Connecting the Dots in Colorado and North Carolina: Preventing multiple forms of violence

Violence prevention is tough with one type of violence in mind, let alone multiple types. Increasingly, violence prevention and public health practitioners are disrupting siloed, issue-specific approaches to create broader solutions that address multiple forms of violence at the same time. But coming together with distinct styles of communication, different community contexts, and multiple voices at the table with diverse priorities requires dedicated, creative thinking and collaboration—it’s challenging!

In March 2017, PreventConnect and CALCASA hosted a webinar facilitated by PI’s Lisa Fujie Parks and Alisha Somji: How Do We Connect the Dots? State and Local Approaches to Preventing Multiple Forms of Violence. The basis of the webinar was Connecting the Dots, a paper by PI and the Centers for Disease Control and Prevention, on how different forms of violence (such as sexual abuse, child abuse, bullying, interpersonal violence, etc.) often have many risk factors (norms that support aggressive behavior, substance abuse, economic stress, family conflict, etc.) in common. Communities are now using the research from Connecting the Dots to bolster protective factors that buffer against violence (like community connectedness and positive social norms) and reduce shared risk factors that increase the likelihood of violence. On March 15, PreventConnect and PI hosted a panel-style web forum during which guests from state-level and local communities told the stories of how the process has unfolded on the ground.

Connecting the dots to reduce multiple forms of violence at the state level: Colorado

For 10 years, Colorado has searched for comprehensive ways to reduce violence. Danielle Tuft, Sexual Violence Prevention Program Manager of the Department of Public Health and Environment, shared how the Connecting the Dots research has influenced state-level work. The Department used research on shared risk and protective factors to inform the Colorado Violence and Injury Prevention Mental Health Promotion Strategic Plan for 2016 to 2020. In Danielle's words, “Our goal was to move theory and research into practice. We invested in this approach so that we can take limited resources and increase reach across our community. It enables us to talk about health in a more creative, meaningful way.”

How Colorado’s Department of Public Health and Environment moved forward

1. Prioritize the types of violence to address
With different types of violence occurring daily, the Department had to get specific: Was there existing momentum around particular types of violence? Where was political will to intervene strongest? Where was the funding, and was it flexible enough to address multiple issues? What were their partners’ highest priorities? Based on the answers to these questions, traffic crashes, interpersonal violence, child maltreatment, traumatic brain injury, suicide, drug overdose, and older adult falls emerged as critical areas where intervention would be most effective.

2. Connect the Dots, address shared risk and protective factors
Funding for violence prevention is often limited, and violence prevention efforts can be narrow in scope when focused on one issue.  A major benefit of the shared risks and protective factors approach is that it enables practitioners to zoom out, and create trainings, programming, and partnerships that respond to multiple forms of violence at once. Among the types of violence they identified, the Department found that their shared risk factors could be reduced by implementing policies, programs, and initiatives that increased connectedness, positive social norms, good behavioral health, economic stability, and resilience. Since these protective factors applied to all issue areas, the Department was able to combine otherwise siloed funds and partnerships to build and implement creative, multifaceted programming.

3. Leverage partnerships, braid funding
The Department has built many partnerships to operationalize its strategic  plan. With nonprofit grantees, the CO Department of Education, Colorado Youth Matters, Tony Grampsas Youth Services, Colorado Coalition of Sexual Assault, and other organizations, the Department found many sources of funding with shared interests to build comprehensive prevention efforts. One standout result was the work that came out of a partnership with Sources of Strength, a national youth suicide prevention project that builds on peer social networks to change unhealthy norms and culture, ultimately preventing suicide, bullying, and substance abuse. In Colorado, Sources of Strength trains influential peers in social cliques to become leaders with conflict management skills. The program increases connectedness between students and their school, peers, and teachers. With the success of Sources of Strength in building the protective factor of connectedness, the Department is addressing multiple forms of violence, including sexual violence -- braiding funding together, and implementing it in seven high schools in Colorado.

Tips from Colorado about how to connect the dots at the state level:

• Create a strategic plan to help unify work and direction, and build an understanding around shared risk and protective factors.
   
• Provide space and time for staff to connect and get out of the office to talk to partners.
   
• Develop your communications strategy; shared language is huge internally, and when talking to partners. Find ways to talk about your work on multiple forms of violence in ways that resonate with others.
   

Forming unlikely partnerships to connect the dots at the local level: Charlotte, North Carolina

In the second half of the webinar, Deena Fulton, Prevention Coordinator of the North Carolina Coalition Against Domestic Violence (NCCADV), and Allison Preston, Senior Vice President of Resident Safety at Charlotte Housing Authority (CHA), shared how the unique partnership between the coalition and housing authority has led to great community gains in violence prevention.

1. Change more things than you think you can change, with unexpected partners
Multisector discussions present an opportunity for communities to reframe the conversation around violence as diverse stakeholders leverage knowledge, share resources, and form unique partnerships. Allison (from CHA) and Deena (from NCCADV) partnered together after meeting through the Mecklenburg County Violence Prevention Coalition, a multi-sector coalition out of the Mecklenburg County Health Department. Deena and NCCADV had held trainings during the coalition’s meetings on shared risk and protective factors, and Allison saw how the Connecting the Dots approach could work for CHA.

The CHA was already monitoring crime statistics monthly from the local police department.  Domestic violence and conflicts between neighbors are the most common types of violence in public housing communities, often increasing and affecting other types of violence. Allison noticed that the CHA public housing residents, those most directly affected by violence, were not included in most conversations about prevention. With this in mind, Allison attended multi-day NCCADV prevention training, and identified opportunities for the CHA and its residents to take action in partnership with NCCADV. After discussing the types of violence occurring in CHA communities, and within the community of Charlotte at large, the CHA and NCCADV identified key risk and protective factors to address:

• Cultural norms that support aggression toward others
• Coordination of resources and services among community agencies
• Poor neighborhood support and cohesion
• Community connectedness

2. Create community strategies that address the factors
Together the organizations created programming that would train residents and property managers in public housing to take a proactive stance to reduce violence. Allison shared, “We realized property managers didn’t have a way to address domestic violence. We made sure they got trainings on what domestic violence looks like, how to address it, and how it affects the community if it isn’t addressed. We asked the residents to take part of that training as well.” Deena shared, “Intervention and community meetings are all about changing norms around aggression. We are hopeful that the protective factors we boost will impact not only domestic violence, but other forms of violence as well.”

3. Linked but distinct – Consider your picture, their picture, and the big picture
A shared risk and protective factor approach that addresses multiple forms of violence at once takes time and effort to understand and use. It requires that stakeholders with varying mandates congregate to share the distinct factors behind the type of violence they face or work to address. For example, sexual and domestic violence prevention advocates may focus on specific gender norms that those working on other forms of violence may not prioritize right away. At the same time, practitioners must zoom out to find commonalities for joint work, not only thinking about ‘your picture’ vs. ‘their picture,’ but the big picture.

It also takes time to develop a shared language to work simultaneously with large organizations and coalitions, and to navigate through politics to collaborate. Deena explained that most stakeholders that her coalition serves don’t have an understanding of this model to begin with, and so the coalition is constantly creating a baseline of knowledge. “We need to improve the language around how we talk about shared risk and protective factors. While large group meetings are valuable, it’s key to have one-on-one meetings with a defined ‘ask’ and the right words to communicate how our work relates to our stakeholders’ interests.”

Tips from North Carolina about how to connect the dots at the local level:

• Include and elevate the voices of those most affected by violence when discussing issues that permeate entire communities.
   
• Use shared risk and protective factors as a springboard for new partnerships and strategies to expand prevention strategies and maximize impact across broader segments of the community.
   
• Find champions at all levels –in communities and organizations– who will go the extra mile to promote the work.
   
• Don’t let go of an identity or get mission creep just because you are working with other partners. Find ways to see your picture, their picture, and the big picture through several lenses.
   
• Change takes time – be realistic and keep everyone on the same page.
   

Engage with Connecting the Dots

Listen to recording of the webinar

Read PI/CDC Connecting the Dots Publication

Check out CDC’s 2016 Strategic Vision

Read Colorado’s strategic plan

Visit preventviolenceNC.org