Department of Community Health, Atrium Health, Charlotte, North Carolina (Dr Mayfield); Department of Psychological Sciences, University of North Carolina Charlotte, Charlotte, North Carolina (Ms Siegal and Dr Langhinrichsen-Rohling); Department of Social Work, Johnson C. Smith University, Charlotte, North Carolina (Dr Herring); Office of Violence Prevention, Mecklenburg County Public Health, Charlotte, North Carolina (Ms Campbell); and Mecklenburg County Criminal Justice Services, Charlotte, North Carolina (Dr Clark).
J Public Health Manag Pract. 2022;28(Suppl 1):S43-S53. doi: 10.1097/PHH.0000000000001426.
Community violence is a public health problem that erodes social infrastructure. Structural racism contributes to the disparate concentration of violence in communities of color. In Mecklenburg County, North Carolina, increasing trends in community violence show racial and geographic disparities that emphasize the need for cross-sector, data-driven approaches to program and policy change. Cross-sector collaborations are challenged by data sharing barriers that hinder implementation.
In response to community advocacy, Mecklenburg County Public Health (MCPH) launched a Community Violence Prevention Plan with evidence-based programming. The Cure Violence (CV) model, a public health approach to disrupting violence through equitable resource provision, network building, and changing norms, was implemented at the community level. The Health Alliance for Violence Intervention (HAVI) model, a hospital-based screening and case management intervention for victims of violence, was implemented at Carolinas Medical Center in Charlotte, the region's only level I trauma center.
A data collaborative was created to optimize evaluation of CV and HAVI programs including MCPH, the city of Charlotte, Atrium Health, Charlotte-Mecklenburg Schools, Johnson C. Smith University, and the University of North Carolina Charlotte. A comprehensive approach to facilitate data sharing was designed with a focus on engaging stakeholders and generating solutions to commonly reported barriers. Structured interviews were used to inform a solution-focused strategy.
Stakeholders reported perceptions of their organization's barriers and facilitators to cross-sector data sharing. Common technology, legal, and governance barriers were addressed through partnership with a local integrated data system. Solutions for trust and motivational challenges were built into ongoing collaborative processes.
Data silos inhibit the understanding of complex public health issues such as community violence, along with the design and evaluation of collective impact efforts. This approach can be replicated and scaled to support cross-sector collaborations seeking to influence social and health inequities stemming from structural racism.
社区暴力是一种破坏社会基础设施的公共卫生问题。结构性种族主义导致暴力在有色人种社区的集中程度存在差异。在北卡罗来纳州的梅克伦堡县，社区暴力呈上升趋势，显示出种族和地域差异，这强调了需要采取跨部门、以数据为驱动的方法来改变项目和政策。跨部门合作受到数据共享障碍的挑战，这些障碍阻碍了实施。
为响应社区的倡导，梅克伦堡县公共卫生部门（MCPH）启动了一项基于循证方案的社区暴力预防计划。“治愈暴力”（CV）模式是一种通过公平提供资源、建立网络和改变规范来打破暴力的公共卫生方法，在社区层面实施。“暴力干预健康联盟”（HAVI）模式是一种针对暴力受害者的医院筛查和病例管理干预措施，在夏洛特地区唯一的一级创伤中心卡罗来纳医疗中心实施。
创建了一个数据协作组织，以优化对 CV 和 HAVI 项目的评估，包括 MCPH、夏洛特市、Atrium Health、夏洛特-梅克伦堡学校、约翰逊 C. 史密斯大学和北卡罗来纳大学夏洛特分校。设计了一种全面的方法来促进数据共享，重点是让利益相关者参与进来，并为常见的障碍报告解决方案。使用结构化访谈为解决方案焦点策略提供信息。
利益相关者报告了他们组织在跨部门数据共享方面的障碍和促进因素的看法。通过与当地综合数据系统合作，解决了常见的技术、法律和治理障碍。信任和激励挑战的解决方案被纳入到正在进行的协作过程中。
数据孤岛阻碍了对社区暴力等复杂公共卫生问题的理解，也阻碍了对集体影响努力的设计和评估。这种方法可以复制和扩展，以支持寻求影响结构性种族主义导致的社会和健康不平等的跨部门合作。
