NIH State-of-the-Science Conference Statement on preventing violence and related health-risking social behaviors in adolescents.

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of currently available data on preventing violence and related health-risking social behaviors in adolescents. PARTICIPANTS: A non-DHHS, non-advocate 13-member panel representing the fields of community and family medicine, pediatrics, nursing, psychiatry, behavioral health, economics, juvenile justice, outcomes research, and a public representative. In addition, 21 experts in fields pertaining to the conference topic presented data to the panel and to the conference audience. EVIDENCE: Presentations by experts and a systematic review of the scientific literature related to youth violence prevention provided by the Southern California Evidence-Based Practice Center, through the Agency for Healthcare Research and Quality's Evidence-based Practice Centers Program. Scientific evidence was given precedence over clinical anecdotal experience. CONFERENCE PROCESS: Answering pre-determined questions, the panel drafted its statement based on scientific evidence presented in open forum and on the published scientific literature. The draft statement was read in its entirety on the final day of the conference and circulated to the audience for comment. The panel then met in executive session to consider the comments received, and released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government. A final copy of this statement is available, along with other recent conference statements, at the same web address of http://consensus.nih.gov.
CONCLUSIONS: The panel highlights the following findings and recommendations: (1) Violence affects all of us at some level and represents an issue of vital national and international importance; (2) Some interventions have been shown by rigorous research to reduce violence precursors, violence, and arrest. However, many interventions aimed at reducing violence have not been sufficiently evaluated or proven effective, and a few widely implemented programs have been shown to be ineffective and perhaps harmful; (3) Programs that seek to prevent violence through fear and tough treatment appear ineffective. Intensive programs that aim at developing skills and competencies can work; (4) Interventions to reduce violence may be context dependent. Research must proceed in varying contexts and take account of local culture; (5) Attention to diversity among investigators involved in violence prevention research is important. Universities and funding agencies should make improving the situation a priority; (6) We encourage funding sufficient to promote the dissemination of violence prevention programs that have been shown to be effective through rigorous RCT research. Funding must include support for research, and monitoring must continue as these programs are more widely implemented.