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Quasi-experimental designs for community-level public health violence reduction interventions: a case study in the challenges of selecting the counterfactual

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Objectives We highlight the importance of documenting the step-by-step processes used for the selection of comparison areas when evaluating a community-level intervention that targets a large-scale community. Methods We demonstrate the proposed method using a propensity score matching framework for an impact analysis of the Cure Violence Public Health Model in Philadelphia. To select comparison communities, propensity score models are run using different levels of aggregation to define the intervention site. We discuss the trade-offs made. ResultsWe find wide variation in documentation and explanation in the extant literature of the methods used to select comparison communities. The size of the unit of analysis at which a community is measured complicates the decision processes, and in turn, can affect the validity of the counterfactual. Conclusions It is important to carefully consider the unit of analysis for measurement of comparison communities. Assessing the geographic clustering of matched communities to mirror that of the treated community holds conceptual appeal and represents a strategy to consider when evaluating community-level interventions taking place at a large scale. Regardless of the final decisions made in the selection of the counterfactual, the field could benefit from more systematic diagnostic tools that document and guide the steps and decisions along the way, and ask: “could there have been another way of doing each step, and what difference would this have made?” Overall, across community-level evaluations that utilize quasi-experimental designs, documentation of the counterfactual selection process will provide a more fine-grained understanding of causal inference.
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... The evaluation of FD also included an assessment of the impact of the intervention directly on the targeted groups. Details on the designs of the evaluations can be found in Roman, Link, et al. (2019) for FD and Roman et al. (2018) for CV. With regard to the implementation of Philadelphia FD, during the evaluation period, the lead agencies held four notification meetings and 16 enforcements. ...
... The research team then re-validated the geocoding process 4 and created four dichotomous 'locational' variables: The shooting occurred (1) in the CV target area; (2) a propensity scorematched CV 'control' neighborhood; (3) the FD target area; and (4) a propensity score-matched FD 'control' area. The two sets of matched control areas were calculated for the original evaluations; details about how the counterfactuals were created can be found in Roman et al. (2018) and Roman, Link, et al. (2019). ...
... The data were derived from the 2007-2011 American Community Survey and other local data sources. More detailed information on the operationalization of these variables can be found in Roman et al. (2018). ...
... Evaluating complex interventions such as GVI inherently present methodological challenges (Brantingham et al., 2021;Corsaro, 2018). As a practical matter, GVI implementations in most cities do not involve randomly assigned treatment and control groups; therefore, randomized controlled trials are often not a feasible evaluation option (Braga et al., 2001(Braga et al., , 2018Roman et al., 2018;Saunders et al., 2015;Weiner et al., 2007). ...
... This study had several limitations. As is typical for GVI implementations, the current implementation in Philadelphia did not entail randomly assigned treatment and control groups; therefore, randomized controlled trials were not a feasible evaluation option (Braga et al., 2001(Braga et al., , 2018Roman et al., 2018;Saunders et al., 2015;Weiner et al., 2007). Instead, the effect of the GVI implementation on firearm violence was quasi-experimentally assessed through variation in treatment start times for group-units as well as for census tracts (Braga et al., 2019;Mark & Reichardt, 2009;Roman et al., 2019;Welsh & Farrington, 2001). ...
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Objectives This study assesses the effects of a Group Violence Intervention (GVI) implementation in Philadelphia on group member-involved (GMI) firearm violence. Because the implementation began in August 2020 during the COVID-19 pandemic, public health restrictions necessitated relying on individualized Mobile Call-In Team (MCIT) custom notifications, rather than large-scale call-in meetings, as the primary implementation method. Methods During the January 2020–May 2022 study period, not all at-risk group-units received GVI treatment at the same time. Likewise, not all census tracts received GVI treatment at the same time. Given this variation in treatment initiation, a quasi-experimental stepped wedge design assessed the effect of GVI treatment on GMI shootings on the dimensions of both group and place. Estimates were calculated using Poisson regression. The effects of treatment dosage were also assessed. Results A group-unit, post-treatment relative to pre-treatment, experienced, on average, a significant 38.6% reduction in shootings per week. Where a census tract received between 4 and 7 doses relative to 0 doses (pre-treatment), there was a significant 51.0% reduction in GMI shootings per week. Conclusions A GVI implementation through custom notifications appears to maintain the effectiveness of GVI. Future research should assess the role of GVI components, including both enforcement actions and social services, as mechanisms for GVI effectiveness in a custom notification-based implementation.
... The three areas selected for the CV intervention were selected because they had the highest levels of firearm violence in the 3-year period leading up to program implementation. Following prior research (Roman et al., 2017(Roman et al., , 2018, we employed an iterative process for selecting comparison sites. We focused on five selection criteria, which included size, location, levels of firearm violence, population demographics, and proximity to the CV interventions. ...
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Research Summary Firearm violence continues to be a leading cause of death in the United States. As alternatives to law enforcement intervention, community‐based violence prevention programs, such as Cure Violence, have become increasingly popular across U.S. cities. This article documents the results of a multiyear, mixed‐methods, quasi‐experimental study of the implementation and impact of Cure Violence in St. Louis, Missouri, from 2020 to 2023. We analyzed data from semistructured interviews, a two‐wave community survey, and police records of neighborhood violence, finding limited evidence of program effectiveness. Although some interview participants stated that the program had a positive impact, we observed no change in community 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 violence prevention. More work is needed to unpack the mechanisms responsible for turning program activities into measurable impacts in both the short and long term. Implications for planning and evaluating community‐based violence prevention programs are discussed.
... Contemporary evaluations of streetwork initiatives have universally measured program impact at the area level. Here, we advance streetwork program evaluation methodology by assessing the programmatic impact of SSB at the gang level; among other benefits, this approach yields direct measures of program impact closely bound to program theory and activities, while avoiding the many practical and methodological challenges involved in developing area-level counterfactuals (see Roman et al., 2018). ...
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Spurred by the success of public health violence interventions, and accelerated by policy pressure to reduce violence without exacerbating overpolicing and mass incarceration, streetwork programs—those that provide anti‐violence services by neighborhood‐based workers who perform their work beyond the walls of parochial institutions—have positioned themselves as the most important non–law‐enforcement violence prevention option available to urban policy makers. Yet despite their importance, the state of the field seems difficult to interpret for academics and practitioners alike. In this article, we make several contributions that bring forth new findings and deliver new perspectives on streetwork as a violence reduction strategy. First, we offer an extended analytic review of the streetwork evaluation literature that connects the study of contemporary public health violence interventions to a preceding tradition of criminologically inspired streetwork studies. Second, we present the results of an impact evaluation of StreetSafe Boston (SSB)—a multiyear streetwork intervention that served 20 Boston gangs. We find that the SSB intervention had no detectable effect on violence among the gangs that it served. We conclude by offering a framework for understanding a field at multiple crossroads: past and present, proclaimed successes and failures, help and harm.
... Evaluations must compare the effects of interventions with estimates of the "counterfactual," or what would have happened to key outcomes if an intervention had not been implemented (Roman, Klein and Wolff 2018). Simply measuring outcomes before and after an intervention, or what researchers call a pre-post design, is not reliable evidence. ...
Technical Report
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The crime and justice field recently started to label a wide array of violence prevention strategies as Community Violence Interventions (or CVI). Many of these strategies depend on law enforcement and social services, but the most innovative approaches are community-centered and community-sourced. They are grassroots efforts that rely on the resources of neighborhoods and residents themselves, operating separately from law enforcement and traditional human services. These strategies could be called Community Violence Interventions at the Roots (or CVI-R). The most established CVI-R programs are Cure Violence and Advance Peace. They offer highly localized and potentially cost-effective approaches to public safety, but do they work? Evaluation evidence is recent and not yet consistent, but the grassroots approach to community violence prevention is highly promising. To build sustainable CVI-R models, communities and researchers must collaborate in designing rigorous evaluations to produce reliable and actionable evidence.
... 30 However, studies of Cure Violence's impact on gun violence outcomes, while generally positive, have produced varied estimates of program effect across sites-sometimes within the same city-with some studies reporting null or negative results. 31,32,33,34 The Operation Peacemaker Fellowship in Richmond, CA, from which the Advance Peace model was created, was associated with statistically significant reductions in firearm violence, but the evaluators attributed a smaller yet nontrivial increase in non-firearm violence to the model as well. 35 An evaluation of Advance Peace in Sacramento found that the program was associated with mean gun violence incident decreases ranging from -8% to -29% in the four communities where the program was implemented, compared with an overall +9% increase in gun violence incidents in non-Advance Peace zones, but interrupted time series analyses did not find those reductions to be statistically significant. ...
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