and rigorously evaluated, and without this, there is the potential to actually do harm. Developing effective programs is a continuous and iterative process that requires sustained commitment and resources. It involves identifying the nature of the problem through good epidemiologic work; specifying and clarifying risk factors and, more importantly, trying to figure out how to translate those risk factors into prevention programs; and then the arduous task of testing and refining those programs and determining how best to facilitate their diffusion. This public health approach, she stated, can really make a difference in helping governments increase their knowledge of and confidence in workable interventions while providing them with alternative options to policing and public security to address violence.
From her experiences in high-income countries and in a few low- and middle-income countries, she acknowledged that the process is doable. There are, however, some challenges, including empowering stakeholders with the tools for planning, developing, implementing, and evaluating programs—building infrastructure capacity in the countries. She asserted that this is a question not only for those who are involved in prevention work, but also for donors and decision makers in terms of where their investments could and should be made. Another challenge she identified is seeking economies of scale wherever possible and whenever feasible—that is, making the most of existing prevention infrastructures and expertise. She reiterated what was said earlier in the day about the tendency to work in silos and the need for more effective methods that call for really looking at the intersection of different types of violence, breaking down those silos, and determining how prevention efforts can be integrated so that we are not only changing one outcome but potentially changing many outcomes or reducing many types of violence. She also encouraged examining the intersection with other health outcomes and other health areas—for example, HIV infection or maternal and child health—to tap into existing prevention structures and expertise, acting accordingly, and possibly reducing multiple health problems. Her closing remark identified the challenge of really bridging science and practice. It is insufficient, she argued, just to identify effective programs. Determining how to disseminate those programs and policies and get them adopted in different settings and with different populations is critical—in other words, finding ways to accelerate what we do know that works. This is important not only for those who do this kind of work, but also for governments and the development community—everyone is a partner in making sure this is a reality.
David Hawkins, Rodrigo Guerrero, Elizabeth Ward, and Charlotte Watts gave presentations to summarize what is known about the effectiveness of different interventions, the importance of data collection in guiding prevention efforts, the types of interventions and their outcomes, the