2

Transforming Violence
Prevention Through
New Communications

Billions of men, women, and children around the world have been exposed to violence. More than 1.6 million people a year die from violence, and many more are injured. Low- and middle-income countries bear 90 percent of the burden of violence (IOM, 2008). Many workshop participants believed that the potential of information and communications technology (ICT) to help in violence prevention efforts is great, but that ICT could also be used to facilitate violence and abuse.

Speaker and Forum co-chair Mark Rosenberg of the Task Force for Global Health noted that violence has traditionally been considered to be the product of evil and, consequently, not preventable. But today, he said, more people believe that violence is preventable, which is an important step in understanding violence and moving toward prevention. Dr. Rosenberg outlined a public health model that the Centers for Disease Control and Prevention (CDC) and others have applied to the prevention of violence. This model includes four steps: (1) defining the problem, (2) identifying risk factors, (3) exploring potential points of intervention, and (4) designing, implementing, and evaluating solutions (further information can be found in Chapter 6). This model has yielded much data on what works in violence prevention, and, as ready access to information and resources increases, dissemination of knowledge about how to prevent violence also increases.

VIOLENCE IN THE MEDIA

Speaker and planning committee member Vish Viswanath of the Harvard School of Public Health discussed the relationship between exposure



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2 Transforming Violence Prevention Through New Communications B illions of men, women, and children around the world have been ex- posed to violence. More than 1.6 million people a year die from vio- lence, and many more are injured. Low- and middle-income countries bear 90 percent of the burden of violence (IOM, 2008). Many workshop participants believed that the potential of information and communications technology (ICT) to help in violence prevention efforts is great, but that ICT could also be used to facilitate violence and abuse. Speaker and Forum co-chair Mark Rosenberg of the Task Force for Global Health noted that violence has traditionally been considered to be the product of evil and, consequently, not preventable. But today, he said, more people believe that violence is preventable, which is an important step in understanding violence and moving toward prevention. Dr. Rosenberg outlined a public health model that the Centers for Disease Control and Prevention (CDC) and others have applied to the prevention of violence. This model includes four steps: (1) defining the problem, (2) identifying risk factors, (3) exploring potential points of intervention, and (4) designing, implementing, and evaluating solutions (further information can be found in Chapter 6). This model has yielded much data on what works in violence prevention, and, as ready access to information and resources increases, dissemination of knowledge about how to prevent violence also increases. VIOLENCE IN THE MEDIA Speaker and planning committee member Vish Viswanath of the Har- vard School of Public Health discussed the relationship between exposure 9

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10 COMMUNICATIONS AND TECHNOLOGY FOR VIOLENCE PREVENTION to media violence and aggressive behavior in some individuals. Although the evidence is not solid, some studies indicate that the impact of continued exposure to violence can desensitize individuals to violence and lead to the belief that the world is unsafe. Violence in television programming or in cartoons models violent behavior for viewers. It can also lead to the belief that physical aggression is the way to resolve conflict. Speaker Dale Kunkel of the University of Arizona said that there is consensus in the literature that media violence risks harmful effects on children and that greater exposure increases the risk. He cited a number of institutions that are part of this consensus, including the American Medical Association, the American Academy of Pediatrics, the American Psycho- logical Association, the National Academy of Sciences, and the National Institute of Mental Health. Dr. Kunkel sees violence in the media as a risk factor for aggressive behavior—not the only and not the most powerful factor, but one that is “consistent and meaningful.” He explained that contextual factors can increase the risk of later violent behavior. There is less research on the impact of violent video games than there is on the effect of violent TV, but there is enough to say there is a correlation be- tween aggression and playing violent video games. A recently published meta-analysis of the effects of video games found that when the games are violent, exposure to them can increase aggression and decrease empathic behaviors. Dr. Viswanath also discussed cyberbullying through social media and its connection to violence. He said there is now evidence that text-based harassment is increasing, while harassment through other Internet media is neither increasing nor decreasing. Dr. Kunkel brought up policy steps that could reduce children’s expo- sure to media violence. One such step would be to reduce the violent media content production and its distribution. The First Amendment, which guar- antees freedom of speech, limits what can be done in restricting production and distribution of media that contain violence. Another policy direction would be to “facilitate” industry self-regulation, which would avoid the is- sue of First Amendment rights. Formal government restrictions could, for example, regulate the hours during which such media could be shown, as has been done in the United Kingdom. The United States uses this strategy to regulate indecency but not violence, because there is less public concern in the United States about violence than there is about sex. Dr. Viswanath speculated that there is probably much more organized opposition to por- trayals of sex than there is to violence in the United States, despite the fact that most likely there is more programming with violence than with sexual content. Dr. Kunkel cited a study showing that children are more attracted to high action and that violent media generally has lots of action. The United Nations Children’s Fund’s (UNICEF’s) office of research, Innocenti, published a report in December 2011 titled Child Safety Online: Global

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11 NEW COMMUNICATIONS Challenges and Strategies (UNICEF, 2011). It explores the links between child abuse and information and communications technology and suggests ways to build a protective environment for children. Media can be used for positive aims; for example, Sesame Street uses positive modeling for pro-social behavior. The Sesame Workshop is in more than 150 countries, and in 30 of them it is indigenously produced. It is de- signed to counter the negative images children see, particularly in relation to conflict and violence. CREATING CONVERSATIONS AND EMPOWERING PEOPLE Throughout the workshop, a number of speakers referred to the rapid change that has occurred in the technology space and to the transforma- tional impact it has had on society. In his keynote address, Erik Hersman, co-founder of Ushahidi, illustrated how technology has provided tools for interaction among ever-expanding networks. Technology is no longer used only to send out information, but is instead used as a two-way communica- tion channel and for the creation of dialogue among multiple parties. Such community networking is replacing, to some degree, one-way communica- tion by experts or authority figures. Gaming is another information and communications technology that has potential to influence behavioral change through empowerment, as noted by speaker Ben Sawyer from Games for Health. For example, the President’s Emergency Plan for AIDS Relief has created a game to get Kenyan youth engaged in HIV prevention. Speaker and planning commit- tee member Jody Ranck of the Public Health Institute mentioned another game, Owning Asthma, which enables youth with high rates of asthma to figure out where they are when they encounter their triggers. The game encourages their engagement with the politics of environmental pollution, particularly in relation to race and class. Mr. Sawyer discussed Games for Health as an example of organizations being able to identify, package, and make available accessible tools that allow people to model and play with health as a form of intervention. He said that when people think about games, “it really starts . . . with an engaging and motivating experience, but it also can be a supporting experience.” Games can give people models and frameworks focused on concepts such as positive health behaviors that they can use in their lives to make better choices. Dr. Rosenberg discussed the paradox of disconnection. As people are becoming more connected through technology, they have less face-to-face time. Increasing our disconnectedness poses a risk, he said, because people may be less cautious about hurting those they have not met or seen than people they have met or seen. Other speakers spoke of technology as creat- ing “trust” between groups who may never have met.

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12 COMMUNICATIONS AND TECHNOLOGY FOR VIOLENCE PREVENTION COMMUNITY BUILDING AND FLATTENING HIERARCHY Interactive social media are facilitating the development of communities from which ideas and innovative solutions to a wide array of problems can emerge. Participation in these networks by individuals from different disci- plines and backgrounds allows boundaries to be bridged and cross-cutting ideas to develop. Social media are affecting societies and lowering barriers and, in the process, disrupting the status quo of hierarchical structures. The National Suicide Prevention Lifeline was presented by speaker Ashley Womble as an example of a violence prevention initiative that is utilizing ICT to carry out its work. Established in 2005 and focused on the prevention of suicide, the hotline now receives about 2,200 calls per day. Lifeline also works with Facebook to reach out to individuals who have posted suicidal messages and refer them to a help center. It also has an online space where users can create avatars, interact virtually, and share their experiences. Another example of a violence prevention initiative that is utilizing ICT is Bell Bajao!, presented by speaker Eesha Pandit of Breakthrough, which was established in India in 2008 to interrupt violence against women. The campaign urges people who hear or notice domestic violence taking place near their homes to ring the bell of the home where the disturbance is oc- curring in order to alert the perpetrator that the community is watching and does not condone the violence. Mr. Hersman spoke about the ability of the new interactive technol- ogy and the communities it helps build to bypass hierarchies and experts. New technologies allow people to organize to solve their own problems. Ushahidi arose in response to the post-election violence in Kenya in 2008, and it allowed people to send reports of violence through the Web, which could then be put on a public map. The technology was built by people fascinated with innovation and driven by urgency, despite a lack of cre- dentials, permissions, funding, and time. Mr. Hersman referred to the space in which the most innovation takes places as “white space”—a place “where the rules are vague, authority is fuzzy, strategy unclear, and budgets non-existent.” Speaker John Pollock of Technology Review described how, during the Arab Spring, live-streaming created a space where people of all back- grounds could meet to acquire and share information that could be used to protect people and save lives. In situations of urgency, trust between people who have never met can be built through technology. Skype, in particular, provides a relatively secure environment in which to strengthen relationships, raise profiles, raise funds, shape stories, and help journal- ists get stories, quotations, and interviews. The flexibility of networks is a tremendous advantage vis-à-vis hierarchical institutions, which can freeze

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13 NEW COMMUNICATIONS up in crisis situations. Mr. Pollock talked about the strength of diversity in networks, saying, “monocultures collapse as soon as there’s rapid change.” As several speakers noted, one of the key barriers to the use of new technologies is the need for accompanying organizational change. Using networking technologies with “analog mindsets and analog organizations” is a challenge for organizations and individuals. Formal institutions may take 2 years to gather data, making the information about a health problem 2 years old before it is released. The appearance of severe acute respiratory syndrome, or SARS, brought about a change in response in managing a rapidly spreading epidemic, and more such changes are needed. Reporting information rapidly and acting on it quickly, whether the information con- cerns post-election violence, rape, sexual harassment, or disease, requires huge shifts in the ways institutions do their business. Speaker Mick Fealty, founder of Slugger Consults, discussed the post- conflict challenges Northern Ireland has faced in sustaining peace. There was a huge loss of trust not only between the Catholic and Protestant communities but also among those within each community who were most affected by the conflict. In the early l990s, the advent of the digital age fa- cilitated conversation beyond the power groups that negotiated ceasefires and peace. Mr. Fealty set up a blog, Slugger O’Toole, through which those outside the establishment could bypass politicians and the mainstream media and speak directly to each other. In order to preserve the pluralism of the conversation over the blog, Mr. Fealty established some rules, the principal one being that participants had to stay with the argument and not attack the other person. Mr. Fealty also felt that diversity was critical to gaining new perspectives on old issues that already have champions who do not want to be displaced. These conversations and connections take power away from authorities and put it in the hands of the users. “This is a show-me, not a tell-me paradigm,” he said. Mr. Fealty also discussed consultation, which he said has to be part of the design of a solution, not something that is done after a solution already has been proposed. People want to have agency through partnerships built on trust. Speaker John Gordon of Fenton said that social media allow an “ex- traordinary degree of diversity.” People from across the socioeconomic and socio-demographic spectrums self-organize. Mr. Pollock also noted that the diversity is not just in identity, but also in cognition. Forum member Rowell Huesmann of the University of Michigan agreed, saying that there is also diversity of opinion and communication messages. He warned that a consequence of the explosion of new information and communications technology may be that each of us is exposed to less diversity of opinion, as we focus more on what we want to hear; these platforms readily allow these filters.

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14 COMMUNICATIONS AND TECHNOLOGY FOR VIOLENCE PREVENTION NEAR REAL-TIME DATA Mr. Hersman stressed that technology is not a panacea and that it is actually less important than the use case.1 He gave several examples. Ha- rassmap, developed in Egypt, uses Medic:Mobile tools that receive messages that are then mapped to show the public where sexual harassment is hap- pening in Cairo. The beauty of these maps is that they are based on near real-time data. Bully Mapper in Australia, Hollaback in the United States, and ApartheidWatch in Israel and Palestine perform similar services. In In- dia, Maps4Aid is tracking violence against women. PeaceTXT in Chicago brings together people within the community who can interrupt violence, with CeaseFire as the largest user. In Benin, Plan International has focused on violence against children. Kids or adults who see violence against children can send text messages to alert the government and the police. There are plans to scale it up to eight countries across the region. A new website called Street Watch Palestine was launched in late 2011 to draw attention to harassment of women in Ramallah, Palestine. Near real-time data make it possible to respond to a problem almost immediately; it is no longer necessary to wait a long time for information or data before interventions can be mounted. Speaker Devon Halley of Deloitte Research GovLab (XBC) suggested that the most powerful idea circulating now is the idea of turning citizens into “sensors.” These sensors are low-cost, put forth a tremendous amount of data, and they feed directly into the “here and the now.” Whether it is through Twitter feeds or Facebook feeds or other mechanisms, “people are putting a tremendous amount of information out there.” With technology, it is now easy to set up networks or to detect patterns in datasets that one might not otherwise recognize. These data can help people discover various actionable areas or “hot spots to act in.” COLLABORATION AND CONNECTION Connections through today’s large networks can link those who deal with specific types of violence, helping break down the barriers between disciplines and different approaches to violence. Successful violence preven- tion depends upon effective collaboration between public health agencies, members of law enforcement, social services providers, educators, and other actors. Linking those who work on prevention and treatment is also important. 1 A use case describes the interaction between an actor or “user” (either a person or an organization) and a system or enterprise.

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15 NEW COMMUNICATIONS Many speakers stated that collaboration is fundamental to finding in- novative solutions to prevent violence. Mr. Hersman talked about the fact that both networks and technological innovations are often created by peo- ple driven to organize to resolve problems to which existing institutions are not responsive. Dr. Rosenberg cited the need for establishing connections between the officials who can respond to a problem and the people who are reporting the violence as well as the need to incentivize participation and reporting. At present, the connections between a citizen making a report and the institutional responders are tentative or inconsistent, and a “trust bridge”—a term offered by Mr. Hersman—should be formed between the two sides. Huge institutional shifts might be required to form such connec- tions and trust. Law enforcement is beginning to make this shift through the combination of social media, citizen reporting, and police practice. Dr. Viswanath cited the importance of institutions maintaining contact with citizens, especially those under stress, so they have an ongoing connection. Mr. Halley echoed other speakers, agreeing that the larger the network, the more powerful it is, and that cross-boundary connections are impor- tant for innovation. His remarks were based on a paper he co-authored, “XBC: Creating Public Value by Unleashing the Power of Cross-Boundary Collaboration.”2 The central questions that this work tries to answer are: How can maximum value come from a network? What network structures are best for which purpose? How does one manage structures, and what should be considered in developing a network? Technologies for online col- laboration can allow much larger numbers of people to become involved than is possible with the traditional networks used to find information or solve problems. Mr. Halley cited three steps that are at the heart of cross-boundary collaboration: connect, innovate, and execute. Connections break down barriers and increase the broad awareness of situations. When organizations take advantage of connectivity, they can rapidly source in- formation and solutions at lower cost. Given the transboundary issues and complexity in the world today, Mr. Halley said an approach able to rapidly handle complex situations is needed. Dr. Rosenberg mentioned the important role that advocacy groups have played in preventing and countering violence. Advocates began working to prevent violence against women 35 years ago. Attention to HIV/AIDS was galvanized by advocacy groups. Other types of violence prevention are now being supported by emerging advocacy networks, often facilitated through social media. 2 See http://www.deloitte.com/assets/Dcom-Global/Local%20Assets/Documents/Public%20 Sector/dtt_ps_xbc_060311.pdf.

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16 COMMUNICATIONS AND TECHNOLOGY FOR VIOLENCE PREVENTION BOX 2-1 Key Messages Raised by Individual Speakers • se of information and communications technologies disrupts the flow of U information and hierarchies, with a transformational impact on society. • n important barrier to the realization of the potential of new technologies is A the need for and resistance to organizational change. • he use case is more important than the technology itself. T • he dialogue about the advantages, disadvantages, and dangers of commu- T nications in the field of violence prevention might benefit from greater stake- holder prioritization. REFERENCES IOM (Institute of Medicine). 2008. Violence prevention in low- and middle-income countries. Washington, DC: The National Academies Press. UNICEF (United Nations Children’s Fund). 2011. Child safety online: Global challenges and strategies. Florence, Italy: UNICEF Innocenti Research Centre. http://www.unicef-irc.org/ publications/pdf/ict_eng.pdf (accessed March 30, 2012).