American Journal of Preventive Medicine
Introduction and overviewThe Matrix Comes to Youth Violence Prevention: A Strengths-Based, Ecologic, and Developmental Framework
Section snippets
Public Health Approach
In the United States, just 100 years ago, at the beginning of the last century the average life expectancy was only 45 years. Over the course of the 20th century, the life expectancy has increased to 75 years. That was the equivalent of adding 8 hours a day, every day for 100 years (Bill Foege, personal communication). How did this happen? This did not come about because of improvements in medical care. It was not because of better treatment of heart disease, cancer, and stroke. Rather, it
The Matrix Makes Us Look Upstream
The public health approach places an emphasis on prevention. Consistent with this, the Child Well-Being Matrix emphasizes problem prevention beginning before birth and continuing across the early life span. The importance of focusing on prevention can most easily be illustrated through a legendary public health story:
One fall afternoon, two people are sitting on the bank of a river, quietly drinking coffee and reading their books when one of them sees a body floating down the river. She turns
Like the Public Health Approach, the Matrix Is Based on Science
One of the most promising frameworks for understanding and preventing youth violence today is the evidence-based, four-step public health model, the same four-step model that has resulted in major advances in other areas, such as the prevention of motor vehicle injuries, cancer, and infectious diseases, and tobacco control. The questions that were asked in those fields are the same ones the model poses regarding the prevention of youth violence:
Step One: What is the problem? Who are the
Consistent with the Public Health Approach, the Matrix Is Collaborative
Because the factors that affect the health and safety of populations are complex and not solved easily through simple interventions, effective youth violence prevention efforts require the input of multiple sectors: law enforcement, education, public health, health care, and social services. There have been outstanding examples of collaborative approaches at the national level among the U.S. Department of Health and Human Services (DHHS), the Department of Justice, and the Department of
Contributions of the Science of Child Development
The Matrix is also grounded in developmental science. At different stages in human development there are significant differences in one’s sense of self, connectedness to others, ability to learn from others, and in one’s competencies, skills, and activities, all of which have implications for prevention and intervention in youth violence. The Matrix builds on the recognition that strengths and skills develop and are affected by different external influences across the life course, and considers
Combining the Public Health Approach with the Developmental Approach
Combining the public health approach, the framework that guided the first 30 years of youth violence prevention, with developmental theory produces a framework that creates a multidimensional, evidence-driven, developmentally sensitive framework from which to identify opportunities for youth violence prevention that involve not only prevention and risk reduction but also the promotion of positive development. Instead of thinking about interventions that take place in one setting, at one time,
Implications of the Matrix for Healthcare Professionals
The Matrix and other integrative models of problem behavior prevention and positive youth development have important implications for healthcare practice in violence prevention. First, they suggest that healthcare provider efforts in youth violence prevention have two foci: one on risk reduction, and a second on promoting the development of core developmental competencies in children and the environmental and familial resources necessary to accomplish this.
Second, these models suggest that
Family Practice–Based Example of the Integrated Model
To imagine this integrated model in practice, consider the following example. A pregnant mother presents for prenatal care at a community clinic in her area during her second trimester. The physician conducts a history and physical and provides counseling appropriate to her stage of pregnancy on nutrition and alcohol, among other pregnancy-related concerns. Along with this, the mother-to-be receives health education directed toward increasing her competency as a parent and building the skills
Discussion
The field of youth violence seems to be on the cusp of exciting breakthroughs. Significant progress has been made in violence prevention by designing and testing discrete evidence-based interventions that work. This has been a major step forward. We must continue to collect this information and data as we go. If we exclude certain types of approaches because of political bias or fear, or if we continue to invest large resources into approaches for which there is no evidence of effectiveness, we
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