TRUE HAVEN: TRUsted rEsidents and Housing Assistance to decrease Violence Exposure in New Haven - ABSTRACT Community gun violence kills more than 17,000 people each year. In the United States (US), these deaths are concentrated among low-income, young men, yielding one of the largest attributable cause of years of potential life lost. In addition, people living in communities with high rates of gun violence experience long-term negative physical and mental health effects from persistent trauma. At the root of neighborhood conditions that allow such violence and trauma to persist is long-term disinvestment in these neighborhoods and disruption of community bonds. This proposal seeks to apply a positive community-level approach to change the context within which intergenerational cycles of gun violence, trauma, and incarceration persist and address the social context that stymies positive relationships by permitting and normalizing trauma after exposure to gun violence. Dr. Emily Wang, MD, MAS, Director of the SEICHE Center for Health and Justice at Yale, Dr. Brita Roy, MD, MPH, MHS, Director of Community Health and Clinical Outcomes at NYU Langone Health, and Virginia Spell, CEO of Urban League of Southern Connecticut, an economic self-reliance organization, have partnered with stakeholders across New Haven, Connecticut, to design a program to reduce gun violence by improving the community context within which violence persists. TRUE HAVEN: TRUsted rEsidents and Housing Assistance to decrease Violence Exposure in New Haven is a multi-level, multi-component, assets-based intervention to increase the stability, wealth, and well-being of neighborhoods affected by gun violence by: (1) setting up a citywide community stakeholder-led governance structure to oversee the program and identify and address policies that limit access to stable and affordable housing and employment, (2) increasing housing stability by enrolling 400 families affected by incarceration each year in a program that couples comprehensive financial education with rental assistance or down-payment and loan assistance, and (3) providing greater support for mental health and well-being by training trusted community members (e.g., barbers, educators, faith leaders, youth mentors) in trauma-informed counseling techniques to recognize and support those affected by the trauma of gun violence. We will target implementation of this intervention package to individuals and families affected by incarceration residing within six New Haven neighborhoods with high rates of gun violence. We will perform a hybrid type 1 effectiveness/implementation study to assess the effects of TRUE HAVEN on neighborhood rates of incident gun violence using a stepped wedge study design and identify organizational and policy factors that act as key barriers and facilitators to TRUE HAVEN implementation. We will also track the number and types of policies changed and project their city-wide impact using a simulation model that can be adapted by other communities. This study will yield a roadmap for how cities can effectively and systematically reduce rates of gun violence and improve community health and well-being.
