow up with less exposure to ACEs, less adversity, and a better understanding of ACEs overall.
Secondary prevention includes early intervention of ACEs to reduce the severity of the consequences of ACEs, thereby reducing the incidence of the negative outcomes including chronic health problems, mental illness, substance abuse problems, and greater criminal involvement. (Oral et al., 2016). At this level, we will intervene by building adaptive skills, such as self-regulation (Salinas-Miranda, 2023). We will complete this via the Self-regulation app described above, peer support, and the presence of a stable adult. Psychological involvement such as a stable adult figure can help reduce the psychological impact of trauma; thereby reducing the impact of the ACEs experienced.
Tertiary prevention includes efforts to treat and reduce long-term consequences of ACEs. At this level, we will intervene by treating and reducing the long-term consequences of ACEs (Oral et al., 2016). Utilizing the trauma informed approach in our program will help build stronger social, emotional, and cognitive health leading to a reduced number of negative outcomes.
Levels of Social Ecological Model
The Social Ecological Model considers the complex interplay between individual, relationship, community, and societal factors. The overlapping rings in the model illustrate how factors at one level influence factors at another level. The model also suggests that it is necessary to act across multiple levels of the model at the same time. This approach is more likely to sustain efforts over time and achieve population-level impact (CDC, 2022). Additionally, interventions that focus on building resilience across multiple ecological levels are the most effective (DeCandia & Guriano, 2015).
This program will utilize the CDC Model and intervene at two levels of this model (CDC, 2022).
The individual level focuses on the biological and personal history factors that increase susceptibility to Trauma/ACEs. Some of these factors are age, genetics, education, income, and geographic location. Prevention strategies at this level promote attitudes, beliefs, and healthy behaviors. At this level, we will help provide resources including availability to trained healthcare workers to work through trauma and self-regulation training to help build resilience. This level was chosen due to the great impact this program can have on the individual level. Education and building resilience on the individual level will ensure sustained change through the youth’s lifetime going forward.
The relationship level examines close relationships that may increase the risk of experiencing ACEs. A person’s closest social circle-peers, partners, and family members-influences their behavior and contribute to their experience. Prevention strategies at this level focus on mentoring and peer programs designed to strengthen communication, promote positive peer norms, problem-solving skills, and promote healthy relationships. At this level, we will create the peer support groups to help build resilience and self-regulation in the boys in this community. This level was chosen due to the importance of sustainability of change for these youth. The peer support that will stay with these youth even after the program is complete will ensure sustained change going forward. The relationship, communication, and problem -solving skills learned at this level will assist the youth in all parts of life going forward.
Trauma-Informed Principles
Given the prevalence of ACEs and trauma, it is imperative that programs across all sectors apply a trauma-informed lens (Cawley, J. et al., 2016). Therefore, trauma informed approaches will be built into this program to ensure its success. We will adhere to the SAMSHA’s six key principles of a trauma-informed approach as well as the SAMSHA’s ten implementation domains (SAMHSA, 2014). We will put a strong focus on the key principles of Safety and Trustworthiness and Transparency and the implementation domains of Engagement and Involvement and Evaluation.
For the principle of safety, we will ensure the staff involved and all the people being served through the program feel physically and psychologically safe. Specifically, the physical setting and interpersonal interactions will promote a sense of safety (SAMHSA, 2014). Experiencing trauma can lead to an increased fear of stigma. We will have all training and peer groups conducted in private spaces so that the space feels safe from being stigmatized or judged.
For the principle of Trustworthiness and Transparency, we will conduct all interactions and steps throughout the program with transparency; helping lead to a relationship of trust with the people that the program serves as well as the staff involved in running the program (SAMHSA, 2014). For this program, seeking input from the target population at the beginning, throughout, and at the end of the program will help build and maintain trust. Additionally, explaining each step by step that will occur throughout the program at each time point will provide transparency which will lead to trust in the relationship.
For the implementation domain of Engagement and Involvement, we will ensure that individuals receiving services have meaningful involvement in all levels of decision making from program planning through evaluation (Thompson et al., (2018). To accomplish this, we will involve the CAB, as well as the two people from the target population serving in a leadership capacity.
For the implementation domain of Evaluation, we will ensure a commitment to measuring and continually improving the efficacy of our services. We will implement a robust evaluation plan to ensure a successful outcome.
Through this intervention, participants will learn about ACEs and how these experiences could have affected their lives. Participants will learn self-regulating tools. This knowledge along with the self-regulation app will help participants gain the skills needed to build resilience for themselves. A strength-based approach that includes participants in decision-making will empower participants and build up their confidence. Through the peer groups, participants will be able to form bonds and potential friendships with other individuals who have similar experiences, as well as create a community to help them feel less alone. The relationships built through this program, including peers, community members, and healthcare providers will help individuals cope with their trauma and any other problems they are dealing with. This can be empowering, build resilience, and lead to better mental and physical health outcomes. This all will lead to fewer juvenile arrests in black youth in Broward County, Florida.
References:
Cawley, J. et al., (2016). Trauma-Informed Philanthropy: A Funders Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley. Philanthropy Network of Greater Philadelphia. file:///C:/Users/rivka/Downloads/FINAL_TraumaGUIDE-single-1.pdf
Centers for Disease Control and Prevention. (2022). The Social-Ecological Model. Center for Disease Control and Prevention. https://www.cdc.gov/violencepr...ecologicalmodel.html
DeCandia, C., & Guarino, K. (2015). Trauma-Informed Care: An Ecological Response. Journal of Child and Youth Care Work, 25, 7-32. https://doi.org/10.5195/jcycw.2015.69
Oral, R., Ramirez, et al. (2016). Adverse childhood experiences and trauma informed care: the future of health care. Pediatric research, 79(1-2), 227–233. https://doi.org/10.1038/pr.2015.197
Salinas-Miranda, A. (2023). Adverse Childhood Experiences – Understanding the Data and Research Gaps in Trauma Informed Care Approaches. [Video]. University of Florida Canvas: file:///C:/Users/rivka/Downloads/Adverse%20Childhood%20Experiences%20-%20Understanding%20the%20Data.pdf
Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma informed Approach. SAMHSA. file:///C:/Users/rivka/Downloads/SAMHSA-1.pdf
Thompson, K. et al., (2018). Trauma-Informed Philanthropy: Leveraging resources and relationships to advance trauma-informed practice and move from knowledge to action. Philanthropy Network of Greater Philadelphia. file:///C:/Users/rivka/Downloads/Trauma2-web%20(1)-1.pdf
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