Harvard T.H. Chan
School of Public Health
Public Health Approach to the Evaluation of Violent Extremism Prevention Programs in the Greater Boston Area
Leesa Lin, MSPH Senior Program Manager
Emergency Preparedness Research, Evaluation and Practice (EPREP) Center Division of Policy Translation and Leadership Development
Harvard T.H. Chan School of Public Health
September 8th, 2016 National Academies of Sciences, Engineering, and Medicine
Washington, DC
Harvard T.H. Chan
School of Public Health
• ELENA SAVOIA, MD MPH / Project Director
• LEESA LIN, MSPH / Senior Program Manager
• SOULEYMANE KONATE, PHD / Research Fellow
• NOAH KLEIN / Program Coordinator
• JESSICA STERN, PHD / Project Expert
• RICHARD SERINO / Project Expert
• MARCIA A. TESTA, PHD, MPH / Co-investigator
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http://www.hsph.harvard.edu/preparedness/
Our team DHS Project Title: Evaluation of the Greater Boston Countering Violent Extremism Pilot Program
Harvard T.H. Chan
School of Public Health
This project was funded by the U.S. Department of Homeland Security (DHS), Science & Technology Directorate, Resilient Systems Division
(Cooperative Agreement Number: 2015-ST-108-FRG005 Evaluation of the Greater Boston Countering Violent Extremism Pilot Program).
The content of this presentation as well as the views and discussions expressed in this presentation are solely those of the authors and do not
necessarily represent the views of any partner organizations, the DHS nor does mention of trade names, commercial practices, or organizations imply
endorsement by the U.S. Government.
Acknowledgement
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School of Public Health
What’s up in Boston?
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School of Public Health
Aug, 2011- White House -
National Strategy
on Empowering Local
Partners to Prevent
Violent Extremism
Dec, 2011- White House -
Strategic Implementatio
n Plan (SIP)
March, 2014 – NSC - Boston
chosen to be a pilot region.
Feb, 2015 –
USAO-MA - A Framework for Prevention and Intervention
Strategies: Incorporating Violent Extremism into
Violence Prevention Efforts
&
The White House Summit
March, 2016 – MA EOHHS – Request for Information
(RFI)
Aug, 2016 – MA EOHHS – Request for
Proposal (RFP): “PEACE” Project
Oct, 2015 – DHS-Harvard
EPREP
May, 2016 – Boston
Stakeholders Meeting
Formative Evaluation
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School of Public Health
Define the Problem
Identify Risk and Protective Factors
Develop and Test Prevention Strategies
Assure Widespread Adoption
Source: Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control, Division of Violence Prevention
CDC’s 4 Key Steps in Implementing a Public Health Approach to Violence Prevention
reliable data: “who”, “what”, “when”, and “how”
Additional evaluation, training and/or technical
assistance
scientific research methods: what factors protect people
or put them at risk
evaluation
Harvard T.H. Chan
School of Public Health
Snow Ball
20 IN THE
FRAMEWORK
32
OUTSIDE THE FRAMEWORK
>24 HOURS
APPROX 2000 STATEMENTS
Who was interviewed?
Community-based
Organizations
40%
Government agencies
(including law
enforcement and schools)
24%
*Healthcare and
Mental/Behavior Health
16%
*Academia 20%
No. of Agencies Interviewed (n=45)
*Not mutually exclusive
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School of Public Health
• Name and Scope: Controversial history associated with “CVE”; lack of support for violence prevention initiatives which are narrow in scope
• Definition of Outcome: Lack of clear definition for “VE” • Violent extremists defined as “individuals who support or commit
ideologically motivated violence to further political goals.”
- National Strategy on Empowering Local Partners to Prevent Violent Extremism, 2011
• Evidence: Limited evidence on the risk factors for VE
Review of Literature and Stakeholders’ Feedback: Challenges
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School of Public Health
Industry of Violence
Primary
Prevention
Secondary
Prevention Tertiary
Prevention
No violent
behavior
Onset
of the precursors
of the violent
behavior
Act of Violence
Re-engagement in
Violent activities after
arrest
Primordial
Prevention
Quaternary
prevention
People potentially exposed to the risk and/or protective
factors: prevent personal exposure to risk factors and/or increase
protective factors
System: address broad
health determinants
Screening: detect and treat in early stages
Levels of Prevention in Public Health
Prevent progression and rehabilitation: reduce the risk of subsequent events, treat and rehabilitate persons as well as facilitate a return to (close to) normal
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“A screening program is only as good as the predictive ability
of the risk factors that the population screened is based upon.”
- Dr. Marcia Testa, Department of Biostatistics,
Harvard T.H. Chan School of Public Health
Harvard T.H. Chan
School of Public Health
False Positives
3,229,900
Image by Resnick B & Zarracina J via Vox
2016 US Population = 323m
10,000 VE in the U.S. and a powerful test
“How likely is it that this person is truly a Violent Extremist given that the test result is POSITIVE?”
= 0.003056 (0.3056%)!!
Screening Test
(person) (person)
VE
10,000 Non-VE
322,990,000
Positive Predictive Value (PPV)
= True Positives
True Positives + False Positives
True
Positives
9,900 False
Negatives
100
9,900
9,900 + 3,229,900
True Negatives
319,760,100
(Sensitivity: 99%) (Specificity: 99%)
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Theory of Change
Foster civic engagement and cultural awareness
Improve human conditions and reach
human potential
Build trust and earn
social support
• Listen and validate the opinions of stakeholders • Prevent profiling • Expand community policing
• Encourage civic conversation and open forums • Increase diversity in the “system”
and improve cultural sensitivity •Develop counter-narratives
• Invest in school systems and education initiatives • Expand youth programs and services •Address housing issues and nurture healthy and safe
neighborhoods
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School of Public Health
• Goals: - To prevent Violence, and help to prevent people from joining organizations
that promote, plan or engage in “Violence”
- To promote resilience by strengthening protective factors
• MA EOHHS is listening and validating stakeholders’ feedback! - Focus on primary prevention
- Keep away the concerning concepts: CVE, radicalization, ideology, risk factors
- Define “Violence” and “Violence Extremism” as:
MA EOHHS Promoting Engagement, Acceptance and Community Empowerment (PEACE) Project
An act that violates state or federal law and causes physical harm to a person, or property
Motivated by Hate
Intention of Domestic Terrorism
and and/or
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Leesa Lin, MSPH o: 617.384.9872 Email: [email protected]
Thank you!