Service and healthcare providers are an integral part of educating each other about the prevalence of youth violence and their important role in recognizing the signs of risk and preventing the spread of violent behaviors. Choose Peace/Stop Violence has developed a presentation for professionals to share with other interested service and healthcare providers. Connecting the Dots is an AMA-approved PowerPoint presentation and guide designed to educate professionals who have contact with youth and their parents.

1. Connecting the Dots to Prevent Youth Violence
A training and outreach guide for physicians and other
health professionals.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

2. Name
Date
Institution
Health Professional Training
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

3. The Problem
The United States has the
highest youth homicide and
suicide rate among the
wealthiest developed
nations (Task Force on
Violence, 1999).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

4. Impact of violence on health
 Homicide is second leading cause of death for
youth ages 15-19 ( Cohen And Potter, 1999).
 Medical costs just for firearm injuries are estimated
to be $2.3 Billion a year (Cook et al, 1999).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

5. Impact on health
The bright regions in these scans (at left, a top-down view of the brain; at right, a view of the brain from the
back of the head) indicate greater hippocampus activity in healthy children during memory recall than in
children with PTSD symptoms. (Credit: Copyright 2009: Journal of Pediatric Psychology)
Recent research shows changes to the brain
structure and chemistry following exposure to
extreme violence (Niehoff, 1999).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating safe,
healthy and thriving environments for our children and families.

6. The public health approach
 Like polio and other public health threats, violence can
be prevented.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

7. The causes of youth violence
 Risk Factors are personal characteristics or environmental conditions
scientifically established to increase the likelihood of problem behavior.
 Protective Factors are characteristics or conditions that interact with risk
factors to reduce their influence on violent behavior and may or may not have a
direct effect on violence. Protective factors may exert positive effects in direct
opposition to the negative effects of risk factors or by buffering individuals
against the negative effects of risk factors.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

8. Violence is learned by being victimized
Approximately 772,000 children were victims of
maltreatment in 2008 (US DHHS).
Experiencing child abuse and neglect increases the
likelihood of arrest as a juvenile by 53% and of committing
violent crimes by 38% (Widom, 1992).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

9. Violence is Learned
The 3.3 million children who witness domestic
abuse each year are 15 times more likely to
become victims or perpetrators of violence
(Carlson, 1994; Horn, 2000).
They are also more likely to be victimized in
intimate relationships as well as to become a
perpetrator or victim of violence on the streets
(Widom, 1992).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

10. Violence is learned by exposure
to violent media
By the age 18, a child has seen 200,000
acts of violence on TV and other
media.
Studies suggest that children confronted
incessantly by violent images may become
immune to the horror of violence and may come
to accept violence as a way to solve problems.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

11. Alcohol and drugs are risk factors
50% of youth homicide victims have
elevated blood alcohol levels.
(Mann, et al, 1998; Adams et al, 1992; Prothrow-Stith, 1992).
50% of youth who commit homicide
have elevated blood alcohol levels.
(Mann, et al, 1998; Adams et al, 1992; Prothrow-Stith, 1992).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

12. Firearms
Teenage boys are more likely to die from gunshot
wounds than from all natural causes combined.
Family and friends are the primary source of guns for
young people.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

13. A combination of factors
 Violence is not the result of a single factor.
 Violence is the result of the interaction of multiple
individual, situational, contextual and society influences
(National Youth Violence Prevention Resource Center, 2001).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

14. What health care professionals
can do:
• Educate youth about ways to reduce risk and increase
protection.
• Screen youth for risk and exposure.
• Refer them to comprehensive support programs.
• (Brandt, 1997; Sege et al, 2001; Cohn, 2001)
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

15. Three Phases of the Haddon Matrix
Pre- Injury  Prenatal care
 Routine preventive care
 Acute care unrelated to injury from violence.
Injury
Post-Injury  Acute
 Urgent
 Emergency care related to injury
from violence.
(National Committee for Injury Prevention and Control, 1989)
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

16. Post-Injury: Educate
Educate parents on methods to help child avoid
re-injury, and to cope with emotional trauma.
Educate young people on the same topics.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

17. Post-Injury: Assess
 Document injuries and surrounding events.
 Seek further psychiatric evaluation.
 Risk factors for re-injury:
 Is conflict settled?
 Does person feel safe leaving health setting?
 Is He/she thinking about revenge?
 Is there a safe place to go while things cool off?
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

18. Post-Injury: Refer
•Refer young people and families to mental health and
crisis services.
•Refer to long-term comprehensive services.
•Notify authorities in case of abuse/ neglect or when
plans for revenge warrant.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating safe,
healthy and thriving environments for our children and families.

19. “Invisible victims” of violence
 Child witnesses to domestic violence are victims -
we often forget them.
 In a “cycle of violence,” many young perpetrators have
also been witness to and victims of violence.
(Widom, 1992).
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

20. Post-Injury: “invisible injuries”
 Educate caregivers on emotional impact of witnessing
violence and methods to help child cope.
 Screen young people for exposure.
 Refer to comprehensive programs with mental health
services.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

21. Three Phases of the Haddon Matrix
Pre- Injury  Prenatal care
 Routine preventive care
 Acute care unrelated to injury from violence.
Injury
Post-Injury  Acute
 Urgent
 Emergency care related to injury
from violence.
(National Committee for Injury Prevention and Control, 1989)
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

22. Pre-Injury: Educate
 Educate parents on strategies to build protective
socio-emotional competencies.
 Educate on the effects of media violence and ways
to reduce exposure.
 Educate on firearms and ways to reduce risk such
as safe storage procedures.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

23. Pre-Injury: Screen
 Age-appropriate screening for risk factors throughout
child’s development.
 Examples of tools for use with adolescents - FISTS:
 Fighting
 Injuries
 Sex
 Threats
 Self Defense
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

24. Pre-Injury: Refer
 Connect young people who show risk and their families to
comprehensive and effective prevention programs.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

25. Effective Programs
 Early Start
 Long Term
 Intense
 Strong Connection with Supportive Adult
 Involves Many Sectors:
 HEALTH CARE
 SCHOOLS
 POLICE
 COMMUNITY
 BUSINESS
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

26. GALVESTON TEXAS-
ISLAND YOUTH PROGRAMS
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

27. Beyond the clinic
 Work with schools
 Work with the community coalitions.
 Advocate for effective policy.
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.

28. Discussion and Closing
Some years ago, a wise person wrote, “In violence we forget
who we are.”
The tragedy of youth violence is that so many young
people, who either caused violence or were themselves the
victims, lost the chance to find out who they really were.
Thank you!
Choose Peace/Stop Violence is a community movement of concerned
Broward County residents and agencies dedicated to creating
safe, healthy and thriving environments for our children and families.