Preventing youth violence in a park-based setting

Youth violence is a significant public health problem facing our nation. Every day, 1,374 U.S. youth on average, between the ages of 10 to 24 years, are victims of physical assault injuries treated in hospital emergency rooms (500,000 per year in 2016). Violence is the leading cause of death and nonfatal injuries for U.S. youth and its prevention is a primary objective of the Centers for Disease Control and Prevention (CDC). Afterschool, park-based organizations can provide optimal settings for youth to acquire important social-emotional skills to improve resilience and reduce the likelihood of participating in at-risk behaviors and violence.

Violence prevention efforts among youth must begin early. Half of adult mental health disorders are diagnosed by age 14, and evidence demonstrates a strong relationship between depression, anxiety, chronic emotional stress, low impulsivity and violence. Moreover, these experiences are aggravated by exposure to poverty. Effective juvenile violence prevention strategies include promoting positive adult role models and peer engagement, healthy relationships, and academic/career aspirations. In fact, the CDC has called for the development, broad dissemination and implementation of youth programs to increase resiliency and reduce risk of violence.

Fit2Lead Program Design
The Fit2Lead park-based afterschool resilience program in Miami-Dade County (MDC), Florida, provides daily mental/emotional/physical health and wellness activities and communication/problem-solving skills training for at-risk youth ages 12–17. This program was initiated in 2016 by multiagency partners, including MDC Department of Parks, Recreation and Open Spaces (MDPROS), Juvenile Services Department, Public Schools, and Police Department as part of the Mayor’s Roundtable on Youth Community Safety and is central to the MDPROS continued effort to create a healthier, more livable and sustainable community.

The Fit2Lead program includes two arms: From 3 p.m. to 7 p.m. Monday–Friday, September to June, youth ages 12–14 in high-need neighborhoods attend 12 MDC parks at no charge (approximately 400 participants at a given time). During these hours, they receive daily academic support from a licensed MDC teacher and participate in workshops that provide them with opportunities to hone their communication/problem-solving/emotion regulation skills, and engage in sports, recreation and nature excursions. Transportation from the schools to the parks is provided at no cost to families, and each park serves two to nine feeder schools. During the summers, youth can attend MDPROS summer camps at no charge.

At age 15, participants who are in good standing become eligible for the second arm of the program: a year-round paid internship for youth ages 15–17 (approximately 150 participants at a given time). Interns are paid $9.05 per hour (a total salary of up to $4,289.70 per participant, per year) and participate in a three-hour weekly resilience workshop, combined with daily on-site, practical work experience. The uniqueness of this program is that a park and recreation department provides at-risk youth with a job, where they support our park staff and receive a paycheck each week and where they learn communication, conflict resolution and problem-solving skills.

Intern assignments support MDPROS operations and recreation staff, and assignments rotate every eight weeks to increase exposure to a variety of job opportunities, mentors and supervisors. Participants are referred to the program by MDC Juvenile Services Department, MDC Public School counselors and by park managers.

The Fit2Lead curriculum leverages teachable moments in sports and physically active recreation to introduce and hone life skills to reduce risk and promote resilience. “Our hope is that it inspires kids to seek out other options when making decisions,” says Cathy Burgos, the MDC Department of Juvenile Services Division director of operations. “Through the program, participants are being exposed to something different and learning from productive adults who are instilling in them that they have something to lose.”

Youth begin each afternoon session practicing mindfulness through guided breathing and imagery. Park staff hired specifically for the Fit2Lead program lead the lessons and include engaging/hands-on activities and team-oriented games, using sports equipment and art supplies, to teach and reinforce the target skills for that unit. The program averages 34 youth per site with a staff-to-child ratio of 10:1 or less. This allows for an intimate, safe setting, with repeated exposure to consistent mentors, peer groups and messaging, where youth can learn and can express themselves through enrichment workshops and journaling. “If the kid is in our parks, [they’re] off the streets. Being in the program teaches them alternatives to fighting,” adds Wayne Silvestro, parks recreation leader for Fit2Lead.

Implications of Fit2Lead and Next Steps
A recent study published in the American Journal of Public Health demonstrates a strong relationship between Fit2Lead implementation among at-risk youth and changes in neighborhood youth violence statistics over two years. Findings from this study have important implications for park systems and other community-based programs aiming to reduce youth violence. This work builds on a growing body of evidence, demonstrating that park systems have immense capacity as vital health resources in our communities to promote our mental and physical health.

“At Miami-Dade Parks, with the support of the Children’s Trust, the Parks Foundation and other partners, we ensure that every child in our community is given the necessary tools to reach her or his greatest potential,” says Maria I. Nardi, director of Miami-Dade County Parks, Recreation and Open Spaces Department. “Our Fit2Lead program provides essential opportunities for teenagers from underserved communities to achieve academic excellence, develop leadership abilities, be inspired to attend college, learn a trade and pursue careers. Our goal is to continue to expand the reach of parks programs like this, to provide kids with the life skills and tools to become productive members of our community and fulfill their dreams.”

Some Key Findings from a Recent Fit2Lead Study

Key findings from recent research on the relationship between Fit2Lead implementation among at-risk youth and changes in neighborhood youth violence statistics in MDC, Florida over two years were published in the American Journal of Public Health and include:

After two years of program implementation, juvenile arrests declined significantly more in Zip Codes where the Fit2Lead program was offered compared with Zip Codes matched by baseline crime, and neighborhood socio-demographics (age, gender, race/ethnicity, single-parent households and poverty) where the program was not offered.

After two years of program implementation, there were 166 fewer arrests per 10,000 population in Zip Codes where the program was versus was not offered. Similar significant arrest declines were also found within a half-mile radius of MDPROS park sites that offered Fit2Lead compared with another youth program.

MDPROS parks that offered other youth programs but were within 0.5–1 mile of a Fit2Lead program showed decreases in youth arrest rates, in contrast to farther distances, which showed no change or even an increase in juvenile arrest rates.

References

1. David-Ferdon C, Vivole-Kantor AM, Dahlberg LL, Marshall KJ, Rainford N, Hall JE. A comprehensive technical pacakge for the prevention of youth violence and associated risk behaviors. Updated 2016. Accessed April 11, 2018.
2. Rabin C, Veiga C. Gunfire deaths take toll on teens all through Miami-Dade County. Miami Herald. December 27, 2015;Crime. Accessed April 11, 2018.
3. CDC, National Center for Injury Prevention and Control. Understanding youth violence fact sheet. Updated 2015. Accessed April 11, 2018.
4. Frazier S, Dinizulu S, Rusch D, Boustani M, Mehta T, Reitz K. Building resilience after school for early adolescents in urban poverty: Open trial of leaders @ play. Adm Policy Ment Health. 2015;42(6):723-736.
5. O'Connell ME, Boat T, Warner KE. Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, D.C.: National Academies Press; 2009.
6. Lösel F, Farrington DP. Direct protective and buffering protective factors in the development of youth violence. Am J Prev Med. 2012;43(2):S8-S23.
7. Bernat DH, Oakes JM, Pettingell SL, Resnick M. Risk and direct protective factors for youth violence: Results from the national longitudinal study of adolescent health. Am J Prev Med. 2012;43(2):S57-S66.
8. Cappella E, Frazier S, Atkins M, Schoenwald S, Glisson C. Enhancing schools’ capacity to support children in poverty: An ecological model of school- based mental health services. Adm Policy Ment Health. 2008;35(5):395-409.
9. Hammond WR, Arias I. Broadening the approach to youth violence prevention through public health. J Prev Interv Community. 2011;39(2):167-175.
10. Pardini DA, Loeber R, Farrington DP, Stouthamer–Loeber M. Identifying direct protective factors for nonviolence. Am J Prev Med. 2012;43(2):S28-S40.
11. Boustani M, Frazier S, Becker K, et al. Common elements of adolescent prevention programs: Minimizing burden while maximizing reach. Adm Policy Ment Health. 2015;42(2):209-219.
12. D’Agostino EM, Frazier SL, Hansen E, et al. Effects of a community park-based mental health promotion program on neighborhood youth violence over two-years of implementation, 2015-2017. AJPH (Invited Manuscript). 2019;February, in-press. DOI: 10.2105/AJPH.2019.305050
13. Messiah SE, D’Agostino EM, Hansen E, et al. Longitudinal impact of a park-based afterschool healthy weight program on modifiable cardiovascular disease risk factors in youth. J Community Health. 2017.
14. D’Agostino EM., Patel HH, Hansen E, Mathew MS, Nardi M, Messiah SE. Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5- year results from an afterschool fitness programme in the USA. J Epidemiol Community Health. 2017.
15. D'Agostino EM, Patel HH, Ahmed Z, et al. Impact of change in neighborhood racial/ ethnic segregation on cardiovascular health in minority youth attending a park- based afterschool program. Soc Sci Med. 2018;205:116-129.
16. Maller C, Townsend M, Pryor A, Brown P, St Leger L. Healthy nature healthy people: Contact with nature as an upstream health promotion intervention for populations. Health Promot Internation. 2006;21(1):45-54.
17. Molaodi OR, Leyland AH, Ellaway A, Kearns A, Harding S. Neighbourhood food and physical activity environments in England, UK: Does ethnic density matter?(report). Int J Behav Nutr Phys Act. 2012;9(1).
18. Pitas NAD, Barrett AG, Mowen AJ, Graefe AR, Godbey GC, Sciamanna CN. The relationship between self- rated health and use of parks and participation in recreation programs, United States, 1991 and 2015. Prev Chronic Dis. 2017;14(1).
19. Roth J, Brooks-Gunn J, Murray L, Foster W. Promoting healthy adolescents: Synthesis of youth development program evaluations. J Res Adolesc. 1998;8(4):423-459.
20. United States Census Bureau. American Community Survey (ACS). Accessed August 29, 2017.

Emily M. D’Agostino, DrPH, is Assistant Professor in the Dept. of Family Medicine and Community Health, Duke University School of Medicine. Stacy Frazier, Ph.D., is Professor in the Clinical Science Program in Child and Adolescent Psychology, Florida International University. Eric Hansen, MPA, is Chief of Recreation Programs and Services for Miami-Dade County Parks, Recreation and Open Spaces Dept. Sarah E. Messiah, Ph.D., is a Professor and Director, Center for Pediatric Population Health, University of Texas Health Sciences Center.