Tolan P H, Guerra N G
Department of Psychiatry, University of Illinois at Chicago 60612, USA.
Am J Prev Med. 1996 Sep-Oct;12(5 Suppl):129-31.
The evaluation of youth violence-prevention projects using sound methods is very important. Up to now, the evaluation literature has (1) inadequately heeded known epidemiologic patterns of violence, (2) failed to differentiate types of violence, and (3) failed to differentiate the levels of risk-influence addressed by the intervention. The reports in this supplement have considered these past deficiencies. These reports also make some notable advances, such as illustrating the role that efficacy trials can and should play in violence prevention, demonstrating that programs can and should be evaluated and that design characteristics such as random assignment are plausible, balancing the practical and theoretical aspects of violence prevention, and reflecting the importance of the setting on the style and scope of the intervention. The reports and projects also have remaining limitations. Length of planned follow-up is generally quite brief. In some cases the rationale for the intervention is not adequately explained. Some reports do not clarify whether the intervention is intended for all youths or selected high-risk youth. The next steps for these and similar projects are to determine the program impact and implementation, strive for longer follow-up, document conditions that interact with proximal impact on distal outcomes, and further broaden evaluation efforts into modifying situations instead of modifying only individuals. Finally, we must recognize that the goal of evaluation is not to declare all earnest efforts effective, but to determine which efforts merit further consideration.
运用合理方法对青少年暴力预防项目进行评估至关重要。到目前为止，评估文献存在以下问题：（1）对已知的暴力流行病学模式关注不足；（2）未能区分暴力类型；（3）未能区分干预所针对的风险影响水平。本增刊中的报告考虑到了这些以往的缺陷。这些报告也取得了一些显著进展，比如阐明了功效试验在暴力预防中能够且应该发挥的作用，证明项目能够且应该接受评估，以及诸如随机分配等设计特征是可行的，平衡了暴力预防的实践和理论方面，并反映了环境对干预方式和范围的重要性。这些报告和项目仍存在局限性。计划的随访时间通常较短。在某些情况下，干预的基本原理没有得到充分解释。一些报告没有阐明干预是针对所有青少年还是选定的高风险青少年。这些项目以及类似项目的下一步是确定项目的影响和实施情况，争取更长时间的随访，记录与对远期结果的近端影响相互作用的条件，并进一步扩大评估工作范围，从仅改变个体转向改变环境。最后，我们必须认识到，评估的目标不是宣称所有认真的努力都是有效的，而是要确定哪些努力值得进一步考虑。
