Background: Communities across the United States are using street outreach workers (SWs) to prevent violence. SW programs are generally recognized as a promising model, particularly in light of a 2008 evaluation that demonstrated positive impacts associated with one well-known program. The United Teen Equality Center (UTEC) includes an SW program.
Objectives: Through this paper we aim to (1) document the work of the UTEC SWs, (2) describe UTEC's approach to training SWs and managing the program, and (3) understand interviewees' perspectives (including UTEC managers, SWs and partners) on how the SWs impact youth violence in Lowell.
Methods: We designed a single-site observational study using qualitative methods to address our study aims. We collected data from in-person, semistructured interviews with the two UTEC SW program managers, the six SWs employed during the study period, and 17 representatives from partner agencies.
Results: UTEC SWs outreach to youth, respond to crises in the lives of youth as opportunity, work to facilitate access to resources for youth, and engage in intensive follow-up with youth when needed. These findings are consistent with UTEC's pyramid model of SW outreach. The program emphasizes peacemaking (not only preventing violence) and partnerships as priorities. SWs participate in structured training, receive a comprehensive benefits package, and have opportunities for professional development.
Conclusion: Several aspects of UTEC's program may be useful for other SW programs: Involve youth in hiring SWs, invest in SW training, incorporate peacemaking strategies into outreach, and partner with agencies that also serve youth.
Outreach worker, qualitative methods, training, management, advocacy, youth development
Across the United States, community-wide violence prevention programs are utilizing SWs—members of the community who work with violence-involved individuals to intervene and prevent conflict and retaliation.1–3 Outreach activities include establishing relationships with members of a target population, connecting clients with services, maintaining supportive relationships, and follow-up.4 Prior research suggests that SWs are an integral and effective component of public health prevention programs, especially for injecting drug users and homeless mentally ill individuals.4–7 Research also suggests that community health workers, considered outreach workers, effectively deliver community-based preventive programs.8
The federal government supports the use of SWs as one strategy to engage gang-involved youth.1 SWs are integral to the comprehensive gang model (CGM), designed to be a comprehensive [End Page 171] approach for gang prevention, intervention, and suppression. The SWs reach out to youth in gangs or at risk for gang membership, and connect them with opportunities such as education and job training.1 Evaluation of the CGM in Bloomington–Normal, Illinois, highlighted the importance of hiring SWs with strong connections to the target community, and identified challenges with collaboration between SWs and local police.9 The CGM encourages hiring SWs who will be credible with the target population, including former gang members, and notes the importance of extensive professional development.
The CeaseFire-Chicago program expanded SWs' role beyond outreach and connection to services to include direct mediation of street conflicts. The program uses violence interrupters to intervene in conflicts and SWs who provide resources and social support as individuals transition away from violent lifestyles. Much of what is known about SWs in relation to violence prevention is from a 2008 evaluation of CeaseFire-Chicago.2 The evaluation demonstrated the program's effect on reducing shootings and also revealed ongoing challenges, including staff turnover and inadequate continuing training. This finding points to a need to understand how similar SW models handle these complex issues. In addition, as a large city, generalizability of the findings from Chicago to smaller communities is limited.
The UTEC, in Lowell, Massachusetts, opened in 1999 after a 2-year organizing movement of young people who sought to develop their own center in response to local gang violence. The theoretical underpinning of UTEC is a youth development model that emphasizes a holistic, that is, comprehensive, approach to engaging young people. Four interrelated centers comprise the programming infrastructure of UTEC: Street Worker, Youth Development (cultural arts and workforce development), The Open School (GED and an alternative school), and Youth Organizing. Ultimately, UTEC provides a pathway from peacemaking to political action for older youth most often overlooked and considered disengaged.
The UTEC approach to SW outreach is reflected in the pyramid model (Figure 1) developed by UTEC. Intensive follow-up is central to this model, which occurs via telephone calls, home visits, and contacts with members of the youth's social supports. Outreach, access to resources, and using crisis as an opportunity for positive change, are the other components that comprise the UTEC model. Under this approach, SWs are involved with every component of the model. Unlike CeaseFire-Chicago, the same SW engages in outreach, access to resources, crisis intervention (which includes conflict mediation), and intensive follow-up.
To achieve a greater understanding of UTEC's SW program, and to address the gaps in the literature previously [End Page 172] discussed, this paper presents findings from in-depth, semistructured individual and group interviews with the United Teen Equality Center (UTEC) managers who oversee the SW program, the UTEC SWs, and representatives from select partner organizations in Lowell. These results are part of a larger evaluation of the SW program. In this paper, we focus on the processes involved with fielding and managing the SW program and stakeholders' perceptions of the SW program. The aims of this paper are to document the work of the SWs, describe UTEC's approach to training SWs and managing the program, and understand interviewees' perspectives on how SWs affect youth violence in Lowell.
We designed a single-site, observational study using qualitative methods to address our study aims. We focused on descriptive aims as a way to inform the scant literature about SW interventions to prevent youth violence. Qualitative methods are particularly well-suited to capturing the perceptions of people who are knowledgeable about a topic that is only beginning to be understood.10
Lowell, Massachusetts, is a small, industrial city (2000 population: 105,167)11 north of Boston, with a diverse and changing population. Lowell's Asian community comprised 17% of the city's population in 2000, an increase from 10% a decade before.12 Many Asian residents trace their origins to the South East Asian countries of Laos, Cambodia, and Vietnam. Lowell's Hispanic and black populations are smaller (14% and 4%, respectively).11 In contrast, about 85% of Massachusetts's population is white.13 Lowell residents are generally poorer and younger than those of the Commonwealth; about 17% of Lowell residents are below the poverty line (compared with 9% of Massachusetts residents) and nearly 20% of the population in Lowell is 15 to 24 years old, whereas 13% of Commonwealth residents fall within this age range. The rate of violent crime in Lowell is twice that of Massachusetts.14 With an estimated 19 active street gangs and 650 to 750 individual members,15 gang-related violence is a significant contributor to violence in Lowell.
We conducted semistructured, in-person interviews with the two UTEC staff (co-authors on this paper) who train and manage the SWs, and with all six SWs employed during data collection to understand SW training, activities, and the skills and knowledge that are important to their work. We interviewed the UTEC staff individually with the exception of two SWs who we interviewed together because of scheduling constraints. SWs were provided a $20 gift certificate to thank them for their time. We also interviewed 17 representatives from five partner organizations who work with the SWs. We included partners at the recommendation of our UTEC collaborators who view partnership as a critical mechanism for connecting youth with needed resources. UTEC staff identified key partners of the SW program (school administrators, police department representatives, court personnel, city manager, and a representative from a nonprofit agency) and arranged for the interviews. To facilitate scheduling these interviews, we conducted group interviews with three partners that included 2, 3, and 10 participants. We interviewed the remaining two partner representatives individually. We conducted the interviews during four visits to Lowell between July 2007 and March 2009. (Additional site visits were made during this period, but for other research-related purposes.) Two co-authors (SF and KP) conducted all of the interviews either together or individually based on scheduling.
We developed interview guides that included questions about interviewees' backgrounds and professional experiences, the SW program and its impact, and violence in Lowell. With interviewees' permission we recorded the interviews. We also collected documents that could inform our understanding of the SW program, including informational materials about UTEC, reports to funders, and relevant media coverage.
A transcription service transcribed the interviews and the research staff validated the transcripts against the recordings. We then uploaded the transcribed files into NVivo8, a qualitative data software package.16 We reviewed the transcripts multiple times, and developed data summary forms17 for each transcript. These forms included information about interviewees' backgrounds and the key points pertaining to the study aims and the SW model. We combined these summary points across the interviews for each aim to identify the consistent, salient points conveyed by interviewees. We also captured [End Page 173] illustrative quotes from the interviews on these forms. We reviewed (but did not code) the documents we collected and referenced them to clarify details about the SW program, as needed.
Community-Based Participatory Research Approach
Our research–program collaboration began when staff at a foundation that supported UTEC expressed interest in funding an evaluation of the SW program. Before drafting the proposal that ultimately funded the evaluation, we met with the UTEC Executive Director to discuss his interest in an evaluation. We shared an early draft of the proposal with UTEC leadership and discussed their feedback on a conference call. Several less formal communications took place via e-mail and short phone calls before submitting the final proposal.
The research team conducted the interviews, managed the data, and led the analysis. Throughout these processes, the research team and the UTEC staff discussed the data and the implications of the findings via e-mail, phone conversations, and during site visits. These communications were both scheduled and spontaneous, reflecting the close working relationship that had developed between our two groups. These communications served to clarify details about the SW program, provide additional information about UTEC's approach to training and management, and add anecdotes and context. Finally, our collaborative partnership also informs the dissemination of study findings.
The Johns Hopkins Bloomberg School of Public Health Institutional Review Board approved this research.
Aim 1: Overview of the UTEC Streetworker Program
Our data revealed an SW program consistent with the pyramid model that UTEC developed. UTEC SWs outreach to youth is designed to "meet youth where they are," intervene directly to prevent or mitigate violence (crisis as opportunity), and serve their clients through a personalized approach tailored to individual youth's needs. During street outreach SWs invite youth to participate in UTEC programs (e.g., dance workshops, poetry readings, job training, and recreation activities—access to resources) and begin a dialogue that may lead to a more formal relationship with an SW (intensive follow-up). SWs' time on the street also increases their visibility in the community (they wear bright orange shirts and jackets, and visibly display their identification badges) and creates opportunities to interact with youth informally.
Outreach. Their street presence places SWs in the daily routines of Lowell youth. SWs spend their time in places where youth are, striking up conversations with youth they do not know and reconnecting with youth they have met before or are working with. SWs describe this outreach as a way to connect with youth and raise awareness about UTEC services.
Spending their time with youth gives SWs access to information about when disagreements may be escalating, when situations turn violent, and where violence is occurring. The SWs seek out areas where violence may occur (e.g., outside Lowell High School at the end of the school day, when almost 4,000 students leave). SWs are trained on how to intervene in fights and volatile situations. Depending on the situation, intervention may involve verbal negotiations, de-escalation strategies, physically stopping fights, and/or calling the police to restore order.
Crisis as Opportunity. Fundamental to UTEC's SW model is the idea that a crisis for a youth can be an opportunity for positive development and growth. Although a crisis may take many forms (homelessness, pregnancy, school suspension) this feature of the program is illustrated well in the use of peacemaking when an SW has a connection with a youth who is involved in escalating gang violence. The peacemaking process begins with identifying and engaging gang leaders. A peace circle follows, whereby members of the same gang dialogue with SWs and other UTEC staff about the peacemaking process. Additional relationship building between the youth and SWs and staff occurs through a peace trip where SWs and staff seek to understand the rivalry underlying the threat of violence. The peacemaking process concludes with a peace summit that brings together disputing gangs for a weekend retreat. Rival gang members work together, come to know one another, and negotiate and agree to a peace contract.18
Intensive Follow-Up. The SWs spend much of their time working with individual youth. Most youth clients need several types of resources, have few options for social support, and/or are facing other significant social challenges. At the time of data collection, UTEC estimated that each SW was serving between 25 and 30 teens. (UTEC serves approximately 1,900 [End Page 174] youth annually through all of their programs and outreach.) The SWs' relationships with youth vary depending on youth's needs. SWs are flexible to accommodate both intense relationships (e.g., youth in crisis who require multiple services) and relationships that require brief, episodic attention (e.g., youth looking for summer employment). SWs provide a range of services and support to youth as illustrated in
Access to Resources. The SWs and managers described the SWs role within the Lowell community, and the importance of their relationships with city agencies, other community-based organizations, and businesses. These relationships facilitate SWs' ability to connect youth with needed resources and advocate in their best interest. Through partnerships with public and private service agencies, SWs know the people and agencies that youth need. Partnerships with resource providers can facilitate access and help problem solve when youth are in trouble. In the words of one criminal justice representative,
I have worked with the SWs for a long, long time. I never give my cell phone number to anybody, but they all have mine and I have theirs. And I talk with them quite often. Recently [we've been talking] about a kid … that I can't find that they can get in touch with for me—not as a witness, but as a client that I'm worried about.
These partnerships often need to be navigated delicately. The SWs work hard to gain the trust of the youth they work with, and their effectiveness in outreach rests on their reputation. The SWs are sensitive to the threat of being perceived as "snitches," and they are careful not to associate too closely with front line officers. As described by one UTEC manager,
If we get labeled as a snitch, … there's no way that we are going to be able to gain that trust [of youth]. So what we've come up with is the higher officers and myself are the ones who really do the talking.
The relationship between the UTEC SWs and the police is one that both parties describe as respectful and mutually beneficial. They emphasize the importance of understanding the complementary roles of each in reducing youth violence in Lowell.
Aim 2: The Streetworkers: Recruitment and Training
The SWs are a diverse group demographically (
Once hired, SWs participate in a structured training program that involves didactic instruction and role playing (
Part of the process of training new SWs and transitioning them into the program is identifying a particular role for them within the team. Each of the SWs has a specialty area, as defined by the program: Homelessness, community service, health, and gangs. These specialty areas influence, but do not dictate, the youth–SW match. For example, an SW who specializes in gangs is more likely to be known by gang-involved youth and more likely connect though their outreach with youth who are gang involved than an SW who focuses on homeless youth. Because SW relationships with youth are intimate and candid, there are times when youth connect better with SWs whose expertise may not match with their most immediate needs.
The UTEC managers we interviewed value the training, and also highlight the strategies they use to create and nurture the sense of family that the SWs described as so valuable to group morale. We heard how the camaraderie and support within the SW team results from consideration of the team dynamics during hiring, and attention to SWs' quality of life. For example, SWs' benefits include a monthly paid wellness day, 3 weeks of vacation, 3 personal days, and 10 sick days. Biannual SW retreats provide an opportunity for the SW team to leave the intensity of their responsibilities in Lowell and devote uninterrupted time to professional development or program planning in a relaxed setting. Weekly SW meetings are another strategy for institutionalizing SW support. Quarterly UTEC staff retreats provide a mechanism for the SWs to stay integrated with the UTEC staff, and participate in planning for the organization. Importantly, the UTEC managers who oversee the Program are former SWs, providing them with understanding and insight into how they can best support the SW team.
These strategies are noteworthy, particularly in light of the low turnover that exists among UTEC SWs. At the time of our interviews, the least experienced SW had been on the job for 11 months; everyone else counted his or her time in years (
Having people from the community helps keep turnover low. … You have to really institutionalize how you hire new staff, train and retain people. We expect a lot … but you get a lot in return.
[End Page 176]
Aim 3: Streetworker and Youth Violence Prevention: Stakeholders' Perspectives
We asked every interviewee to share with us how they think the SWs affect youth violence in Lowell. The responses included direct explanations, such as when SWs physically stop a fight and when they are able to talk people out of fighting. The SWs qualified these explanations with the knowledge that although not all outcomes occurring after their intervention may be known to them, their presence offers a unique opportunity to encourage dialogue between disputing parties and a way to maintain contact with rivals. SWs use peacemaking tools to engage them in a process of resolving their conflict and committing to nonviolence.
Interviewees also view the regular presence of the SWs on the streets in their bright orange shirts as a deterrent to violence. Knowing the SWs will intervene may cause some youth to think differently about how they react to a situation.
Interviewees described the SWs' work with their clients as a form of violence prevention. By creating opportunities for youth to advance their education, gain skills, find employment, participate in community organizing, or engage in recreation options, SWs are creating viable alternatives to violence. One city leader saw these efforts as a way to "create space" for youth, allowing them, in the words of a court official to "be a more important part of the fabric of the community." Through our interviews, we came to understand the SW program, and the relationships and services that result as a process that works to provide youth with the resources and support that help youth make a healthy and safe transition to adulthood.
As communities around the country continue to struggle with how to address youth violence, the findings from this study offer several important contributions to the current literature. Despite the fact that core components of the CGM and CeaseFire-Chicago model have been replicated in cities across the United States, we were unable to identify any publication in the peer-reviewed literature that describes these programs or evaluates their implementation or impact. The recently published CeaseFire-Chicago evaluation is a fine example of the value of such efforts, but to our knowledge, [End Page 177] it stands alone and has yet to appear in journal format. This paper begins to address that gap in the literature by examining the UTEC program (which, like CeaseFire-Chicago uses SWs, connects youth with resources, and intervenes to stop violence) from the perspectives of stakeholders; documenting how the program works and how it is managed and how SWs are trained; and presenting community-based perspectives on how the SWs may affect youth violence. As future studies aim to compare the impact of different SW programs, this study presents insight into the complexity of these processes and the ways SW programs may differ. Such differences should be understood and considered in any comparative research.
UTEC's model uses outreach as the starting point for intervention. Although the UTEC SW approaches youth with a similar skill set,2,9 offering similar services2 as other SW programs to prevent violence, the UTEC SW is responsible for both resources and conflict mediation (which is unlike the CeaseFire-Chicago model). Although many of the components of outreach in the UTEC model are similar to the SW programs that have demonstrated impact, the method of delivering the intervention is somewhat different. Which approach results in lower rates of violence is a question for future research.
The UTEC SW model includes access to resources. UTEC managers, SWs, and their partners shared examples of how connecting youth with services or working collaboratively addressed concrete needs for their youth clients. They perceive such assistance as important to creating alternatives to violence. These perceptions are consistent with program components of similar, evaluated models associated with reductions in violence.2,9 Efforts to mediate violent interactions may rely on connecting youth with specific resources or assistance with getting out of a gang. Obtaining a better understanding of what these resources are and the level of intensity with which they are delivered will help to illuminate the pathway through which SWs may affect reductions in violence, allowing for more targeted and valid evaluations.
Crisis as opportunity is also part of CeaseFire-Chicago insofar as violence interrupters serve to link youth with outreach workers on their team who facilitate access to services. In the UTEC model, crisis may take many forms. The peacemaking process that may be triggered in response to gang violence (or the threat of gang violence) is one that we believe is unique in the extent to which it is articulated as a process with defined steps. The UTEC team has invested in peacemaking because they believe it has helped to reduce conflict among some gangs that participated in this process. UTEC's peacemaking process is ripe for evaluation.
As with any research, this study has certain limitations. This research was not designed to be generalizable to other communities. Our purpose was to create a written record of the UTEC SW program that can be used to enhance existing programs and to create new programs. Thus, we focused on one SW program in a single city and systematically collected and analyzed information from individuals who have experience with a long-standing SW program.
Some readers may be critical of our decision to rely on the subjective perspectives of individuals. However, in considering how best to document the work of the SWs and UTEC's approach to training and management, we deem individuals' opinions to be a valid source. UTEC has been employing SWs since 1999. This is an organization and a city that has experience with this model, which is similar to the CeaseFire-Chicago model that was recently shown to reduce violence.2 Our interviewees' experience provides perspectives that can inform the larger understanding of SWs' role in youth violence prevention.
We view these findings as relevant to UTEC, other SW programs that aim to prevent youth violence, and to communities that are considering an SW approach to prevent youth violence. We note the following features of UTEC's SW program that may be particularly useful for replication efforts.
• Involve youth in the process of hiring SWs. This role that UTEC provides for youth involvement in hiring is perceived as valuable for identifying effective SWs.
• Invest in quality SW training. According to our interviewees, street outreach requires skill and knowledge that can be learned and refined over time. Equipping SWs with those skills before they enter the field, and providing opportunities to improve over time represents a sound investment.
• Provide SWs with benefits. UTEC's method of supporting SWs with a benefits package and team retreats may be worth incorporating into other outreach programs as a [End Page 178] way to prevent staff turnover and burnout.
• Peacemaking is a logical complement to violence prevention. Incorporating a structured peacemaking process into the SW approach is a defining and valued characteristic of UTEC's approach to youth violence prevention.
• Community partnerships should be a priority. The emphasis on community partnerships is perceived to facilitate SWs' ability to connect youth with resources and advocate effectively on their behalf.
UTEC's SW program is well-regarded by the SWs who do the work, the managers who oversee the program, and their partners. Each of the representatives from the partner organizations we interviewed shared the view that their efforts to improve Lowell, and the lives of youth, were enhanced by the work of the UTEC SWs. As described by our interview sample, the impact of the SW program extends beyond that of the individual youth served by the SWs and into Lowell and neighboring areas.