Intervention Summary

SANKOFA Youth Violence Prevention Program

The SANKOFA Youth Violence Prevention Program is a strengths-based, culturally tailored preventive intervention for African American adolescents ages 13-19. The goal of the school-based intervention is to equip youth with the knowledge, attitudes, skills, confidence, and motivation to minimize their risk for involvement in violence, victimization owing to violence, and other negative behaviors, such as alcohol and other drug use. The intervention promotes resilience and survival in difficult and even life-threatening situations. SANKOFA, a word of African origin, means "looking back in order to move forward," and traditional African values of consciousness, caring, connectedness, character, competency, commitment, and courage are basic tenets of the intervention, which is guided by an ecological framework and the theory of planned behavior.

The intervention includes an adolescent curriculum and an optional parent curriculum:

The adolescent curriculum (24 modules and 3 booster modules) addresses goals and values; reasons for fighting and carrying and using weapons; stereotypes, beliefs, and attitudes that render one at risk for violence-related injury and death; responsibility to self, family, and community; stages of conflict escalation; strengthening of internal locus of control; exercising of choices; risk assessment; motivation to use nonviolent conflict resolution; and strategies, as well as mental and behavioral rehearsals, for nonviolent conflict resolution. The curriculum is designed to be compatible with an existing school curriculum, and modules are available in formats suitable for 45-, 60-, or 80-minute class periods. The length of the implementation schedule depends on the number of curriculum modules taught per week.
The parent curriculum (4 modules) emphasizes adolescents' concern with violence, provides an overview of the adolescent curriculum's key concepts, and asks parents to examine their personal beliefs and attitudes regarding violence. The curriculum also emphasizes the importance of positive parent-child interactions and offers practical strategies for reinforcing violence prevention skills (e.g., role modeling, stress and anger management).

The intervention includes didactic instruction, demonstration, experiential exercises, case studies, games, group discussion, small group activities, role-play, performance feedback, and multimedia. To deliver the intervention, facilitators must have completed training and should have prior experience working with youth and at least an associate degree (or its equivalent).

The study reviewed for this summary assessed only the adolescent curriculum, using 60-minute sessions, without the booster modules. Although the intervention is designed for the specific challenges and context of African American youth, the study reviewed also included Latino and White youth.

Descriptive Information

Areas of Interest	Mental health promotion Substance use disorder prevention
Outcomes	1: Fighting and bullying behaviors 2: Violence-related bystander behaviors 3: Personal victimization
Outcome Categories	Social functioning Physical aggression and violence-related behavior
Ages	13-17 (Adolescent)
Genders	Male Female
Races/Ethnicities	Black or African American Hispanic or Latino White Race/ethnicity unspecified
Settings	School Other community settings
Geographic Locations	Urban
Implementation History	Since the intervention's inception, the SANKOFA Youth Violence Prevention Program has been field tested and implemented by trained facilitators at an estimated 130 sites in eight States and in Canada and England; more than 14,000 youth have participated in the program.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: Yes Evaluated in comparative effectiveness research studies: No
Adaptations	No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects	No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories	Universal Selective

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Hines, P. M., Vega, W., & Jemmott, J.. Final report: A culture based model for youth violence risk-reduction. Unpublished manuscript.

Outcomes

Outcome 1: Fighting and bullying behaviors
Description of Measures	Fighting and bullying behaviors were measured using the 8-item Modified Aggression Scale, which was adapted from the 22-item Aggression Scale. The Modified Aggression Scale is composed of four subscales: fighting, bullying, anger, and cooperative/caring behavior. The fighting and bullying subscales were used in this study. Participants were presented with items (e.g., "I hit back when someone from my school hit me first," "I teased other students") and asked to indicate the number of times (ranging from "no opportunity" to "5 or more times") they engaged in each behavior during the past 30 and 90 days. The scale was administered by the research assistant at baseline, immediately after the intervention, and at 3 and 12 months after the intervention.
Key Findings	Students in the intervention schools reported fewer fighting and bullying behaviors over the past 30 days compared with students in the control school at 3 months (p < .001) and 12 months (p < .001) after the intervention.
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.1 (0.0-4.0 scale)

Outcome 2: Violence-related bystander behaviors
Description of Measures	Violence-related bystander behaviors were measured using the 6-item SANKOFA Violence Scale, which was developed for the study. Participants were presented with items (e.g., "Have you seen other people fighting?" and "Did you stay around to see the outcome of the fight(s)?") and asked to indicate the number of times (ranging from "never" to "more than once a week") they engaged in each behavior during the past 30 and 90 days. The scale was administered by the research assistant at baseline, immediately after the intervention, and at 3 and 12 months after the intervention.
Key Findings	Students in the intervention schools reported fewer violence-related bystander behaviors over the past 30 days compared with students in the control school at 3 months (p < .05) and 12 months (p < .001) after the intervention.
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.0 (0.0-4.0 scale)

Outcome 3: Personal victimization
Description of Measures	Personal victimization was measured using a 10-item scale developed by Orpinas and Kelder, which assesses the frequency of personal victimization events perpetrated by other students. Participants were presented with 10 items (e.g., "a student teased me to make me angry," "a student beat me up") and asked to indicate the number of times (ranging from "0 or never" to "six or more occasions") another student did each to them during the past 30 days. The scale was administered by the research assistant at baseline, immediately after the intervention, and at 3 and 12 months after the intervention.
Key Findings	Students in the intervention schools reported fewer incidents of personal victimization over the past 30 days compared with students in the control school at 3 months (p < .001) and 12 months (p < .001) after the intervention.
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.3 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study	Age	Gender	Race/Ethnicity
Study 1	13-17 (Adolescent)	57.4% Female 42.6% Male	70% Black or African American 26.2% Hispanic or Latino 3.6% White 0.2% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

Reliability of measures
Validity of measures
Intervention fidelity
Missing data and attrition
Potential confounding variables
Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome	Reliability of Measures	Validity of Measures	Fidelity	Missing Data/Attrition	Confounding Variables	Data Analysis	Overall Rating
1: Fighting and bullying behaviors	2.0	2.0	2.0	2.5	2.0	2.3	2.1
2: Violence-related bystander behaviors	2.0	1.0	2.0	2.5	2.0	2.3	2.0
3: Personal victimization	3.0	2.0	2.0	2.5	2.0	2.3	2.3

Study Strengths

The developers reported good reliability for two of the measures, citing an unpublished work that reports psychometric tests for the instrument. Most of the measures have face validity. The intervention is manualized. Fidelity ratings, which were based on facilitators' evaluation logs, were good within most schools. The analysis was appropriate for the study.

Study Weaknesses

For one of the measures, there is very little information on how it was psychometrically tested; it appears to have been developed for this study and is not found in the published literature. No psychometrics were provided regarding validity of the scales. Only self-reported data were used. Although the intervention is manualized, its implementation across the three schools was inconsistent, and information on student attendance at sessions was missing. Attrition was high, particularly in two of the schools. Comprehensive data were not presented on the attributes of students who completed questionnaires versus students who did not complete questionnaires.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Quality assurance tools:

Adolescent After-Session Debriefing Survey
Adolescent Female Posttest
Brief Version of Adolescent Female Pretest
Facilitator Curriculum Log Sheet
Facilitator Session Evaluation
SANKOFA Youth Violence Prevention Training Program Evaluation Toolkit
School Climate Pre- and Posttest--Adolescent
School Climate Pre- and Posttest--Teacher

SANKOFA Violence Prevention Kit:

Agree/disagree cards
Ankh
Cloth
The Past Serves as a Guide for Planning the Future (SANKOFA Review Booklet)
Program handouts
Program posters
SANKOFA Adolescent and Parent Curricula With Trainer's Manual
SANKOFA Curriculum Video Clips [DVD/VHS tape]
SANKOFA Orientation Video [DVD]
SANKOFA role-play and game cards

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

Availability of implementation materials
Availability of training and support resources
Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation Materials	Training and Support Resources	Quality Assurance Procedures	Overall Rating
4.0	3.8	3.5	3.8

Dissemination Strengths

The curricula binder is thorough, well scripted, and detailed, and it clearly outlines session delivery procedures. It also provides guidance on how to abbreviate sessions for different time segments, as needed. Handout masters and role-play cards are provided and clearly identified. Training programs are available for group facilitators, program staff, and administrative personnel. Program training is required and includes information for building the cultural competence of facilitators. Evaluation forms are provided to support adherence monitoring for quality assurance purposes. Pre- and posttests are included for use in measuring outcomes. Curriculum log sheets are provided and can be used to facilitate fidelity monitoring.

Dissemination Weaknesses

Few supplemental resources for implementers are identified by the developer. Although each session in the curriculum has a stated objective, a clear definition of the desired behavioral and attitudinal outcomes for youth and parents is not provided.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description	Cost	Required by Developer
SANKOFA Violence Prevention Kit (includes one SANKOFA Orientation Video on DVD)	$750 per kit	Yes
Additional SANKOFA Orientation Videos	$10 per DVD	No
7-day, on-site Group Facilitator Training (5 consecutive days plus 2 follow-up days)	$750 per person (minimum of 12 participants) or $12,000 per group (maximum of 24 participants) plus travel expenses	Yes
Certified Group Facilitator Training (minimum of 24 hours, in addition to the 7-day Group Facilitator Training)	Varies depending on location and format of training (i.e., one-on-one or small group)	No
2-day, on-site Staff Awareness Training	$3,000 per group (maximum of 24 participants) plus travel expenses	No
Half-day, on-site Administrative Training	$750 per group (maximum of 24 participants) plus travel expenses	No
Phone, email, and Web-based consultation	Free	No
On-site individual or group consultation	$125 per hour plus travel expenses	No
Quality assurance tools	Included in the cost of the kit	Yes

Additional Information

Trainings also can be held at a centralized location and include participants from multiple organizations.

Replications

No replications were identified by the developer.