J Primary Prevent (2014) 35:21–31 DOI 10.1007/s10935-013-0328-x
ORIGINAL PAPER
‘‘You Get Caught Up’’: Youth Decision-Making and Violence Luke O. Hansen • Barbara Tinney • Chisara N. Asomugha Jill L. Barron • Mitesh Rao • Leslie A. Curry • Georgina Lucas • Marjorie S. Rosenthal
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Published online: 20 October 2013 Springer Science+Business Media New York 2013
Abstract Violence is a major cause of morbidity and mortality among adolescents. We conducted serial focus groups with 30 youth from a violence prevention program to discuss violence in their community. We identified four recurrent themes characterizing participant experiences regarding peer decision-making related to violence: (1) youth pursue respect, among other typical tasks of adolescence; (2) youth pursue respect as a means to achieve personal safety; (3) youth recognize pervasive risks to their safety, frequently focusing on the prevalence of firearms; and (4) as youth balance achieving respect in an unsafe setting with limited opportunities, they express conflict and frustration. Participants recognize that peers
achieve peer-group respect through involvement in unsafe or unhealthy behavior including violence; however they perceive limited alternative opportunities to gain respect. These findings suggest that even very high risk youth may elect safe and healthy alternatives to violence if these opportunities are associated with respect and other adolescent tasks of development. Keywords Youth violence Adolescent development Qualitative research Focus groups
L. O. Hansen (&) Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 East Ontario Street, 7th Floor, Chicago, IL 60611, USA e-mail:
[email protected]
L. A. Curry G. Lucas Yale University School of Medicine and the Robert Wood Johnson Foundation Clinical Scholars Program, New Haven, CT, USA
B. Tinney New Haven Family Alliance, New Haven, CT, USA
M. S. Rosenthal Department of Pediatrics, Yale University School of Medicine and the Robert Wood Johnson Foundation Clinical Scholars Program, New Haven, CT, USA
C. N. Asomugha Department of Health and Human Services, Centers for Medicare and Medicaid Services, Baltimore, MD, USA J. L. Barron Yale University School of Medicine, New Haven, CT, USA M. Rao Northwestern University, Chicago, IL, USA
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Introduction In 2007, homicide accounted for approximately one in five deaths among youth aged 15–24 (Singh, 2010). In 2008, over 656,000 people between the ages of 10 and 24 were treated in Emergency Departments in the United States for injuries resulting from violence (Centers for Disease Control (CDC), 2012). Individuals in racial and ethnic minority groups and those from disadvantaged communities are disproportionately affected by this morbidity and mortality (Bernard, Paulozzi, & Wallace, 2007; Bretsky et al., 1996; Farmer, Robinson, Elliott, & Eyles, 2006; Hu & Baker, 2008). The scale of the problem of youth violence and the disparities evident in its demographic distribution reflect a complex interaction in which the risk of violent injury associated with normal adolescent development is exacerbated by socioeconomic factors present in disadvantaged communities. While the experience of high risk adolescent behavior is developmentally common, engagement in a distinctly disadvantaged community compounds the potential for behavior leading to injury and death. Ecological theory describing how the intersection of adolescent developmental psychology and sociology is associated with youth violence has largely derived from epidemiologic approaches, which incorporate survey and other observational quantitative data (Dahlberg & Krug, 2002). Insights from this literature include regular correlations between sociodemographics and criminal justice, education, and health outcomes. Factors consistently associated with the perpetration of violence include history of victimization, history of aggressive behavior, and high emotional distress (Blitstein, Murray, Lytle, Birnbaum, & Perry, 2005; Cotten et al., 1994; DuRant, Cadenhead, Pendergrast, Slavens, & Linder, 1994; Herrenkohl et al., 2000; Herrenkohl et al., 2007; Resnick, Ireland, & Borowsky, 2004). Qualitative studies have added further insight to this quantitative literature. For example, the ethnographic work of sociologist Elijah Anderson is grounded in close observation and interview methods in order to support the inductive development of an ecological model. In his seminal work The Code of the Street, Anderson wrote that he attempts to ‘‘focus on the distinctive collective reality that patterns of criminal violence create in inner-city neighborhoods’’(Anderson, 1999, p. 326). He concludes that
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youth violence occurs in a context of community characteristics including economic disadvantage, racial discrimination, and social dislocation, and he argues that this context fosters attitudes and developmental pathways that differ from those associated with other neighborhoods. He classifies this context as ‘‘street’’ and proposes that the rules and attitudes that define the ‘‘Code of the Street’’ are associated with participation in violence. Subsequent quantitative work has supported Anderson’s theory, demonstrating an interaction between self-reported adherence to the code of the street, social and environmental characteristics, and violence (Brezina, Agnew, Cullen, & Wright, 2004; Stewart & Simons, 2006). Anderson’s theory explaining the neighborhood social context for youth violence aligns with other contemporary themes in health and sociology research including theories of social capital and social determinants of health. Social capital, defined by Robert Putnam as ‘‘the collective value of all ‘social networks’ and inclinations that arise from these networks to do things for each other,’’ can be seen as a complementary concept to the Code of the Street, informing understanding of the relationship between individual behavior and the community (Putnam, 1995, p. 19). Putnam describes two sub-types of social capital, ‘‘bridging’’ and ‘‘bonding.’’ Bridging social capital reflects social networks that bring together people who are unlike, while bonding capital describes networks that are characterized by homogeneity of key characteristics including ethnicity, age, gender, and social class. Putnam identifies communities dominated by bonding social capital as at risk for what he starkly calls ‘‘sinister ends,’’ which result from fewer ‘‘crosscutting allegiances and diverse perspectives’’ (Putnam, 2002, p. 11). The code of the street might thus be seen as a set of social norms tied to the bonding social capital shared by the youth profiled in Anderson’s work. There is also increasing evidence that neighborhood or locality are highly associated with not only behavior but also health outcomes. This has been called the ‘‘power of place’’ in urban sociology and has been similarly described in the public health sphere, where research over the last decade has described the association among neighborhood, social determinants of health including local social and economic factors, and health outcomes including violent injury (Marmot & Wilkinson, 2009; Sampson, Morenoff, & GannonRowley, 2002; Sampson, Raudenbush, & Earls, 1997).
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Qualitative methods, which include Anderson’s ethnography, have been described by Israel et al. as ‘‘alternative inquiry paradigms’’ that can create opportunities for novel insights through open-ended and inductive data collection (Frattaroli, 2012; Israel, Schulz, Parker, & Becker, 1998, p. 175). Existing qualitative literature on youth violence has identified relationships with high risk peers, use of alcohol and drugs, family quality of life issues, and concern over respect as some of the determinants of youth involvement in violence (Johnson, Frattaroli, Wright, Pearson-Fields, & Cheng, 2004; Le’Roy, Vera, Thompson, & Reyes, 2001; Mathews, 1993; Zimmerman et al., 2004). However, the qualitative literature related to youth violence has often failed to engage the specific population that is at highest risk of involvement in violent episodes to explore the interaction of adolescent development and social context. Qualitative studies of youth violence have generally focused on average risk populations, exclusively female participants or pre-teen populations (Le’Roy et al., 2001; Shuval et al., 2012; Zimmerman et al., 2004), and these studies have interviewed caregivers rather than youth themselves (Barkin, Ryan, & Gelberg, 1999; Brezina et al., 2004); or have been conducted in international contexts rather than high prevalence communities in the United States (Marsh, McGee, Nada-Raja, & Currey, 2007; Mathews, 1993; Parkes, 2007; Po¨so¨, Honkatukia, & Nyqvist, 2008). A full exploration of the experience of youth most closely exposed to street violence is key to the development of an accurate health behavior model for reducing adolescent violent injury, and can inform domestic policy related to violence (Glanz, Rimer, & Viswanath, 2008; Strecher, DeVellis, Becker, & Rosenstock, 1986). In order to include the perspective of youth residing within communities with high rates of violent injury, we developed a research partnership between academic representatives and an urban community-based organization administering a program of tertiary prevention to high risk youth. As opposed to more common primary and secondary prevention, tertiary interventions target individuals who have already actively manifested the disease or condition in question, and prevention efforts attempt to prevent its recurrence (Office of the Surgeon General (US), 2001). Using qualitative methods, we collectively undertook to measure reasons for decisionmaking related to violence in a high risk cohort of youth actively followed by the program.
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Methods Study Design and Sample In September 2007, the Executive Director of a local community-based organization, the New Haven Family Alliance (NHFA), approached the leadership of an urban academic research training program to discuss how research might improve understanding of why youth engage in violent behavior. The communitybased organization administered a tertiary violence prevention intervention, the Street Outreach Worker Program (SOWP), using acute violence interruption and longitudinal street-based mentoring strategies that were modeled on an evidence-based intervention design endorsed by the Centers for Disease Control (Resnick et al., 2004; Skogan, Harnett, Bump, & DuBois, 2008). Street outreach workers have detailed knowledge of community social networks and resources, allowing them to provide both violence interruption interventions and referral services to community social services for high risk youth. Youth participants followed in the SOWP were identified using input from juvenile justice officials, community leaders and youth service agency workers. SOWP youth ranged in age from 13 to 23. The prevalence of prior violent offenses was 40 %. In order to convene a group of key youth informants with experiential knowledge of youth violence, SOWP recruited a purposive sample of youth participants from among those expressing interest in discussing causes of youth violence and considering strategies to decrease it. Purposive sampling methodologies preferentially recruit individuals who would be considered most likely to contribute insight to the research (Sofaer, 1999). Recruitment occurred within the context of the usual SOWP mentorship and violence interruption activities. The research participant sample consisted of 30 individuals, of whom the mean age was 16.4 years (interquartile range 3 years). Half were male (50 %, n = 15) and the majority were African American (87 %, n = 26). Participants’ residences included five distinct communities within a single metropolitan area. Ninety percent (n = 27) came from femaleheaded households. One participant came from a two parent family, and one was homeless at the beginning of the project and subsequently found shelter. Approximately two-thirds of the youth clients initially
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recruited (63 %, n = 19) attended the majority of focus groups. Participants’ received fifteen dollars per focus group attended commensurate with stipends provided for participation in other organization activities related to skills training, and were provided with meals during the focus group sessions. In the first meeting, study participants engaged in a problem analysis to generate focus group topics reflecting the roots of violence that the youth perceived within their communities. A ‘‘problem tree’’ analysis approach, which conceptualized the problem of youth violence as a tree with both roots (causes) and branches (effects), guided this discussion (Thunhurst & Barker, 1999, p. 129). This visual representation of causal association has been used in previous problem structuring efforts for healthcare improvement (Snowdon, Schultz, & Swinburn, 2008; Williams, Bray, Shapiro-Mendoza, Reisz, & Peranteau, 2009). Incorporating input from NHFA program staff experienced in group activities with the SOWP participant cohort, as well as from a pediatrician and a child psychiatrist with training in adolescent health and psychology, the team decided that separation by gender would reduce participant response bias and support equitable participation across genders. A member of the academic research staff and a staff member of the SOWP moderated the problem tree exercise and subsequent focus groups. We elected to conduct focus groups rather than individual interviews in order to benefit from the additional insights possible through dialogue among participants and to provide a more comfortable setting for discussion within a group of peers rather than in isolation (Krueger & Casey, 2009). Prior to data collection, academic and community-based organization moderators received focus group facilitation training from the Yale School of Public Health faculty and from staff of the Institute for Community Research (Hartford, CT), a communitybased research organization. This training included exercises and strategies to engage all group participants in dialogue, to redirect participants to researchrelevant discussion, and to use effective follow-up questions and probes. Following the problem tree exercise, focus groups met weekly for seven 90-min sessions in July and August 2008. Each session was dedicated to one discrete conceptual roots defined in the introductory problem tree exercise. The final session addressed a conceptual root from the tree exercise as well as an additional conceptual root
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identified in preliminary transcript analysis in order to obtain further information regarding this recurrent concept. Each focus group session included an introductory period in which participants discussed their photo-taking experiences for the week, which are described in the next paragraph, and selected a single image for group discussion. Group discussion of all participant images continued for approximately 60 min, and the remainder of the group time was spent reviewing major discussion points from the session for further comment. We audio recorded and professionally transcribed the focus groups, and a moderator then reviewed the transcripts for accuracy. Weekly focus group discussion employed ‘‘photo elicitation’’ to precipitate discussion (Clark-Ibanez, 2004, p. 1507; Harper, 2002). We incorporated this method, which uses photographic images to initiate or focus research interviews, into the research design in order to support youth engagement in the research and to facilitate presentation of individual experiences of community. In the week prior to each focus group, participants photographed images in their communities that they felt reflected the particular root of violence planned for discussion. Focus group moderators encouraged participants to compose photographs that represented where and when violence occurred, and who was involved in it. We encouraged participants to obtain as many images as they desired, and over the course of the project participants obtained over 2000 images; however, in each focus group meeting each participant selected a single photograph to present to the group as a discussion focus. Participants received digital cameras upon recruitment to the study. During the participants’ orientation to the project, staff of the Yale University Art Gallery and a professional photographer instructed participants in visual literacy and technical photography skills. The Human Subjects Committee of the Yale College of Arts and Sciences, New Haven, Connecticut approved the protocol. The research team obtained informed written consent from participants 18 years old or older and from the parents of those under the age of 18. We considered privacy issues related to participant photo-taking, and provided with guidelines designed to preserve the privacy of both participants and community members. We adopted these guidelines from journalistic norms allowing photography of public spaces while considering accuracy, transparency and restraint (Pew Research
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Center, 1997). We encouraged participants to consider both safety and privacy in composing pictures. A street outreach worker accompanied participants on dedicated photo-taking sessions in the initial 2 weeks of the project to reinforce these guidelines. Photographs that did not adhere to the guidelines were not used in focus groups. Community organization staff and leadership requested that youth photographs not be presented in scholarly publications to protect participant privacy and safety. The partnership’s research was guided by the principles of community-based participatory research (CBPR; Israel et al., 1998). All major decisions including protocols for the protection of research project participants, participant and community member privacy, and publication of photographic images were made collectively by a research team composed of the executive director and program officer of the community-based organization, the program manager of the SOWP, and faculty members and trainees participating in a post-doctoral research training program. Consensus was reached on the research and dissemination approach including disclosure of focus group dialogue and nondisclosure of youth photographs for publication. Analysis The analysis team consisted of two adult community members who had been raised in New Haven and were employed in youth social services provision, four focus group moderators who were trainees in a post-doctoral research training fellowship, a medical school faculty member, and a senior case manager at the partnered community-based organization. The research team, advised by team members with graduate training or vocational experience in child and adolescent development, chose to bring a community perspective and more advanced abstract thinking ability to the analysis by including adult community members identified by the leadership of the NHFA rather than the participants themselves (Cashman et al., 2008). The research team analyzed focus group transcripts using the constant comparative method of qualitative research (Bradley, Curry, & Devers, 2007; Glaser & Strauss, 1967). This method cataloged qualitative data by assigning conceptual codes to sections of the transcript. Researchers refined the codes in an iterative
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manner and created new codes as additional transcripts were examined (Patton, 2005). Once the research team established a comprehensive, stable code structure that accounted for all content discussed, two three-person teams divided the remaining transcripts and reviewed them separately (Boyatzis, 1998). Qualitative analysis software (ATLAS.ti 5.0) electronically cataloged coded text and facilitated data retrieval (Muhr, 1997). After considering the qualitative data in its entirety, the team reached consensus regarding definition of themes and subjected these themes to a process of participant confirmation (Barbour, 2001; Lincoln & Guba, 1985; Mays & Pope, 2000; Nunez-Smith, Curry, Berg, Krumholz, & Bradley, 2008). As part of this process, participants reviewed the thematic findings and confirmed the appropriateness of the themes to their personal experiences.
Results Serial focus groups identified these seven roots of violence: people (thugs, dirty cops), ‘‘the System’’ (government), family, drugs, guns, money, and survival/fear. The discussion of fear was added based on preliminary transcript coding. Upon analysis, four major themes emerged that characterized participants’ views and experiences regarding peer decision-making related to violence. Theme 1 Youth pursue respect, among other typical tasks of adolescence. Participating youth described their pursuit of normal adolescent developmental tasks including belonging, identity formation, and self-efficacy (Erikson, 1980). The desire for belonging was evident as they recounted typical experiences of peer pressure and their wish to be perceived as significant among their peers. ‘‘If you go to [a] fashion school like Hill House [High School]… if you not fresh, I bet you by the next year you gonna try to [be]… I talking about a lot of people who are not fresh and stuff, they gonna try to get money. That’s why everybody try to get money, ‘cause they got to.’’ (17 y/o male) ‘‘It’s harder because they [are] under peer pressure. They try to do so much to get their name known.’’ (18 y/o male)
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In this context, self-efficacy represents individuals’ confidence that they can be effective in prospective situations (Bandura, 1993). Youth referred frequently to the need for ‘‘respect’’—a term which reflected many of the tasks commonly attributed to adolescent development, including the desire for self-efficacy (de Vries, Dijkstra, & Kuhlman, 1988). Respect represented a particularly valuable form of social capital to participating youth, as has been observed previously by Anderson who remarked that respect attains particular value when ‘‘other forms of capital have been denied or are unavailable’’ (Anderson, 1999, p. 66). The importance of respect as a means to define the transition from childhood to adulthood as well as to address daily social needs was repeatedly emphasized, and provided a common element across the identified themes. Participants contrasted adolescent developmental tasks of respect and liberty with the vulnerability of childhood. They shared confidence that by completing these tasks they would gain ‘‘status’’ which afforded safety both within and outside their neighborhood. ‘‘They just try to make their name more known…because see when your name known, you can leave your ‘hood and still have respect. They leave their ‘hood, they ain’t gonna have no respect. They got just ‘hood names.’’ (19 y/o male) The ‘‘hood’’ name, reflecting respect only in their immediate block or neighborhood, was inadequate. Participants craved greater independence and a social presence. Theme 2 Youth pursue respect as a means to achieve personal safety. The accrual of respect, as a developmental task as well as a means of achieving personal safety, was a central concern to participants: ‘‘…if you got money and you don’t got no respect on the street, they gonna set you up, like, they gonna take the money from you. That’s how the game goes.’’ (16 y/o male) However, available means of achieving the respect of peers and community were limited. The most readily accessible sources of respect that youth perceived were associated with a social and economic
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context that they defined as the ‘‘street,’’ consistent with Anderson’s ‘‘Code of the Street’’ (Anderson, 1999). Participants repeatedly cited ‘‘Street’’ individuals as those who were protected by the amount of respect afforded to them. ‘‘He got his red flag in his pocket, everything. He’s a true Blood. He’ll sit on Congress Ave all day just waiting for somebody to walk by with a blue flag and fight…So, like, with him, he got all his respect ‘cause you can sit in somebody else[‘s] hood. You could sit in the Crip hood. Like without nothing going on… He got mad respect.’’ (16 y/o female) ‘‘Street’’ individuals were cited as individuals protected by the amount of respect afforded to them. Theme 3 Youth recognize pervasive, unavoidable risks to their safety, frequently focusing on the prevalence of firearms. Youth reported the need for constant vigilance regarding threats to their safety. They described fear of being victims of violence on the street and fear that street violence would spill into their homes. They expressed frustration at how readily their peers could become engaged in or victimized by violence. While they repeatedly characterized violent behavior as ‘‘crazy,’’ youth also made clear that the problem was endemic in scale: ‘‘Every time somebody comes around you, you think they are going to hit you.’’ (17 y/o female) The prevalence of firearms made the danger more urgent: ‘‘It’s just crazy. Why do you have to go and kill somebody over something dumb, over stealing a bike or the drugs? Why do guns even have to be invented?’’ (19 y/o female) ‘‘See my friends who carry guns around be for protection for their life. Is not like they just carrying it just to have it [or] shoot and rob somebody, [it] is for their life.’’ (19 y/o male) Attempting to intervene to de-escalate or avoid violence was particularly dangerous. In considering how they could reduce violence among their peers, youth described ambivalence at getting involved due to fear for their safety.
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‘‘I seen it happening and I ain’t intruding one bit…. The dude was wrong. I mean I might said something to him but I ain’t actually stop him or pulling him off. I don’t know where that dude at. [He] could have a burner [firearm] and pop [shoot] me, you know what I’m saying?’’ (18 y/o male) While they characterized violent behavior as ‘‘crazy,’’ youth also made clear that the problem was highly prevalent, difficult to avoid, and dangerous to attempt de-escalating with peers. Theme 4 As youth consider how to achieve respect in an unsafe setting with limited opportunities, they express conflict and frustration. While youth reported that the street was a source of respect and wealth, some youth also characterized the choice to derive respect or wealth from the street as self-destructive. ‘‘Cause it’s like, it’s like I used to be a knucklehead… you know what I’m saying? After, you know, I got shot… it makes you think differently, you know what I’m saying? Like this ain’t really worth it! But to people that don’t see that it’s not worth it… they be out there every single day and still don’t wake up to see this is embarrassing. I’m out here and I ain’t gonna make it nowhere. Because believe it or not a lot of people… really think the streets is life…And when you [are] caught up being around [them], it’s just like you don’t move, period.’’ (18 y/o male) Participants described success found on the street as at least temporarily rewarding, bringing respect from peers and a means to purchase a better life for themselves and frequently for their families as well. However, they also recognized the consequences of the violence that was normative in the street. They described the tension in choosing between the financial benefits available on the street and those found in alternative pursuits such as athletics or academics. ‘‘…if the kid plays basketball and if he’s good at basketball and he maintains himself from being in the streets from like [by] playing basketball and don’t make it… the only thing he knows, he only got one more option, and that’s back to them streets. To get money in his pocket and anything.’’ (18 y/o male)
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‘‘Say I’m like the master of all sports, like any sport, whatever, and I get a serious injury or something, and then I’m gonna be like I can’t go that far, so I’ll just go right to the corner and just start selling drugs too. I wanna make money too.’’ (15 y/o male) ‘‘(You) gotta have a high school diploma. Some jobs you gotta have a license. You can’t have no felonies. It’s hard, so instead of going through all that, people would rather sell. Stand on the block and sell drugs… you make quick money at it.’’ (19 y/o female) Even when healthy opportunities off the street were present, participants characterized unhealthy opportunities to gain respect and wealth as alluring and difficult to avoid: ‘‘The streets change a whole kid’s mind. The streets, a lot of kids now… some of ‘em deal with home, but a good majority deal with the streets. Coming up in the street life and it’s not easy. You get caught up… A lot of people really think the streets is life….and when you is caught up being around [them], it’s like you just don’t move.’’ (18 y/o male) The feeling that they were ‘‘caught up’’ in a setting that was unsafe, or ‘‘street,’’ was common.
Discussion In a community-based participatory research partnership, we used focus groups facilitated by photo elicitation to understand participants’ experiences of violence in their lives. Our data indicate that study participants negotiate developmental tasks typical for adolescence while also managing concern for their physical safety. Although they are aware of the risks associated with the street, they feel that the street is often the best option available to find safety, belonging and respect. From their perspective, violence is a side effect of the pursuit of respect and a course of adolescent development occurring in a specific social and economic context. Participants acknowledge a relative scarcity of opportunities for success on the street compared to other settings. We propose that violence reduction efforts can capitalize on this sense of ambivalence through the development of safe
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alternative opportunities for at risk youth to accrue respect and other developmental needs of adolescents. Our findings support Elijah Anderson’s ecological framework as presented in the Code of the Street, in which the ‘‘collective reality’’ described by Anderson as ‘‘street’’ places adolescents at increased risk for involvement in violence (Anderson, 1999, p. 326). We identified youth sentiments of conflict and frustration as they discuss pursuing adolescent tasks such as the development of respect amid a collective reality where violence is endemic. While existing literature offers a portrait of youth at risk for violence defined by observed risk or protective factors, our qualitative method and community-based approach allowed youth to articulate their own concept of individuals’ decision-making regarding violence. Participants expressed that their decision-making is bound by their social context—that peers are ‘‘caught up,’’ perhaps within a form of bonding social capital. Participants described a process of decision-making with limited alternatives to accomplish normal aspects of successful adolescent development. They described knowledge of the dangers of a street orientation and reported that, in their experience, a lack of alternatives to achieve respect represented individuals’ greatest risk for violence. Notably, in the years since the publication of The Code of the Street, sociologist Loı¨c Wacquant has described the split between ‘‘decent’’ and ‘‘street’’ as a false dichotomy that oversimplifies the complexities of identity and behavior in poor urban communities. Our qualitative data do reflect a complex landscape and youth decision-making that is far more conflicted than a dichotomy between ‘‘decent’’ versus ‘‘street,’’ but we do believe the conceptual frame of the code of the street was resonant in our analysis (Wacquant, 2002; Wilson & Chaddha, 2009). Our findings should be considered in light of several limitations. Although we were guided by the work of Elijah Anderson, we were unable to explore how sex and gender, concepts of masculinity and femininity, and romantic relationships affect individuals subject to the Code of the Street (Barr, Simons, & Stewart, 2012; Jones, 2004, 2008; Nowacki, 2012). A more full representation of the female perspective would strengthen our work and is a focus of ongoing research for our community academic partnership. In addition, in the years since the publication of the Code of the Street, there has been an increasing
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understanding of the important role of incarceration and prison re-entry in the problem of neighborhood community violence (Inderbitzin, 2009; Richardson, 2009), which we did not capture in our model. Our decision to include Street Outreach Workers as moderators may have reduced participants’ candor; however, these workers are respected individuals whose personal life histories often resonate with participants and likely also facilitated important focus group content. We considered the possibility of disclosure bias in consultation with the community organization staff and determined that the benefits of Street Outreach Worker presence outweighed any potential biases. Division of the participants into two groups according to gender may also have influenced focus group content. However, we feel that genderdistinct experiences of youth violence exist and our decision to stratify our focus groups by gender facilitated open discussion, particularly for young female participants (Jones, 2004). Strengths of our study include our communitybased participatory approach that offered opportunities for insight into the lives of a population of adolescents who are otherwise difficult to reach. Reflecting the principles of partnered investigation, the research design engaged not only a multi-disciplinary academic team but also community leaders, social service providers, and participant youth themselves. Youth conducted a participant confirmation exercise following analysis, participated in dissemination, and helped organize and curate a local exhibition of their photographs.
Implications for Policy and Practice Participant youth’s characterization of violence as a conflicted choice resulting from limited safety and opportunity offers a lever for policy approaches: decreasing youth violence may be best accomplished by increasing the availability of safe and healthy alternative opportunity structures. This approach requires shifting attention away from characterization of violence as individual pathology and toward often neglected individual and community assets. Youth report feeling ‘‘caught up.’’ In this light, the documented success of Street Outreach Worker initiatives may lie not only in workers’ ability to disarm conflicts but also in their ability to present youth at risk with
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alternative healthy opportunities to feel respected through facilitated connection to education, employment, and social service resources (Skogan et al., 2008). Our findings support violence prevention agendas that invest in the provision of safe and healthy alternate opportunities so that youth in high risk neighborhoods can pursue the tasks of adolescent development. The realization of these opportunities, however, will require partnership with community institutions including schools and the business community. Acknowledgments This work would not have been possible without the generous support of many members of the New Haven community. We are indebted to our youth participants, Tyrone Weston and the Outreach Workers of the NHFA Street Outreach Worker program, and Shirley Ellis-West and the staff of the NHFA. The authors thank Kelley Traister, Erika Brown, Abigail Paine and Emily Bucholz for research assistance; Jessica Sack, the Jan and Fredrick Mayer Associate Curator of Public Education at the Yale University Art Gallery; and The Institute for Community Research (Hartford, CT). This work was supported by funding from the Robert Wood Johnson Foundation Clinical Scholars Program, the Yale School of Medicine, and the Department of Veterans Affairs.
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