Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. In this Idea Gallery, Bryan Samuels, Commissioner of the Administration on Children, Youth and Families, provides his perspective on how communities and organizations and families can work together to keep children safe, in honor of Child Abuse Prevention Month.

Nancy Barrand, Senior Adviser for Program Development at the Robert Wood Johnson Foundation (RWJF), also weighed in to provide some context for Commissioner Samuels' post:

Few events are more traumatic for children than being removed from their families and entered into the foster care system. In 2010, the Robert Wood Johnson Foundation funded the Corporation for Supportive Housing to develop and implement a pilot program in New York City that uses supportive housing to offer stability to families with children who are at risk of recurring involvement in the child welfare system. The New York pilot initiative, called Keeping Families Together (KFT), showed positive results in keeping and reuniting children with their families in a safe, stable environment. A 2011 evaluation indicates that the KFT pilot generated a 91 percent housing retention rate among participating families. By the end of the evaluation, 61 percent of the child welfare cases open at the time of placement in supportive housing had been closed, and there were fewer repeat incidents of child maltreatment.

Now, RWJF has partnered with the U.S. Department of Health and Human Services, Administration on Children Youth and Families and three private foundations – the Annie E. Casey Foundation, Casey Family Programs, and the Edna McConnell Clark Foundation – to jointly fund a $35.5 million initiative to further test how supportive housing can help stabilize highly vulnerable families. The national replication effort will be evaluated and we’re anxious to see whether, again, secure and affordable housing, when paired with the right services for struggling families, can reduce instances of child abuse and neglect.  The long-term gains in health and well-being, and costs saved, could be tremendous.

Commissioner Bryan Samuels on Child Abuse Prevention

Throughout the month of April, we turn our attention to the prevention of child abuse and neglect, celebrating those efforts in neighborhoods, faith communities, and schools that keep children safe and help families thrive. Whether formal or informal, these efforts involve wrapping caregivers and children in supports that reduce risk factors for maltreatment and promote protective factors, by decreasing stress, boosting parenting skills, and helping parents manage substance abuse or mental health issues.

Last year, more than 675,000 U.S. children were victims of maltreatment. These children are more likely than their peers to have emotional and behavioral problems, struggles in school, and difficulty forming and maintaining relationships. The effects of abuse and neglect can be pernicious and lifelong.

In recent years, we’ve come a long way in learning what it takes to help children who have experienced abuse and neglect heal and recover. We have interventions that help put families back together after maltreatment has occurred. But preventing abuse and neglect in the first place by giving families the support they need, when they need it, yields the best outcomes.

On July 20, 2012, during a midnight showing at a local movie theatre in Aurora, Colorado, a gunman opened fire, killing and injuring unsuspecting moviegoers. Ultimately the massacre killed 12 and injured 57 — presenting an enormous challenge for local emergency dispatch, fire departments, police, hospitals, public health, and more, and requiring all to work together on an integrated response in the midst and the wake of a chaotic, unprecedented active shooter situation. Partners came together to share their lessons learned at the 2013 Public Health Preparedness Summit.

>>Read continued NewPublicHealth coverage from the Summit.

When the first 9-1-1 calls came in following the shooting, the University of Colorado Hospital, a level II trauma center, already had full emergency department — 49 out of 50 beds were filled.

“We’d been notified we were going to get three to five gun shot victims,” said Patrick Conroy, manager of support services and safety officer for the University of Colorado Hospital. “But we had this queasy feeling something was not quite right. We started notifying emergency services to get ready.”

A new study funded by Public Health Law Research, a program of the Robert Wood Johnson Foundation at Temple University, addresses the consequences of weak penalties for domestic violence offenders in the U.S.

Domestic violence, also known as intimate partner violence, accounts for an estimated 1,200 deaths and two million injuries among women each year. The new study, authored by Frank Sloan, PhD, professor of health policy and management at Duke University, and published in the journal Risk and Uncertainty, reviewed data from the North Carolina administrative courts and found that there are often repeat offenses for men arrested for domestic violence and that penalties don’t seem to significantly reduce repeat arrests or convictions.

Sloan points to low prosecution rates and minimal fines as reasons behind many repeat offenses. The study did find, however, that defendants who hired a private lawyer are less likely to be arrested or convicted during the follow-up period because the added costs may be a deterrent.  

Tuesday, January 8, from 12:30 to 1:30 p.m. EST, the Harvard School of Public Health, in collaboration with Reuters, will present an hour long live webcast on gun violence, in response to the too many recent gun massacres.

The webcast is part of the school’s ongoing “Forum” series,  whose aim is to provide a platform to discuss policy choices and scientific controversies by leveraging participants' collective knowledge. Tomorrow’s forum on gun violence will look at the legal, political, and public health factors that could influence efforts to prevent gun massacres.

Participants include Laurence Tribe, professor of Constitutional Law at Harvard Law School; Felton Earls, MD, professor of child psychiatry at Harvard Medical School; David King, senior lecturer in public policy at the John F. Kennedy School of Government at Harvard, and chair of Harvard’s Bipartisan Program for Newly Elected Members of Congress; and David Hemenway, PhD, Director of the Harvard Injury Control Research Center.

In advance of tomorrow’s Forum, NewPublicHealth spoke with Dr. Hemenway about ongoing research efforts aimed at preventing gun violence and gun massacres. Dr. Hemenway is the author of Private Guns, Public Health, which demonstrates how a public-health approach—historically applied to reducing the rates of injury and death from infectious disease, car accidents, and tobacco consumption—can also be applied to preventing gun violence. Dr. Hemenway’s book was supported by a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

NewPublicHealth: What is the overall goal of the Forum? 

Dr. Hemenway: The Forum series focuses on how public health can help impact many major issues in the U.S. We are able to gather experts at Harvard who are working on these issues to provide information about what we know and to share ideas on approaches to help address these problems.  

NPH: On tomorrow’s panel, you’ll be discussing the issue from a public health approach. What are some of the concepts you’ll be sharing?

The Institute of Medicine and the Avon Foundation for Women issued the “Ending Violence @ Home App Challenge” to encourage powerful communication through technologies such as social media and mobile apps to help end worldwide suffering caused by domestic violence.  Four winners of the App challenge were chosen from 19 submissions that came in from across nine countries. The four were chosen based on their innovation, design, potential impact, and ability to integrate evidence-based information and usability in different settings. IOM President Harvey Fineberg stated in a release, “I am very impressed with the level of creativity demonstrated by the winning products, which can make a real difference to abused individuals.”  

The top prize of $10,000 was awarded to Wisdom of the Children (Çocuktan Al Haberi), a Turkish group that developed a website to encourage individuals to see that change can start with a simple shift in how we talk to each other. The website encourages families to take old Turkish expressions that condone violence and reinforce traditional gender norms, and turn them into more positive sayings. For example, the traditional saying from the region, “don't spare a baby from your wife's belly and rod from her back,” was changed to “don't spare soup from a women's belly and sunscreen from her back.” Web visitors are encouraged to create their own new, positive, health-reinforcing sayings with their children.

>>Read more about the app challenge.

Debbie Lee, senior vice president at Futures Without Violence and deputy director of Start Strong: Building Healthy Teen Relationships’ national program office, will speak Tuesday, October 30 about lessons learned from the Start Strong initiative at an APHA session on preventing teen dating violence.

Start Strong is a national program of the Robert Wood Johnson Foundation in collaboration with Futures Without Violence. The Robert Wood Johnson Foundation and the Blue Shield of California Foundation have invested in 11 communities across the country to identify and evaluate the most promising pathways to stop dating violence and abuse before it starts. This initiative uses a comprehensive community health model to prevent teen dating violence and promote the development of healthy relationships among 11 to 14 year olds.

NewPublicHealth spoke with Debbie Lee before her APHA session to find out more about the unique approach Start Strong is taking to building healthy relationships skills in youth and tackling teen dating violence before it begins.

NewPublicHealth: First tell us a bit more about the comprehensive approach that Start Strong uses.

Debbie Lee: Start Strong uses a multifaceted approach to promote healthy relationship behaviors among young adolescents in order to stop relationship violence before it starts. Its four key components include: educating and engaging youth in and out of school; engaging the people that influence teens; addressing policy change in schools and environmental factors that affect adolescent development; and then implementing communications and social marketing strategies to create and reinforce positive social norms.

NPH: This year’s theme at APHA is “Prevention and Wellness Across the Lifespan.” How does Start Strong fit into this theme?