Establishing an evidence base for the prevention of youth violence:Evaluation of the Medics Against Violence programme

The importance of violence as public health issue has been highlighted by the WHO in the World Report on Violence and health, which identified violence as a leading cause of death in young people aged 10-29.Furthermore, beyond the extreme outcome of death, violence results in disability and reduced quality of life for many more children and adolescents. Exposure to violence also puts young people at risk of developing chronic conditions such as ischaemic heart disease and engaging in health risk behaviours such as alcohol and drug abuse. The WHO argues that much violence can be prevented using a public health approach.As the onset of serious violence typically begins from 12 and peaks between 16 and 18 early adolescence is an appropriate time to implement violence prevention interventions. Medics Against Violence (MAV), is an example of a primary prevention initiative to tackle violence among Scotland's youth. MAVsessions involve a graphical demonstration of the consequences of violence and discussion of alternatives to violence, delivered to classes of secondary school pupils by healthcare workers. They aim to change attitudes towards violence which mediate translation of aggressive thoughts into violent behaviour. Schools are frequently involved in delivering violence prevention interventions, however, evidence supporting the efficacy of such programmes is often lacking. The WHO therefore argue that systematic evaluation of violence prevention programmes is needed.In order to evaluate the effectiveness of MAV, the independent on-going evaluation utilises a mixedmethods approach. Changes in attitudes towards violence are measured using the Attitudes Towards Violence Scale immediately before and after the session, and at 3-months. This is supplemented with school data on violent offences. Focus groups are then used to explore students? views on youth violence and experiences of the session. Additionally sessions are observed and semi-structured interviews with teachers explore perceived effects on students? behaviour.This paper focuses on the impact of violence on child and adolescent health, the implementation of MAV and how a mixed-methods approach can be utilised in establishing the evidence basis for such primary prevention interventions