The California Wellness Foundation’s violence prevention initiative (VPI)

The initiative

The Board of Directors of The California Wellness Foundation (TCWF) authorised the Violence Prevention Initiative (VPI) in October 1992.  The VPI is a grant-making programme of USD60 million over 10 years, which has approached violence from a public health perspective and taken into consideration the root causes, such as lack of access to jobs, poor educational systems, lack of healthcare and affordable housing, racism and discrimination.

As well as seeking to address the root causes, the VPI also places an emphasis on reducing access to handguns to reduce the lethality of the violence. “There were four interactive components in the VPI: the Policy Programme, Community Action Grants (CAG) Programme, Leadership Programme, and the Research Programme. While conceptually distinct, these components were seen as essentially interdependent and interactive to obtain the greatest impact.” [3]

The VPI had a number of specific policy goals:

• “Work to shift society's definition of youth violence from a law enforcement perspective to include a public health perspective that addresses societal and environmental influences contributing to youth violence.” [This involved educating and informing policymakers, opinion leaders and the media.] ...[4]
• “Advocating for public policies that reduce the access to alcohol and other drugs, which contribute to youth violence. [5]
• “Advocating for public policies to reduce firearm injury and death among youth.”

The challenge

In many parts of California in the 1980s and 1990s, there was a massive amount of gun crime and death from gunshots. “The juvenile arrest rate for homicide more than doubled between 1984 and 1993. In those years, homicide was a leading cause of death of all young people under 24. The murder rate was reaching epidemic portions among young men. In 1991, murders peaked when nearly 25,000 Americans were killed, and California led the nation with close to 4,000 homicides. The impact was felt most profoundly in low-income communities of colour.” [1]

There are a number of theories as to the main cause of gun use and the consequent high levels of homicide. “One authority hypothesises that youths recruited to the crack trade found it necessary to carry firearms, which induced other youths to arm themselves in self-defence. Thus, disputes that would once have ended in a fistfight now ended in lethal violence. Other observers have cited causes ranging from economic stagnation and the social pressures of poverty and racism to a long record of leniency towards juvenile violence on the part of the criminal justice system.” [2]

The public impact

Several VPI-funded programmes have had significant public impact:

• Currently, the state of California has some of the strongest gun control laws in the United States.
• “In July 1996 the Governor signed into law State Senate Bill 1760. Specifically, the bill provided USD 50 million in grants to counties for the purpose of reducing juvenile crime and delinquency.” [6]
• The annual state budget allocation for preventing youth violence was about USD370 million in FY2002-03.
• The California Peace Prize created greater public awareness of individuals and programmes working to prevent violence in California.
• Thousands of young people received mentoring, support, services and training at the Community Action Programmes (CAPs) and Promising Practices (PPs), providing alternatives for youth to stay safe from violence and violent activities.

Stakeholder engagement

The California Wellness Foundation was the major internal stakeholder, planning the VPI and providing the necessary funds for the Trauma Foundation of San Francisco General Hospital to establish the Pacific Center for Violence Prevention and to give grants to the various policy programmes to be carried out under the VPI. The organisations in receipt of funds were also stakeholders, e.g. Martin & Glantz LLC and i.e. communications LLC, which conducted public awareness campaigns.

Eight California-based foundations provided an additional USD10 million for the VPI (see also Feasibility).

Political commitment

The VPI was initiated by a charitable foundation rather than a governmental agency. However, it was able to influence the state government of California in some of its violence prevention legislation, e.g. the gun control laws of 1996.

Clarity of objectives

The objectives stated at the outset were clear, i.e., to help prevent youth violence in California by funding effective programmes and influence policymakers and educators.

Strength of evidence

The initiative was derived from a white paper published by the Trauma Foundation. “Shortly after TCWF was established, six white papers were commissioned and presented to the Board of Directors. One of the papers, authored by staff at the Trauma Foundation, was on the issue of violence prevention. The Board decided to make violence prevention the focus of the Foundation’s first initiative to improve the health and wellbeing of Californians. Strategies and interventions that had been utilised by public health practitioners to reduce death from disease and unintentional injury were to be modified and adapted to help prevent violence in California.” [7]

Feasibility

The white paper addressed ways in which the VPI could be used to influence the debate about youth violence and invest in positive action.

The financial feasibility was addressed by TCWF , which provided USD60 million, along with “eight other California foundations, the James Irvine Foundation, Sierra Health Foundation, Alliance Healthcare Foundation, San Francisco Foundation, S.H. Cowell Foundation, David and Lucile Packard Foundation, Crail-Johnson Foundation and The California Endowment, [which] provided an additional USD10 million for the implementation of the VPI”. [8]

Management

The founding president of TCWF was Howard A. Kahn who had been founding CEO of the Health Plan of San Mateo. Other TCWF staff had the responsibility of managing the overall Initiative. This included the day-to-day management of grants and managing the delivery of technical assistance to grantees as well as overseeing the planning of the annual conference for grantees and convening the VPI advisory committee.

The advisory committee's role was to provide technical assistance, guidance and advice to TCWF about the goals, strategies and activities of the VPI, with a particular focus on the policy programmes. “The Committee was a strong, well-respected group of individuals representing experts in the field of violence prevention, public health and criminal justice … The diversity of experience and professional backgrounds of the committee members provided a mechanism for staff to keep in touch with the ‘real world' from a variety of perspectives.” [9]

Measurement

An independent evaluation of the VPI was conducted by Stanford University, Rand Corporation, and Johns Hopkins Injury Prevention Center at the midpoint of the programme. “The evaluation was designed to provide timely information to the staff and Board to assist in decisions over changes within the VPI, as well as to measure the effectiveness of the interventions utilized by Grantees … The evaluation was designed to not only determine the effectiveness of each Initiative component, but also to develop an understanding of how the components interacted and reinforced each other ... The evaluation reports from the first five years provided useful data and valuable insights; however, the evaluation failed to adequately capture the ‘stories’ of the VPI and the Grantees.” [10]

Alignment

TCWF provided CAGs for 18 Californian communities. Grants were awarded to community collaborations that included youth most at risk.

There were eight other foundations that assisted TCWF in funding the VPI.

The VPI members built a coalition, ‘Prevention Works!', to fund a statewide coordinated public health approach to violence prevention.

The annual conference for grantees provided an opportunity for grantees to “develop and strengthen skills, share lessons and promote collaboration between and across organizations and components of the Initiative”. [11]

There was good alignment with the state and local authorities, as they shared the goal of wanting to reduce levels of violence among young Californians, especially that which led to homicides.

Bibliography

THE VIOLENCE PREVENTION INITIATIVE: Accomplishments, Challenges and Lessons Learned, Nicole J. Jones. and Sandra J. Martínez, 2003, The California Wellness Foundation

The California Wellness Foundation's Violence Prevention Initiative:

Findings from the Evaluation of the First Five Years, Peter W. Greenwood, Jeffrey Wasserman, Lois Davis, Allan Abrahamse, Peter D. Jacobson, James Chiesa, 31 March 2000, The John F. Kennedy School of Government, Harvard University