CHAMP-V + LAW: A program to prevent youth violence by addressing upstream structural determinants through community health worker and civil legal aid interventions - PROJECT ABSTRACT Violence is the leading cause of mortality among US children. In Chicago, violence disproportionately affects children of color on the South and West sides, with studies documenting community violence exposure as high as 85% in some neighborhoods. Research also shows that social, economic, and health inequities, such as poverty and lack of access to quality health and educational resources, increase the risk of violence. Sustained community violence exposure has a detrimental impact on youth’s overall well-being, reducing school engagement, encouraging maladaptive behaviors, and eroding mental health. Therefore, it is critical to develop and implement violence prevention interventions that address the social, economic, educational, and health factors that exacerbate youth involvement in community violence. Such efforts must reach across all levels of the social-ecological model, moving beyond individual and interpersonal focused interventions to address the upstream structural factors that impact violence. Research shows that community health workers (CHWs) can apply their expertise to prevent violence by serving as a nexus between families and social and health services. Also, legal assistance can be used to address structural inequities that contribute to community violence, as seen in medical-legal partnerships. Thus, this project’s objective is to evaluate a novel youth violence prevention program that combines CHWs and legal assistance to address structural inequities— Community Health Advocates in Mitigating and Preventing Violence (CHAMP-V) with and without Legal Aid Wraparound (LAW). We hypothesize that community health advocacy and legal advocacy can work synergistically to reduce violent behavior and improve educational outcomes by holistically addressing social, economic, education, and health-related needs of middle school youth and their families. To test this hypothesis, we will conduct a cluster randomized trial comparing the two intervention groups. In Aim 1, we will adapt the CHW and legal aid interventions to ensure relevance to school settings using a community-driven approach that engages parents/guardians and school principals/staff through focus groups and interviews. Aim 2 will evaluate the effectiveness of CHAMP-V versus CHAMP-V+LAW on violence-related and educational outcomes, using primary survey data as well as administrative data from the Chicago Police Department and Chicago Public Schools. Aim 3 will examine implementation factors and mechanisms by which the interventions promote change in social, economic, educational, and health needs that impact youth violence, using service delivery logs and interviews. Results from this study will provide rigorous evidence about the effect of CHW and legal advocacy strategies to prevent community violence for middle school youth and their families, while offering a scalable approach that targets all levels of the social-ecological model. Further, by addressing structural causes of violence, such programs are vital to help interrupt the cycle of stress, trauma, and violence that contribute to racial health, education, and mortality disparities in communities.
