Short‐term evaluation of Cure Violence St. Louis: Challenges, triumphs, and lessons learned

• Published date: 01 November 2024
• Author: Theodore S. Lentz,Matt Vogel,Brenda Mathias,Alessandra Early,Kimberly Rey,Tobeya Ibitayo,Matifadza Hlatshwayo Davis
• Date: 01 November 2024
• DOI: http://doi.org/10.1111/1745-9133.12687

DOI: ./- .

SPECIAL ISSUE ARTICLE

GUN VIOLENCE

Short-term evaluation of Cure Violence St.

Louis: Challenges, triumphs, and lessons

learned

Theodore S. Lentz1Matt Vogel2Brenda Mathias3

Alessandra Early4Kimberly Rey5Tobeya Ibitayo5

Matifadza Hlatshwayo Davis6

Department of Criminal Justice and

Criminology, University of

Wisconsin–Milwaukee, Milwaukee,

Wisconsin, USA

School of Criminal Justice, University at

Albany,SUNY, Albany, New York, USA

School of Social Welfare, University of

California, Berkeley, Berkeley, California,

USA

Department of Criminal Justice, John

JayCollege,NewYork,NewYork,USA

Institute for Public Health, Washington

University in St. Louis, St. Louis,

Missouri, USA

Department of Health, City of St. Louis,

St. Louis, Missouri, USA

Correspondence

Theodore S. Lentz, Department of

Criminal Justice and Criminology,

University of Wisconsin–Milwaukee, 

Enderis Hall, PO Box , Milwaukee, WI

, USA.

Email: lentzt@uwm.edu

Funding information

City of St. Louis, Department of Health,

Grant/AwardNumber: -;

Institute for Public Health at Washington

University in St. Louis

Abstract

Research Summary: Firearm violence continues to be

a leading cause of death in the United States. As alter-

natives to law enforcement intervention, community-

based violence prevention programs, such as Cure Vio-

lence, have become increasingly popular across U.S.

cities. This article documents the results of a multiyear,

mixed-methods, quasi-experimental study of the imple-

mentation and impact of Cure Violence in St. Louis,

Missouri, from  to . We analyzed data from

semistructured interviews, a two-wave community sur-

vey, and police records of neighborhood violence, find-

ing limited evidence of program effectiveness. Although

some interview participants stated that the program had

a positive impact, we observed no change in commu-

nity norms/perceptions of violence, and our analysis of

police data suggests that program implementation was

associated with declining violence in only one of the

three intervention sites.

Policy Implications: This article highlights challenges

of implementing and evaluating community-based vio-

lence prevention. More work is needed to unpack the

mechanisms responsible for turning program activities

into measurable impacts in both the short and long term.

Criminology & Public Policy. ;:–. ©  American Society of Criminology. 981wileyonlinelibrary.com/journal/capp

982 LENTZ  .

Implications for planning and evaluating community-

based violence prevention programs are discussed.

KEYWORDS

community-based prevention, program evaluation, violence inter-

ruption, violence prevention

Firearm violence is a public health crisis in the United States. It is the leading cause of death

among U.S. citizens aged – (Lee et al., ). As a consequence of racism and structural vio-

lence (Alexander,; Anderson, ), the risk of firearm victimization is distributed unequally

across communities, disproportionately impacting groups that have been marginalized. The con-

sequences of firearm violence are profound, as exposure to violence, for example, is associated

with elevated levels of posttraumaticstress disorder, disrupted sleep, increased anxiety,and dimin-

ished cognitive performance among children and adolescents (Gard et al., ; Sharkey, ).

Violence reverberates within communities, leaving an enduring mark on not only the survivors of

violent crime but their families, friends, and neighbors. Reducing firearm violence is paramount

for the health and well-being of all community members.

St. Louis, Missouri, is at the forefront of the nation’s firearm violence epidemic. Between 

and , the city’s average rateof firearm-related assaults was . per ,. There were 

homicides during this time, translating to an average annual per capita rate of . per ,.

With such a high rate of violence, St. Louis has grappled to find ways to meaningfully reduce

violent crime. In the fall of , the St. Louis Board of Alderman earmarked nearly $ million

to invest in Cure Violence (CV), a prevention program that relies on community outreach and

credible messengers to interrupt neighborhood conflicts before they escalate tothe point of serious

injury or death. The program was implemented in three of the highest crime areas in the city,

beginning in the summer of  and running through June of .

We document here the results of a multiyear, mixed-methods study of the implementation and

impact of CV in St. Louis. Our evaluation was designed toassess whether the CV program is associ-

ated with notable shifts in attitudes and experiences with violence in the intervention areas, and

whether there is evidence of decreasing firearm violence. We weave together findings from ()

semistructured interviews with CV staff and community members, () a two-wave survey fielded

to a stratified random sample of community residents, and () interrupted time-series analyses

of neighborhood violence to assess program impact. In doing so, we highlight the challenges

of evaluating program effectiveness in the short term. St. Louis shares common features with

many urban municipalities across the country—limited resources, competing priorities, shifting

political landscapes, and varying degrees of public support for violence prevention initiatives. As

such, we are optimistic that the lessons shared here will prove useful for communities looking to

implement similar community-based prevention activities.

1BACKGROUND

Community-based violence prevention programs have become increasingly popular since the

establishment of CV and the Boston -point plan in the s (Buggs, ; Slutkin et al., ).

LENTZ  . 983

Following public health models, community-based violence prevention takes a holistic approach

to preventing violence-related injury and death that includes collaboration among community

organizations, public health agencies, social workers and service providers, emergency medicine,

law enforcement, and local governance (Butts et al., ). The conceptual foundation aligns well

with key themes surrounding the etiology of violence. First, structural factors such as socioeco-

nomic disadvantage, segregation, and marginalization are associated with patterns of violence

across place (Peterson & Krivo, ; Sampson, ). The incidence of gun violence tends to

concentrate in relatively small areas within communities (Braga et al., ), whereas the risk

for violent injury and death spreads within social networks of high-risk individuals (Papachristos

et al., ) through cycles of retaliation and normalized violence (Anderson, ). These empir-

ical regularities have pushed prevention efforts towardmultifaceted strategies that leverage acute

intervention models to “treat” high-risk individuals and disrupt ongoing cycles of violence, as

well as broader initiatives to build community capacity,increase equitable access to services (e.g.,

education, housing, mental health), and address community norms around violence and conflict

resolution. Indeed, the Biden administration has recently made evidence-based community vio-

lence prevention efforts a cornerstone of their firearm violence prevention efforts.The CV model

is one example of this multipronged approach.

1.1 The CV model

CV approaches violence as a public health problem and attempts to disrupt its transmission

through methods of disease control and behavioral change. The program operates on three

key pillars: identifying and interrupting potentially violent conflicts, treating high-risk people,

and changing community norms around violence. CV employs credible messengers—referred

to as violence interrupters—to help prevent violence through de-escalation and mediation

services (Wical et al., ). Interrupters work with their communities to help identify ongoing

interpersonal conflicts that could potentially result in serious violence. Working with all parties

involved to prevent escalation (sometimes for months), interrupters consult with victims of

shootings, and their families, to help cool emotions and prevent retaliation. Regarding the

second pillar, treating high-risk people, CV case managers connect with community members

that are identified as having the highest risk of perpetrating violence. Once enrolled in the

program, participants are offered case management services and provided links to community

resources, including employment services, mental health care, and job training. CV staff counsel

participants to embrace nonviolent alternatives to conflict resolution. Finally, CV staff engage

the entire community,including residents, local business leaders, faith leaders, service providers,

and other stakeholders, to shift community norms toward antiviolence. This is accomplished

through community education and events.

If operating as intended, CV should lead to several short-term and long-term outcomes (Butts

et al., ). At the individual level, participants enrolled in CV services should develop pro-social

conflict resolution skills, break contact with violent peer groups, and adopt norms and attitudes

that discourage violence. Ultimately, individuals enrolled in the program should display long-

term, sustained reductions in violent conduct. At the community level, the CV program should

dismantle norms and attitudes conducive to violent conduct. As community norms shift toward

nonviolence, aggregate rates of crime and violence should begin to decline.

CV Global is a (c) that provides guidance and technical support to partner organizations

looking to implement the program in their city.Partners are responsible for securing funding and