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SHIFTING THE FOCUS: AN INTERDISCIPLINARY FRAMEWORK FOR ADVANCING VIOLENCE PREVENTION Written by Larry Cohen, Rachel Davis, Stephanie Franchak, Deborah Prothrow-Stith, Sher Quaday, Susan Swift and Naomi Uchishiba Shifting the Focus is funded in part by a grant from The California Wellness Foundation (TCWF). Created in 1992 as a private and independent foundation, TCWF's mission is to improve the health of the people of California through proactive support of health promotion and disease prevention programs. Additional funding came from Sierra Health Foundation, a private, nonprofit, independent foundation that awards grants in support of health and health-related activities in 26 northern California counties, and the Max Factor Family Foundation in Los Angeles. Our government has the responsibility to work effectively. Often this means that different governmental agencies must work together. Government institutions, however, operate with significant institutional barriers that inhibit collaborative work. The field of violence prevention is one such example. Different government agencies address violence prevention through their own mandates and perspectives, but they face the challenge of effectively communicating and coordinating with each other. It is critical to break through barriers in order to maximize services, especially in addressing a problem as complex and pervasive as violence. Shifting the Focus demonstrates the ability of governmental agencies to move beyond institutional barriers and conceptual differences to work together to more effectively prevent violence. The framework that emerged from this working group can serve as a model from the local to national level for cross-disciplinary collaboration. A framework that provides concrete methods for different sectors of government to work together is a valuable tool in our prevention work. Though the recommendations were developed to advance violence prevention, they are also useful to other health and human service issues. We hope that this will serve as a useful document to begin the process of cross-disciplinary collaborative work. Deborah Prothrow-Stith, M.D. Associate Dean for Faculty Development Director and Professor Division of Public Health Practice Harvard School Of Public Health Larry Cohen Executive Director Prevention Institute

Preface In March 1997, a two-day forum entitled Shifting the Focus: An Interdisciplinary Violence Prevention Approach for California was held in St. Helena, California. It was so named because communities are often asked to collaborate and the government agencies represented here recognized that such collaborative endeavors are important for them as well. The meeting was designed as a springboard for collaboration between the disciplines of education, criminal justice and health, including women's health, mental health and alcohol and drug abuse. Since collaborative efforts are vital to a comprehensive approach to preventing violence, Shifting the Focus aimed to clarify how governmental agencies and organizations with different mandates and perspectives can work together more effectively. Cooperative work can be difficult to accomplish, yet the results of such efforts promise benefits to agencies and organizations involved and, more importantly, the communities and clients they serve. The goal of Shifting the Focus was to develop a shared framework for governmental organizations from which effective, interdisciplinary collaborations could be generated. The catalyst for this forum was a training series conducted by representatives of Harvard School of Public Health and Education Development Center, Inc., "The Advanced Training for Violence Prevention Practitioners." For representatives of justice, health, and education, this training reaffirmed the value of an interdisciplinary framework and an integrated learning environment. Shifting the Focus brought together 24 of California's leading violence prevention practitioners including 10 representatives from state governmental departments and offices and 14 community-based practitioners.1 The meeting was facilitated by nationally-recognized violence prevention practitioners: Dr. Deborah Prothrow-Stith and Sher Quaday from the Harvard School of Public Health and Larry Cohen, Executive Director of Prevention Institute (formerly from EDC). Shifting the Focus built upon the work of several other efforts in the state to address the complex issue of violence within California communities: the Attorney General's Violence Prevention Policy Council, The California Wellness Foundation's Violence Prevention Initiative, and other existing efforts such as the School/Law Enforcement Partnership between the departments of Justice and Education, and the California Department of Health Services' EPIC (Epidemiology and Prevention for Injury Control) projects for prevention of violent injury. The purpose of this paper is to highlight the issues raised and recommendations made at Shifting the Focus. Participants identified barriers to collaboration and formulated recommendations to overcome them in order to significantly advance violence prevention efforts through collaborative strategies across disciplines. Participants agreed that there is value in bringing together practitioners from multiple disciplines to collaborate in violence prevention strategies and recommended that such forums continue to take place. In this way, Shifting the Focus can serve as both a model and a springboard upon which to build. This paper concludes with suggestions for next steps in advancing multidisciplinary violence prevention work. Introduction Because violence is a complex issue, a prevention strategy needs to be multifaceted and comprehensive to be effective. Such an approach integrates efforts across disciplines, employs a spectrum of prevention strategies, and includes action at the local, state, and national levels. At this forum, California governmental agencies reaffirmed the objective of strengthening collaborative efforts across disciplines. The purpose of Shifting the Focus was to maximize this opportunity by jointly defining violence, clarifying barriers to collaboration, and delineating key actions to foster a multidisciplinary, collaborative approach to violence prevention. Violence is an issue that affects the health, social welfare, and safety of all Americans. Since 1980, when only a handful of community agencies and forward-thinking governmental departments were involved in violence prevention, there has been rapid growth of interest in this issue. In California, for example, where communities began grappling with "violence as a public health issue" in the early 1980s, conflict resolution is now commonly taught in public schools, and community policing has received widespread support. The California Department of Health Services began supporting local violence prevention initiatives in 1989. In 1993, the California Wellness Foundation made an unprecedented and generous five year investment in violence prevention, catapulting the state's developing expertise to the forefront, particularly in the areas of community action, policy development, and academic research. Shortly thereafter, the state Attorney General's Office convened the Attorney General's Policy Council on Violence Prevention, a team of experts representing various disciplines and offices. They conducted hearings to examine the underlying causes of violence, and in their final report, recommended ten initiatives for reducing violence. As a result, many new programs were launched and coalitions were born. Some of these initiatives involved partnerships between communities and a governmental sponsor, or invited collaboration among nonprofit organizations. Both locally and at a state level, however, organizations and departments did not find it easy to collaborate across the lines of major disciplines such as education, law enforcement, and health, including alcohol and drugs and mental health departments. The problem was not a lack of individual commitment but rather the absence of tools and knowledge necessary for working across boundaries. At Shifting the Focus, there were two major domains within which gaps in collaboration became clear: inter-sectoral and interdisciplinary. The absence of collaboration between governmental offices is an inter-sectoral gap. The lack of collaboration between fields such as health, education, and law enforcement is an interdisciplinary gap. These divergent "interest groups" have traditionally been divided by philosophy, political perspectives, and resources, and historically worked in isolation from each other. But, violence prevention is not effective when it is handled by just one group or discipline. Violence crosses disciplines and prevention requires coordinated and committed collaboration between agencies, organizations and departments that have different mandates and approaches. A paradigm shift may be necessary for these entities to become part of an integrated approach, rather than remaining territorial competitors. The underdevelopment of inter-sectoral and interdisciplinary collaborations represents enormous potential for study and improvement that can significantly advance the cause of violence prevention in California and throughout the United States. The overarching principle shared by participants from all disciplines at the beginning of the forum was the premise that violence is preventable. Despite the fact that they each had their own set of organizational directives and procedures, participants also shared the premise that a better understanding of collaborative opportunities would result from clarifying their various operating definitions of violence and by recognizing existing and perceived barriers to such collaboration. Through discussions, participants identified several areas for potential collaboration and made specific recommendations regarding interdisciplinary, inter-sectoral work. The following represents the results of these discussions to further collaborative violence prevention efforts. Defining a Common Language When various disciplines begin working together, the need emerges to define terms. Participants often need to learn each other's language, or forge new definitions that accurately reflect commonly shared ideas. The definition of violence is critical because it clarifies what it is that different disciplines are trying to prevent and thus the activities they undertake in the name of prevention. Criminal justice is concerned with public safety and public standards as set forth in our Constitution and laws. Its approach is geared to rights and responsibilities of individuals and punishment of those who transgress societal laws; it utilizes a terminology of "victim, location and perpetrator." Alternatively, the public health approach is derived primarily from the medical disease or epidemic model and seeks to serve the general public through violence prevention efforts. Here there is a similar triad of "host, environment and agent." Finally, education is concerned with the physical and emotional well-being of students so that they will be able to learn and develop into productive citizens. From these different disciplines, then, come different definitions of and approaches to preventing violence. Varying definitions lead to an interest in different data. Public health looks at risk factors, morbidity and mortality rates, criminal justice examines rates of arrest for violent offenses, and education is concerned with harm done by and to children, school suspension rates, and test scores. While each of these approaches provides a part of the picture, looking at each independently does not foster the development of a comprehensive approach. Dialogue among disciplines is crucial for understanding each others' perspective and for developing an integrated approach to prevention which can address the complex nature of violence. At Shifting the Focus one of the first tasks was for representatives of various disciplines to reach consensus on a definition of "violence." While participants saw the limitations in any single definition and no definition was perfect, there was agreement to proceed with the following definitions from The National Committee for Injury Prevention and Control:2 Violence is .. "the use of force with the intent to inflict injury or death upon oneself or another individual or group(s) and includes the threat of force to control another individual or group." "aggressive human behavior involving the use of physical, psychological or emotional force with the intent to cause harm to oneself or others." With this common groundwork laid, participants began to delineate barriers to collaborative work between Clarifying Barriers to Collaboration Shifting the Focus was an opportunity for individuals across disciplines to grapple with barriers to collaboration and to move toward forging a common vision for violence prevention efforts. Participants recognized that effective violence prevention is not an overnight process but requires time to build partnerships and initiatives. It takes even more time to achieve significant results as these efforts need time to develop and make an impact. In addition to the inherently time-intensive nature of successful prevention work, there are barriers which impede its progress. Participants clarified eight barriers to collaborative violence prevention work. Funding: Participants noted that inadequate funding, the fragmentation of state and federal funding sources, and narrow and prescriptive funding streams impede progress in violence prevention efforts. The most commonly cited barrier to collaborative efforts, however, was a lack of sustainable funding. The unreliable nature of violence prevention funding and the competition it engenders discourage many groups from venturing into collaboratives outside their immediate area of concentration. The impact of short term, constantly shifting funds is disruptive to violence prevention efforts that need to extend over time to have an effect. As funding is shifted from one priority to another, so must the priorities of organizations. If violence prevention programs cannot shift their priorities quickly enough, they risk losing their funding, preventing any group from developing the expertise and effective programming necessary for significant change. Furthermore, grants are structured in a way that promotes fragmentation of services rather than promoting effective, stable collaborations at the community level which take time to develop and maintain. Competition: Both at the local level and at the state level, collaboration is often precluded by competitiveness. Competition between and within disciplines is not restricted to funding, but includes issues about who will define the problem and set the programmatic or policy agenda. Concerns regarding who gets attention from the media as well as from colleagues and funders fosters a competitive environment. Competition is also exacerbated by legislative and political battles, which may be borne of differences in viewpoint, but often result from the politician's need to be viewed as the "winner" on a given issue or piece of legislation. Another result of this winner mentality is that when some politicians or funders will not be recognized as leaders on a particular issue, they are unwilling to play a back-up or supporting role. Timeframes: There is a tension between the inherently slow governmental process and the urgency of communities' day-to-day struggles. Also, government tends to be reactive and each government agency tends to be reacting to different issues, resulting in different agendas. Another problem is that while prevention requires a sustained effort over time, politicians' attention focuses on re-election every two to four years. Since effective collaborative work takes times to develop, these election cycles are in conflict with the ongoing, long-term nature of effective, collaborative violence prevention work. The advent of term limits has exacerbated this problem. Data and Technology:The lack of comprehensive data, long term in scope, is a significant barrier to more effective work. Data may be interpreted or manipulated differently by those with different purposes or agendas. Incompatible hardware and software, as well as inconsistent types of data collection make sharing and comparing data difficult. There is an assumption that computer technology is present in all areas when, in fact, standard equipment, including e-mail capability, is lacking in many places. This gap in technology makes it difficult to follow through on ideas such as putting the Vision of Hope document onto CD-ROM, or communicating on short notice between state level agencies and community organizations. New technology has also exacerbated information overload and, at times, increases the day to day pressures of work. Knowledge: Individuals and agencies from different disciplines may lack the vocabulary to effectively communicate or may not understand the perspective or goals of the other. A lack of knowledge of other disciplines adds to divisions and biases that inhibit the development of partnerships and collaborations. Confidentiality: Some potential collaborations may be impeded by internal or legal restrictions regarding confidentiality. Confidentiality problems arise frequently when data are sought to document a problem. Organizations may be concerned about client confidentiality, police departments may be reluctant to make local crime data available, and juveniles have special legal protections that must be observed when they are participants in interviews or studies, or when they appear in the media. Commitment: Because cooperative efforts are extremely time intensive, require many resources, and can take time to develop, it is a challenge to maintain ongoing support. An unwillingness or inability to cooperate can exist within disciplines whenever a group refuses to depart from its own set of historical strategies, regardless of whether or not each of these strategies have proven to be effective. Collaborative prevention work is most effective when there is ongoing support by all participants to a given partnership. Vision: There are movements and individuals that have deemed violence prevention unworthy of concern or funding. Short-sightedness is detectable in the view that somehow violence prevention is not an integral part of health, education or criminal justice. This perspective assumes that violence affects only a certain segment of the population, that it can be solved with one single approach, such as a criminal justice response, or that it simply cannot be prevented at all. These beliefs undermine support for multidisciplinary collaboration as part of a comprehensive violence prevention movement. Also, many practitioners define their work narrowly (e.g. client specific) so that broad, community-based prevention activities may not seem achievable or relevant. They may feel disrespected by those espousing a broader view who do not recognize the contribution to violence prevention of a focus on individual behavior change. The barriers cited above impede important collaborative work in the area of violence prevention. Having achieved a common ground through identification of these barriers as well as acknowledgment of the value of multidisciplinary collaboration, participants at Shifting the Focus moved on to highlight specific steps that could be taken to advance collaborative violence prevention efforts. Moving Beyond Barriers: The Spectrum Of Prevention Because the root causes and expressions of violence are complex and interrelated, prevention initiatives must be multifaceted. An effective strategy involves a range of organizations and agencies and works on multiple levels. One of the tools that is used to assist collaborating agencies develop a comprehensive strategy is called the Spectrum of Prevention. The Spectrum was used throughout Shifting the Focus to help structure discussion and to analyze aspects of collaboration. Using the Spectrum of Prevention enables practitioners, providers, and policy leaders to move beyond an educational approach to achieve broad prevention goals. The Spectrum identifies six levels for promoting prevention which are detailed in the following table. These levels are complementary and when used together produce a "synergistic" effect, resulting in greater effectiveness than what is possible using a single level in isolation. Ongoing data collection and evaluation should be built into the model at each level. Spectrum of Prevention 1. Strengthening Individual Knowledge and Skills: Enhancing an individual's capability of preventing injury or crime. 2. Promoting Community Education: Reaching groups of people with information and resources to promote health and safety. 3. Educating Providers: Informing providers who will transmit skills and knowledge to others. 4. Fostering Coalitions and Networks: Bringing together groups and individuals for broader goals and greater impact. 5. Changing Organizational Practices: Adopting regulations and norms to improve health and safety and creating new models. 6. Influencing Policy and Legislation: Developing strategies to change laws and policies to influence outcomes in health, education and justice. Participants made eleven major recommendations which are detailed below and organized by levels of the Spectrum. Many prevention programs address individuals in an effort to change behavior or reach out to entire communities in order to build a critical mass of people who will support a particular message. These actions, strengthening individual knowledge and skills and promoting community education, take place within the first two levels of the Spectrum. Appendix 3 reports the results of a pre-forum survey delineating the kinds of programs governmental sectors most actively promoted and funded. Because Shifting the Focus was designed for providers and organizations seeking to improve their effectiveness in working collaboratively, the discussions focused on the other four levels. Participants at the forum, however, did agree on the importance of encouraging and supporting individual skill building and public education campaigns. Educate Providers 1. Enhance comprehensive, multidisciplinary violence prevention training. Training providers is a critical component of a comprehensive violence prevention strategy. As providers from different disciplines and sectors are brought together for violence prevention training, they will collectively better their skills and the usefulness of a comprehensive, collaborative approach will be reinforced by trainers. The Harvard/EDC Advanced Training in Violence Prevention is a model which focuses on the diversity of skills needed in a comprehensive approach to violence prevention and the importance of interdisciplinary efforts. Training participants have the opportunity to work together, share ideas, network, and develop and use a common language and violence prevention strategy. Trainings should include a multidisciplinary perspective with input from health, justice, mental health, education, alcohol and drug programs, and employment development in order to promote an interdisciplinary approach to violence prevention. Participants recommended that a survey be administered to local communities to assess technical assistance and curricula needs and the results used to develop or support existing violence prevention training initiatives. 2. Collaborate with colleges and universities to provide multidisciplinary trainings. Since multidisciplinary training is critical to effective, collaborative violence prevention strategies, efforts must be made to train as many people as possible. Institutes of higher education including the University of California, California State Universities, and the numerous community college districts have an important role to play in convening these large numbers of practitioners and future practitioners for training purposes. California schools should be full partners in promulgating training. For example, U.C. Berkeley and Harvard faculty teamed to offer the national violence prevention "training of trainers" and their curricula were integrated as the base for a national model. Additionally, faculty from these universities co-facilitated Shifting the Focus. College and university partnerships will also advance knowledge and skills by generating additional research, internships, publications, and the education of future violence prevention practitioners. Foster Coalitions and Networks 3. Build upon and strengthen efforts to bring together multiple disciplines and sectors. Beyond comprehensive, multidisciplinary trainings, there is significant value in continued meetings between practitioners from justice, health, and education. While each discipline has emphasized community-government partnerships within its field, there has been far less attention paid to the fruitfulness of interdisciplinary collaboration. Additional forums will facilitate the understanding of research, practice issues, and standards and stimulate the growth of violence prevention activities. Therefore, the Shifting the Focus initiative should be continued. The effort will be enhanced and strengthened by expanding the range of participants to include the Department of Mental Health, the California Youth Authority, the Employment Development Department, California Department of Corrections, city planners, social services, and community representatives. At another level, local decision makers should be included in partnerships entered into by state agencies. Participants agreed that the broader the representation, the greater the likelihood that a collaboration will be effective. 4. Encourage opportunities for local interdisciplinary collaboration. While it is important to continue and to expand the dialog among those named above, it is equally critical to encourage collaborative opportunities at a local level and to remove barriers which impede these efforts. Because local coalitions play a significant role in violence prevention, it was recommended that existing departmental rule making authority be used to encourage local interdisciplinary coalitions in future RFPs. One example of a successful local coalition is in El Dorado County where members have been seeking common ground in prevention efforts. This collaboration is being nurtured through a joint needs assessment and strong technical assistance. As a multidisciplinary grants management collaborative, El Dorado County reports having received six or seven grants that they would not have otherwise received, demonstrating the value of multiple disciplines in advancing violence prevention work as partners. In a larger county, the Violence Prevention Coalition of Greater Los Angeles is comprised of over 500 agencies representing all the disciplines as well as the public and private sectors, while the philanthropic community is forming partnerships with local and state governments and actively supporting community collaboratives. 5. Capitalize on existing networks such as the Monthly School's Roundtable. Though new and increasingly interdisciplinary coalitions should be encouraged, there are existing networks and coalitions which can serve to advance violence prevention strategies. For example, the Superintendent of Public Instruction meets monthly with the president of the U.C. System. These meetings are an opportunity to enhance a violence prevention agenda such as facilitating the realization of recommendation #2, that is, partnering with institutes of higher learning to provide multidisciplinary training. Change Organizational Practices 6. Ensure long-term, collaborative funding. Participants agreed on the importance of developing collaborative funding initiatives with foundations and their community-based initiatives. Project funding should be secured for a minimum of four to five years in order to ensure longevity and to establish long-term outcomes. Additionally, a value of collaboration can be utilized through the interdepartmental advocacy for the preservation and enhancement of current violence prevention funds. 7. Integrate the programs of multiple departments to provide comprehensive services. Programs of agencies such as social services, health, education, and justice should be envisioned as components of a comprehensive approach. They will be more effective and efficient by addressing client and community needs without a duplication of effort. For example, programs that unite health, social services, and education programs through home visits and personal case management to high risk families have been found to be an extremely effective form of intervention. Participants recommended a review of requirements to formalize and ensure an integrated, client-centered delivery of services. In addition to this collaborative focus on addressing client problems and need for services, a need for interdisciplinary, asset-based discussions which focus on prevention and proactive strategies while building on community strengths should be encouraged by state partners. 8. Standardize and share interdisciplinary and inter-sectoral data. Data collection is critical both for program development and in the evaluation of prevention strategies. Due to obstacles to data sharing, participants recommended the formation of an interagency working group to reduce and circumvent such barriers. Such a group should focus on the development of state interagency plans to encourage and fund comprehensive long-term data collection mechanisms and the coordination and standardization of data requirements and collection. In addition to a working group, it is important that localities be encouraged to use data from various agencies in order to complement each other. When giving directives, state agencies can facilitate data sharing by expanding their definitions of acceptable data to include one another's. One opportunity for data exchange comes from the Department of Education which has begun tracking school safety and violence prevention data through a new system. This data can be shared with other disciplines to gauge trends and changes in the school setting, including alcohol and drug offenses, vandalism, battery, assault with a deadly weapon, sex offenses, homicide and robbery. Finally, participants recommended that a uniform statewide death and violent injury surveillance system with methods, conditions, victim and perpetrator information be developed and funded. 9. Strengthen an interdisciplinary evaluation process that is meaningful for all players. Traditional evaluation measures have not effectively reflected the work of community-based organizations or partnerships. When interdisciplinary programs are developed and subsequently evaluated, there is a need for one evaluation which includes both qualitative and quantitative measurements. This evaluation should provide community organizations with practical information and state agencies with a sense of the effectiveness of programs. The process needs to utilize newer evaluation approaches which measure the effectiveness of collaboratives in advancing violence prevention initiatives. Evaluations should include asset-based components and resiliency/protective factors since there is a capacity for an inter-sectoral, interdisciplinary approach to operate on broader community strengths. Critically, funders need to support the evaluation process by ensuring for the provision of quality technical assistance to evaluate results. This will increase the frequency of meaningful evaluation. Influence Policy and Legislation 10. Encourage local level policy change. Although violence prevention policy is frequently equated only with statewide and national policy legislation, change at the local level is critical for three reasons. First, community concerns are often best addressed through local policy initiatives. Second, local initiatives are frequently a laboratory for policy change as they provide valuable information as to which models are most effective and which might be most appropriate at a broader level. Third, local initiatives act as an impetus for statewide and national change. They are an accessible forum where constituents express their perspectives and legislators, noting these perspectives, then translate these into laws at higher levels of government. Local level policy changes can be fostered through the coming together of agencies, foundations and other groups. A local "Shifting the Focus" forum, sharing views on the definition of violence and using the Spectrum as a tool, will allow policy recommendations to emerge. Since fostering local policy is a newly developing craft, information sharing between disciplines should be encouraged to promote its understanding. For example, health, education, and justice collaborated on tobacco policies at the local level which decreased the amount of marketing directed at and availability of tobacco to youth. Other recommendations which foster local policy development include allowing for local policy discussions in RFPs and increasing training around policy-related issues. These efforts are conducive to creating and sustaining environmental change to ensure the viability of local violence prevention efforts. 11. Collaborate to strengthen and support important policy and legislation. Much of the policy discussion at Shifting the Focus was in reference to a specific piece of legislation, SB 822 (Lockyer), which would create a Youth Violence Prevention Authority. This discussion is not covered here due to its specificity and time-limited nature. The broader lesson from this discussion, however, is in the value of a multidisciplinary team assessing policy and making recommendations. In order for this to happen on a broader and more regular basis, there is a need for a mechanism for sharing information on and support for legislation that is of mutual interest. In addition to exchanging information with each other, participants agreed that increasing the knowledge of violence prevention issues among state and local policy makers is key to enhancing effective community-based policy development. Next Steps: Conclusions and Recommendations Shifting the Focus is a springboard toward effective interdisciplinary and inter-sectoral collaboration; participants with differing goals and outlooks came together to make practical recommendations to advance such work. Given the extensive barriers to overcome, this collaboration represents a newly emerging model. Allowing agencies and departments to best utilize their own resources and assets synergistically with those addressing the same issues from a different perspective brings a new strength to the violence prevention movement. As a springboard, Shifting the Focus is only the first step in this valuable process. Other steps must be taken in order to build on the gains of this forum and to continue to advance collaborative violence prevention. Based on the proceedings of Shifting the Focus and the subsequent writing of this document, the following are recommended as the next steps in this ongoing process: A follow-up meeting should be held to review and enhance the recommendations contained in this document. The amended and finalized recommendations should be turned into a specific work plan which will allow the recommendations to be implemented. (A series of meetings were held concluding with an action planning meeting on 7/3/98). As indicated in recommendation #3, a broader group of participants should be brought together in order to expand and strengthen interdisciplinary collaborative efforts. A multidisciplinary training should be developed to bring people together and enhance knowledge and tools for interdisciplinary violence prevention efforts. The ideas in this document should be disseminated in conjunction with a specific work plan for comments and feedback, to share the recommendations, and to determine additional practical steps to take to ensure that the gains from this forum are maintained and strengthened. Shifting the Focus has presented a paradigm shift in fostering the idea that though there are barriers, interdisciplinary and inter-sectoral collaborations can achieve greater effectiveness in their efforts than would be possible by a single agency, provider, practitioner, or discipline. As a broader range of participants comes together, there will be greater opportunities to exchange information and resources and to build strategies to work collaboratively in a comprehensive approach to violence prevention. Footnotes 1 For a complete list of forum participants, see Appendix 2. 2 Meeting the Challenge, 1989 Appendix 1 Shifting the Focus Agenda March 5 and 6, 1997, The Harvest Inn, St. Helena, CA Wednesday, March 5 12:00 - 12:55 Lunch, Overview, and Introduction -- Prothrow-Stith/Cohen How this initiative began Gaining a better understanding of how different disciplines approach violence How shared understanding and collaboration will enhance our work Opportunity for California to be a leader on this issue 1:00 - 1:45 Participant Introductions Opportunities and Expectations 1:45 - 2:15 Examining the Disciplines (Harvard research presentation) - Quaday terminology, data, collaborations, core competencies, integration into other areas 2:15 - 3:30 How We Understand Issues of Violence Prevention (small groups) Does the research ring true? Key terms and issues that differ by discipline and where there would be benefit in more synthesis Which need modification, what other issues should be added? 3:50 - 4:30 Report Backs 4:30 - 5:55 Barriers and Opportunities -- Shifting the Focus -- Examples and Discussion Working Toward Creating Collaborations CA Legislative Proposal -- Steinhart (15 min.) Two programmatic case studies 6:30 - 7:30 What We Need to Shift the Focus: Spectrum of Prevention Exercise Assessing What's Working, What Can Work at Different Levels in a Shared Approach 7:30 Dinner Thursday, March 6 8:30 - 9:00 What now? What we've heard. Where to go? 9:00 - 10:00 Group Action Planning: Prioritizing steps each discipline can take vis a vis data, training, policy, etc. (small groups by discipline) 10:15 - 11:15 Multidisciplinary Action Planning: What steps need to be taken to ensure that the work of Shifting the Focus becomes implemented and who, when, and how? (small groups across disciplines) 11:30 - 1:30 Bringing it All Together: Next Steps to an Action Plan and lunch Appendix 2 Shifting the Focus List of Participants Barbara Alberson, DHS, State and Local Injury Control Section, EPIC Branch Tony Borbon, Violence Prevention Coalition of Greater Los Angeles Laura Brown, Brown and Associates Christy Derdowski, El Dorado County Health Department Dennis Fisher, Office of Criminal Justice Planning, Monitoring/Program Effectiveness Branch Patti Giggans, Los Angeles Commission on Assaults Against Women Lupe Gonzales, DHS, Office of Women's Health, Domestic Violence Programs Ruben Gonzales, San Bernardino Sheriff's Office, Community Policing Carol Harbaugh, Modoc County Office of Education Sue Heavens, Dept. of Alcohol and Drug Programs, Office of Perinatal Substance Abuse Jane Irvine Henderson, Dept. of Education Kathy Jett, DHS, Office of Women's Health Michael Jett, Office of Child Development and Education (Governor's Office) Alex Kelter, DHS, Epidemiology and Prevention for Injury Control (EPIC) Branch Nancy Lyons, Office of the Attorney General, Crime and Violence Prevention Center Detective Steve Margolis, Los Angeles Police Department, Community Policing Andrew McGuire, Trauma Foundation, Pacific Center for Violence Prevention Dr. Ed Melia, Physicians for a Violence-free Society Loretta Middleton-Brown, San Diego County Office of Education Willie Panell, Los Angeles Police Department Rebecca Rolfe, San Francisco Women Against Rape Andres Soto, Pacific Center for Violence Prevention David Steinhart, Commonweal (Juvenile Justice) Sean Tracy, Office of the Attorney General, Crime and Violence Prevention Center Facilitators/Staff Larry Cohen, Prevention Institute (formerly Education Development Center) Stephanie Franchak, Education Development Center Dr. Deborah Prothrow-Stith, Harvard School of Public Health Sher Quaday, Harvard School of Public Health Naomi Uchishiba, Education Development Center Appendix 3 State Agency Involvement Survey Prior to the meeting, Harvard and EDC, Inc. conducted preliminary research and analyzed diverse approaches to violence prevention, including criminal justice, public health, social science and educational approaches. This included working with the state agency representatives to explore definitions of violence and of prevention; the types of data utilized; what collaborations currently exist; perceived causes and risk factors, including resiliency and protective factors as defined by each discipline; existing training programs and what action plans were currently being developed in other states. Representatives from each participating government agency identified violence prevention efforts within their own departments, including initiatives funded directly by the state or through federal pass-through programs. Survey results indicated high and low areas of participation and funding in violence prevention target areas. Results of this survey are in the following tables. Violence Prevention Areas/Groups -- Gaps And Overlaps Key for groups who participated in survey: Office of Criminal Justice Planning (OCJP); CA Department of Education, (DOE); Department of Health Services, Office of Women's Health (OWH); Office of Child Development and Education (OCDE); Department of Alcohol and Drug Programs (ADP); Department of Health Services, Epidemiology and Prevention for Injury Control (EPIC); Crime and Violence Prevention Center Office of the Attorney General (CVPCAG). 1) Arts-related Programs: Participate-CVPCAG Funded by- / 2) Child abuse prevention: Participate-OCDE; EPIC; ADP Funded by- OCJP; CVPCAG 3) Conflict Resolution/Mediation: Participate-DOE; OCDE Funded by-OCJP; DOE; CVPCAG 4) Dating violence prevention: Participate-OWH Funded by-OCJP 5) Domestic abuse prevention: Participate-DOE; OWH; ADP; EPIC Funded by-CVPCAG 6) Elder abuse prevention: Participate- / Funded by-CVPCAG 7) Evaluation: Participate-DOE Funded by-OCJP; DOE; CVPCAG 8) Gang prevention: Participate-DOE; OCDE Funded by-OCJP; DOE; CVPCAG 9) Gun reduction/Safety: Participate-OCDE Funded by- / 10) Hate/bias crime prevention: Participate-DOE; CVPCAG Funded by-OCJP; DOE 11) Job/life skills training: Participate-DOE Funded by-OCJP 12) Juvenile Delinquent/criminal rehabilitation: Participate-DOE; CVPCAG Funded by-OCJP; DOE 13) Media planning/presentation skills: Participate-DOE Funded by- / 14) Mentoring: Participate-ADP Funded by-OCJP; ADP 15) Parenting education: Participate-EPIC; ADP; OWH; DOE Funded by-CVPCAG 16) Prejudice reduction/hate viol. prev: Participate-DOE Funded by-DOE; CVPCAG 17) Peer leadership training: Participate-DOE; ADP Funded by-ADP; CVPCAG 18) Recreation/Community Service: Participate-DOE Funded by- / 19) Self-esteem Building: Participate-DOE Funded by- / 20) Survivor or other Support Group Services: Participate- / Funded by-OCJP 21) Violence Prevention Trainings/Ed.: Participate-EPIC; OWH; DOE Funded by-DOE; EPIC; CVPCAG 22) Other: Coalition/Capacity building: Participate- / Funded by-EPIC 23) Other: Safe School planning: Participate-DOE Funded by-DOE 24) Other: Drug/Alcohol abuse prevention: Participate-DOE Funded by- DOE Data Analysis of Violence Prevention Target Areas Areas which have a high concentration of funding sources by the groups surveyed include: Conflict Resolution/Mediation Evaluation Gang prevention Violence Prevention trainings and education. Areas which have a high concentration of participation by the groups surveyed include: Child abuse prevention Domestic abuse prevention Parenting education Violence Prevention Trainings and education. Areas which have a substantially low concentration of funding by the groups surveyed include: Arts related programs Dating violence prevention Domestic abuse prevention Elder abuse prevention Gun reduction/Safety Job/Life skills training Media planning/presentation skills Parenting education Recreation/Community Service Self-esteem building Survivor support group services Coalition/Capacity building Safe school planning Drug/Alcohol abuse prevention. Areas to have a substantially low concentration of participation by the groups surveyed include: Arts related programs Dating violence prevention Elder abuse prevention Evaluation Gun reduction/Safety Job/Life skills training Media planning/Presentation skills Mentoring Prejudice reduction/Hate violence Prevention Recreation/Community Service Self-esteem building Survivor support group services Coalition/Capacity building Safe school planning Drug/Alcohol abuse prevention. Return to top of page Putting Prevention at the Center of Community Well Being preventioninstitute.org