SHIFTING THE FOCUS: CHANGING THE WAY GOVERNMENT DOES BUSINESS TO PREVENT VIOLENCE IN CALIFORNIA

Prepared by Prevention Institute, March 2000

Felicity, California has thirteen mentoring programs. At a recent county-wide meeting, agency directors shared the following comments: "I never know who to call at the state -- they just send me from one department to the next." "Just as I finish one grant, another is due with different requirements." "If I could spend more of my time training and recruiting mentors, I could make far more of a difference than by spending so much time making separate arguments to the Department of Education, Alcohol and Drug Prevention, Adolescent Health, the Department of Justice, and all the rest of them." ¹

I. Introduction

Shifting the Focus is a state interagency violence prevention partnership. Its membership, California's state government leaders, representing 22 departments, recognizes that effective violence prevention requires a new way of doing business. This new way of operation will ensure that California communities are well-served through practice at the state level that supports success at the local level.

Over the years, as public concern about violence has grown, numerous projects and independent sources of funding have been established. But, too often, the left hand doesn't know what the right one is doing. The Shifting the Focus group is committed to crafting an integrated approach to the state's violence prevention goals without sacrificing current programs or curbing local initiative.

II. Defining the Problem

Violence is a complex issue that crosses the boundaries between criminal justice, health and human services, and education. Key risk factors for violence include alcohol and other drug abuse, economic inequality, and negative media messages. Similarly, there are key resiliency factors including education, employment, and family support that reduce the potential for violent behavior. Given the scope of such underlying factors, effective violence prevention requires collaboration among multiple disciplines to design comprehensive, multi-faceted initiatives. While some successes at coordination have been seen at the treatment and intervention level (such as multi-service centers), less attention has been paid to interdisciplinary approaches that address violence before it occurs.

Within state government, the responsibility for reducing and preventing violence spans numerous state agencies, departments and programs. Shifting is not the typical government silo approach of narrow, categorical programs that ignores the complex nature of violence. Nor is Shifting a "czar" or consolidation approach that centralizes violence prevention efforts into a single place while ignoring the interrelated nature of violence. Effective violence prevention does not require the mobilization of so-called 'violence prevention' resources, but rather the mobilization of a broad array of activities, staff, and resources across departments. Through its innovative, collaborative, multi-disciplinary framework, Shifting the Focus can thus effect real solutions to the complex problem of violence. To develop meaningful collaboration requires a two-pronged effort -- establishing common ground between the vocabulary, data, and philosophies of different disciplines and overcoming the structural, financial, and sometimes political divisions between government sectors. Furthermore, an important challenge of state-level collaboration is the ability to translate this new model of partnering into a system that also works at the local level.

Shifting the Focus addresses the barriers to collaboration by developing strategies to expand partnerships. This effort aims to reengineer state government away from isolated efforts to a broader emphasis on serving communities. Such a methodology is critical because California's violence prevention efforts are far too many and too fragmented for the left hand of government to know what the right hand is doing, unless there is a system purposively designed to manage the collaboration process.

Government and community leaders need concrete tools and ongoing forums to learn how to think and act collaboratively across disciplines to implement this paradigm shift. Shifting the Focus has identified a strategy to change the way that state government addresses violence prevention.

III. History and Current Status of Shifting the Focus

Shifting the Focus grew out of "The Advanced Training for Violence Prevention Practitioners," a training series conducted by Deborah Prothrow-Stith of the Harvard School of Public Health and Larry Cohen of Prevention Institute. The series, held in 1996, reaffirmed for key California representatives of justice, health, and education, the necessity of working in an interdisciplinary mode to address the multiple risk factors that lead to violence.

In recognition that government structures tended to reinforce singular, rather than collaborative approaches, a two-day forum, Shifting the Focus: An Interdisciplinary Violence Prevention Approach for California,² was held in March 1997. Facilitated by Prothrow-Stith and Cohen, the symposium brought together leaders from the State of California Department of Education, the Attorney General's Office, and the Department of Health Services (including women's health, mental health, and alcohol and drug abuse). Community-based violence prevention practitioners were included in the forum to ensure that state formulated solutions would also reflect the needs of people working at the local level. The participants agreed that a coordinated, collaborative approach would constitute a more effective strategy, ultimately improving local violence prevention efforts as well as state programs. Not only would programs benefit from each other's expertise, but also they could reduce duplication and avoid re-inventing the wheel, and they could share data resources and "best practices" information. The Shifting the Focus conference clarified how governmental agencies and organizations with different mandates and perspectives could work together more effectively. From the conference a methodology for collaboration emerged and was published in the paper, Shifting the Focus: An Interdisciplinary Framework for Advancing Violence Prevention.

Since this conference a group of state leaders has continued to meet and develop additional strategies for fostering interdisciplinary partnerships on the state and local levels. Many of the original participants continue to meet on an ad hoc basis as members of the Shifting the Focus group. Furthermore, members have incorporated a Shifting the Focus methodology into their work in a number of ways. For example:

• RFP approaches have been shared by departments,
• Departments have encouraged localities to use interdisciplinary data, and
• Training (formerly single-discipline in scope and participation) is now multidisciplinary in nature and training invitations go out to teams representing a variety of departments.

Currently, Shifting the Focus is experiencing a tremendous increase in membership and a renewed enthusiasm from department leaders who have expressed their commitment to this effort. Since January 1999, the number of active members has blossomed from a committed core of ten to a group of 50 leaders representing 22 state agencies and departments. Since June 1999, this interdisciplinary group has met regularly to analyze what is required to maximize the efforts of state programs and funding so that communities can better prevent violence and establish safe and healthy environments. At a meeting in February 2000, the Shifting the Focus group prioritized four particular areas for immediate action and delineated related activities and outcomes. These are described below under "Interagency Activities." Moreover, Shifting the Focus has attracted national and international interest -- it was a topic at the Surgeon General's "Healthy People 2010" conference, as well as the 5th World Conference on Injury Prevention and Control in New Delhi, India. Additionally, the methodology was adopted by Hawaii's Violence Prevention Coalition, which invited Prevention Institute to train its members on the Shifting the Focus approach.

Recently there have been several pieces of legislation grappling with the best way to structure violence prevention in California. One such bill, introduced by Senator Hayden on February 25, 2000 (SB 2097), was modeled intentionally after the Shifting the Focus methodology and concepts.

IV. Vision, Objectives and Activities

VISION

Shifting the Focus is a strategy that supports state interagency violence prevention partnerships. These partnerships are designed to foster safe, healthy, sustainable communities for individuals, families, and children. Shifting the Focus will transform the ways in which government does business in order to ensure that California communities are well served through practice at the state level that is modeled after success at the local level.

OBJECTIVES

Ultimately the goal of Shifting the Focus is to facilitate the state's violence prevention efforts to significantly reduce the incidence of violence over time and to build community infrastructure to help preserve these improvements. This is clearly a goal that will take time. Based upon state-of-the art knowledge in the field of violence prevention, rates of violence appear to be most significantly impacted by sustained interdisciplinary and multi-faceted efforts. Therefore, success can be gauged in the short-term by monitoring the success of activities that aim to improve the comprehensiveness and interdisciplinary coordination of such efforts.

To determine the impact of any initiative resulting from improved collaboration, it is essential to measure and track a variety of both qualitative and quantitative indicators. This is also critical for determining what improvements are needed in program content as well as methodology.

Shifting the Focus Success Indicators:

• Increase Collaboration: Develop new collaborative efforts and initiatives within state government, strengthen existing relationships
• Focus on Primary Prevention: Increase primary prevention initiatives utilizing a multifaceted range of activities and strategies
• Reduce Duplication: Assess overlap and redundancy, develop mechanisms for sharing information to avoid duplication and re-invention (e.g. Website)
• Improve Access to Information: Consolidate information, share data and adopt uniform standards for collection and reporting
• Formalize the Transition Process: Identify persons in each state agency to coordinate and implement the Shifting the Focus agenda
• Build Capacity for Collaboration: Provide interdisciplinary trainings and resources for staff
• Develop Program-specific Collaboration Goals: Produce specific program outcomes from subcommittees -- e.g witnessing violence, mentoring to increase and improve collaboration
• Develop Local to State Evaluation: Create mechanisms for community grantees to evaluate improvement in their work with state violence prevention funding, data, etc. as the state reaches new levels of collaboration

INTERAGENCY ACTIVITIES

In February 2000, the Shifting the Focus group prioritized four areas for immediate action, as mentioned above. The group is firmly committed to these topics as they hold promise for swift and significant reform. Of these areas, two are structural (inventory and data) and two are topical or programmatic (mentoring and early detection). All represent the need for coordination at the state level to benefit local communities.

1. Inventory existing violence prevention programs. An inventory will give a clear picture of the current status of violence prevention in the state. The group has identified steps for collecting and centralizing program information and proposes distributing the information at a web site. The inventory report and establishment of a web site would effectively move local and state efforts to a higher level. Making program profiles and data accessible will help to: stimulate information sharing, reduce duplication, avoid re-inventing the wheel, and identify gaps in services and funding.

2. Review the role of data and barriers to use in violence prevention. Accurate and appropriate data are essential for designing programs and assessing their success or failure. It is also important that more state agencies define the questions that must be answered by data, determine the minimum amount of data needed to answer those questions, and strategize an interdisciplinary data collection mechanism. Communities should be less burdened by current data reporting requirements. Also, given the cross-disciplinary nature of violence prevention, there is a need to bridge departmental differences in data collection and reporting, as well as a need to develop language and protocols for topics related to gender, ethnicity and confidentiality. Establishing some areas of correspondence or consistency across state agencies and departments will enhance the state's ability to communicate internally as well as with communities. More uniform standards for evaluating and reporting are likely to require less administrative time from local programs and services.

3. Preserve mentoring initiatives, while promoting state standards and definitions. A groundswell of mentoring opportunities and programs has sprung up in every city and town in the state. While the concept represents a positive way to combine volunteer spirit with the various needs of today's youth, mentoring programs come in all shapes and sizes and may not always measure up as "violence prevention" programs. Again, as a crosscutting issue, mentoring would benefit from a set of standards and terms that are consistent between departments. The group proposes to: inventory mentor programs, identify evaluation tools, establish outcome and measurement standards, and promote the model of the California Mentoring Initiative.

4. Define primary prevention and early detection of risk factors. The early detection of risk factors is an important element of preventing future violence. To provide more helpful guidelines for programs, knowledge about early detection needs to be synthesized and new assessment tools developed. While early detection is important, it is critical that early intervention follows. Effective early intervention requires interagency coordination and communication to ensure the range of appropriate services are reaching those who need it -- in families, schools, communities, and workplaces. Ultimately, service providers and caregivers will need to be trained to recognize the early signs and how to establish and maintain an interagency response.

In addition to the action areas delineated above, Shifting the Focus members have also committed to pursuing the following activities with the goal of enhancing interagency collaboration more broadly throughout state departments and agencies.

5. Develop and provide trainings. Assess the need for and conduct appropriate forums and training sessions that will remove barriers to collaboration across disciplines and departments. Develop such trainings on effective collaboration for both the state and local government agencies. It is important to train interdisciplinary teams and include working sessions to identify innovative solutions and how to pool funds and resources to implement these solutions.

6. Develop an interagency collaboration briefing package for members to help them institutionalize the methodology of collaboration throughout each agency.

7. Synthesize all commission reports related to violence prevention in California in order to identify and synthesize existing violence prevention recommendations. Future efforts within the state can build on these recommendations and successes while eliminating duplication of effort. Develop a web site and presence as a repository of such reports and link to other relevant sources of information.

8. Hold hearings between Shifting the Focus members and communities in order to delineate key areas in which efforts at the state can support and enhance violence prevention efforts in communities throughout California.

V. Conclusion

Shifting the Focus is poised to fundamentally change the way in which state government operates in order to maximize violence prevention outcomes at the local level by supporting locally-owned, locally-controlled efforts. The overall goal of the strategy is simply to improve the way government conducts business related to violence prevention. The ultimate result of Shifting the Focus will be safer and healthier California communities.

Footnotes

¹ While Felicity, California is a fictional locale, these comments are indicative of the types of issues that communities face in implementing violence prevention programs that are monitored or funded by state agencies and departments.

² Shifting the Focus: An Interdisciplinary Violence Prevention Approach for California was 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 grant in support of health and health-related activities in 26 northern California counties, and the Max Factor Family Foundation in Los Angeles.

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