What works to prevent youth violence: evidence summary

Parenting and family-focused interventions

Classification: Mixed

Background

Most parenting and family-focused interventions are implemented during the early years of a child’s life. By intervening early, they aim to reduce the likelihood that the young person will engage in youth violence later on. O’Connor & Waddell (2015:18) note that:

Family and parent-focused interventions recognise that creating and sustaining positive changes in children and young people when they have challenging, complex, and sometimes chaotic home lives is very difficult. These approaches seek not only to respond to causal factors at the individual level, but at the parent and family level also.

The challenges of demonstrating long term impact following interventions in the early years have previously been acknowledged (Home Office, 2018). It is challenging and costly to measure these outcomes in the long term as a reduction in violence may only be evident several years after the programme has been completed and a range of other factors may also have influenced these outcomes.

As a result, research monitoring the long-term impact of these approaches is limited, and instead evaluations tend to focus on intermediate outcomes that provide information on whether the intervention may prevent later involvement in violence. Evaluation research has largely focused on whether parenting and family-focused interventions influence risk factors for youth violence. Few studies have been longitudinal in nature and so evidence relating to the impact of these programmes on involvement in violence between the ages of 10 to 29 is limited.

Available Evidence

Early childhood home visitation programmes

According to Bellis et al (2017:51), these time-limited programmes “provide intensive support in the home to improve parenting skills, promote healthy child development and support maternal mental health”. One example of this approach for young mothers expecting their first child is Family-Nurse Partnerships (FNPs). Evidence from the USA demonstrates benefits for both the mother and the child relating to youth violence and its risk factors (Bellis et al., 2017; David-Ferdon, 2016; O’Connor & Waddell, 2015), and those who participated in the programme report fewer arrests and convictions by the age of 15 (David-Ferdon et al., 2016).  The UK Cross-Government report Ending Gang and Youth Violence notes that a review of thirty years of research in the United States has shown a 59% reduction in arrests and a 90% reduction in supervision orders by age 15 for the children of mothers helped by this programme in the United States. FNPs are being trialled within the UK, but long-term violence-related outcomes are not yet available within this context.

Moderating factors

The CDC Comprehensive Technical Package for the Prevention of Youth Violence and Associated Risk Behaviors notes that:

Home visiting programs are effective in improving parenting behaviors and children’s social and emotional development, but the evidence is mixed with some programs showing strong effects and others showing few to no effects potentially due to the varying content and delivery of these programs (David-Ferdon, 2016:16).

It is important to bear in mind that differences in healthcare systems between the UK and North America may influence the effectiveness of the Family Nurse Partnership. For example, although this approach has been shown to positively influence a wide range of outcomes in North America, an initial evaluation of United Kingdom implementation did not show significant benefits during the first two years of life compared to existing services already offered to young pregnant women. However, it is possible that benefits may accrue over a long period of time across domains of child development (e.g. violence-related outcomes).^[26]

Pre-school academic enrichment programmes

Classification: Promising

These programmes set out to provide good quality early education with the aim of helping young children to develop their social, emotional, and cognitive skills. They may include parent training or family support and aim to enhance protective factors (Bellis, 2017) and are often implemented with children from low income families who are living in deprived areas. There is promising evidence that these programmes can reduce involvement in violence during childhood and later in life. In addition, they are associated with a reduction in violent offending and criminal activity (David-Ferdon, 2016; Bellis et al., 2017).

The Child-Parent Centre Programme provides education for 3 and 4 year olds, as well as activities to improve child-parent relationships, outreach services and health services. Those participating in the programme reported significantly lower levels of juvenile arrests and arrests for violent offences at age 18 (Reynold et al., 2001). Young people who participated in the program for 4 to 6 years demonstrated reductions in arrests for violence, lower rates for violent convictions, and were less likely to have been incarcerated on more than one occasion during the 15 year follow up period. (Reynolds et al., 2001; Reynolds et al., 2007). Those who had remained in the programme for longer periods were less likely to have been involved in violent crime.

HeadStart is a community-based programme which brings together child education, childcare, health services, and family support within dedicated child centres. Evaluations show that participation in Head Start is associated with lower levels of aggressive behaviour at age 3 (Love et al., 2005) and lower rates of child maltreatment (a predictor of future youth violence) (Green et al., 2014). In England, the Sure Start programme provides similar services to all children living within areas served by a Sure Start Children’s Centre. An evaluation of Sure Start programmes compared 5883 three-year-old children and their families from 93 disadvantaged Sure Start areas with 1879 children and families from 72 similarly deprived areas participating in the Millennium Cohort Study. The study found better social development and more positive social behaviour in children from Sure Start areas (Melhuish et al., 2008). However, effects on aggressive or violent behaviour have not yet been measured.

Moderating factors

Potential facilitators

The WHO report Preventing Youth Violence: An Overview of the Evidence (2015:26) highlights that “The effect of centre-based interventions seems to be larger when parent interventions are an integral part of the programme and/or if the programme is administered to at-risk children and families. Research also shows that programmes which combine group and individual work are more effective than programmes with only one of these elements”.

Potential barriers

Bellis (2017) also notes that targeting programmes at high risk groups can be an effective use of resources but care must be taken to avoid the stigmatisation of such groups.

Parenting training/education

There is evidence that interventions which aim to develop parenting skills and strengthen the relationship between parent and child may have promising effects on perpetration of youth violence (Public Health England, 2019). They do so by encouraging safe, stable and nurturing relationships between parents and young people (WHO, 2013) and targeting risk and protective factors (Farrington, 2007). Triple P and The Incredible Years are both examples of programmes that focus on parenting and aim to promote positive parenting relationships. This is relevant to youth violence prevention as the relationship between parents and their children can directly affect child development (WHO, 2015). Participation in these programmes is associated with a reduction in child maltreatment and problematic child behaviour, both of which represent risk factors for perpetrating violence later in life (Bellis et al, 2012; David-Ferdon, 2016; WHO, 2015). They have been adapted for use within the UK.

The Raising Healthy Children Project, which was implemented as part of the Seattle Social Development Project was designed to reduce vulnerability and increase protection against a range of risk behaviours at the individual, peer, family and school level. It was hypothesised that training parents to manage their families in ways that promotes bonding to family and to school would reduce the likelihood that their children would engage in health-risk behaviours. Young people who participated in the programme reported fewer lifetime violent delinquent acts by the age of 18 years old and were less likely to have criminal records at age 21 (Hawkins et al., 1999).

Whilst the aforementioned programmes are designed to be implemented during the Early Years the CDC Comprehensive Technical Package for the Prevention of Youth Violence and Associated Risk Behaviors notes that the “transitional period into adolescence is when risk behaviors can increase and more severe forms of violence can emerge”. As such, other programs have been developed that incorporate working with families when young people are aged 10–17. Examples of these programs include Strengthening Families 10–14, Coping Power, and Familias Unidas™”(David-Ferdon, 2016:17).

Moderating factors

Potential facilitators

The Preventing Violence: Evaluating Outcomes of Parenting Programmes report (2013) summarises specific components that are associated with effective parenting programmes. These include:

• Opportunities for parents to practice the new skills that they learn (e.g. through role playing or video feedback). Practice effective communication and problem solving strategies.
• Teaching parents principles of positive parenting, rather than specific prescribed techniques in response to certain behaviours. This allows parents to learn the skills (e.g. positive reinforcement and encouragement) to respond positively and appropriately when new situations arise
• Teaching strategies to handle poor behaviour in a positive and age-appropriate way. Alongside these strategies, programmes should include strategies that aim to strengthen positive parent-child relationships through play and praise
• Considers difficulties in the relationships between adults in the family