COUNTERING VIOLENT EXTREMISM THROUGH
PUBLIC HEALTH PRACTICE

Proceedings of a Workshop

Justin Snair, Anna Nicholson, and Claire Giammaria, Rapporteurs

Forum on Medical and Public Health Preparedness for
Disasters and Emergencies

Board on Health Sciences Policy

Health and Medicine Division

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

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This project was jointly supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians; American Hospital Association; American Red Cross; Association of Public Health Laboratories; Association of State and Territorial Health Officials; Child Care Aware of America; Council of State and Territorial Epidemiologists; East West Protection; Emergency Nurses Association; GlaxoSmithKline; Healthcare Ready; Infectious Diseases Society of America; Meridian Medical Technologies; National Association of Chain Drug Stores; National Association of County and City Health Officials; National Association of Emergency Medical Technicians; Robert Wood Johnson Foundation (Contract No. ID#: 73289); Seqirus; Trauma Center Association of America; U.S. Centers for Disease Control and Prevention (Contract No. 200-2011-38807); U.S. Department of Defense (Contract No. HHSP233201400020B/HHSP23337014); U.S. Department of Defense, Uniformed Services University of the Health Sciences (Contract No. HU0001-16-1-0022); U.S. Department of Health and Human Services’ Administration for Children and Families (Contract No. HHSP233201400153P); U.S. Department of Health and Human Services’ Food and Drug Administration (Contract No. 1R13FD005495-01); U.S. Department of Health and Human Services’ National Institutes of Health: National Institute of Allergy and Infectious Diseases; National Institute of Environmental Sciences; National Library of Medicine (Contract No. HHSN26300084); U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (Contract No. HHSO100201550005A); U.S. Department of Homeland Security, Office of Health Affairs (Contract No. HSHQDC-15-C-00079); and U.S. Department of Transportation, National Highway Traffic Safety Administration (Contract No. DTNH22-14-H-00468). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-45365-3
International Standard Book Number-10: 0-309-45365-8
Digital Object Identifier: https://doi.org/10.17226/24638

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Countering violent extremism through public health practice: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24638.

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PLANNING COMMITTEE ON EXPLORING THE USE OF HEALTH
APPROACHES IN COMMUNITY-LEVEL STRATEGIES TO
COUNTERING VIOLENT EXTREMISM AND RADICALIZATION¹

MATTHEW WYNIA (Chair), Director, Center for Bioethics and Humanities, Anschutz Medical Campus, University of Colorado

DAVID EISENMAN, Professor, Division of General Internal Medicine and Health Services Research; Director, Center for Public Health and Disasters, University of California, Los Angeles

JOHN L. HICK, Medical Director for Emergency Preparedness and Deputy Chief EMS Medical Director, Hennepin County Medical Center

LEESA LIN, Senior Program Manager, Harvard T.H. Chan School of Public Health

CYNTHIA LUM, Associate Professor, Department of Criminology, Law, and Society and Director, Center for Evidence-Based Crime Policy, George Mason University

JOUMANA SILYAN-SABA, Director of the Strategies Against Violent Extremism, Los Angeles Mayor’s Office of Public Safety; adjunct assistant professor, California State University, Dominguez Hills

SUSAN SZMANIA, Senior Researcher, National Consortium for the Study of Terrorism and Responses to Terrorism (START), University of Maryland

LEANA WEN, Baltimore City Health Commissioner and Physician

Health and Medicine Division Staff

JUSTIN SNAIR, Senior Program Officer, Forum Director (from August 2016)

JACK HERRMANN, Senior Program Officer (until August 2016)

ASHLEY OTTEWELL, Research Associate (until August 2016)

CLAIRE GIAMMARIA, Associate Program Officer (from February 2017)

ALEX REPACE, Senior Program Assistant

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

Consultants

ANNA NICHOLSON, Consulting Writer

LAURA RUNNELS, Consulting Facilitator and Engagement Strategist

___________________

¹ The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

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FORUM ON MEDICAL AND PUBLIC HEALTH
PREPAREDNESS FOR DISASTERS AND EMERGENCIES¹

DAN HANFLING (Co-Chair), Contributing Scholar and Clinical Professor in the Department of Emergency Medicine, Johns Hopkins Center for Health Security

SUZET M. McKINNEY (Co-Chair), Executive Director, Illinois Medical District Commission

ROY L. ALSON, Associate Professor of Emergency Medicine at Wake Forest School of Medicine, American College of Emergency Physicians

STACEY J. ARNESEN, Branch Chief at the Disaster Information Management Research Center, National Institutes of Health/National Library of Medicine

PAMELA BLACKWELL, Director at the Center for Emergency Preparedness and Response for Cobb/Douglas Boards of Health, National Association of County and City Health Officials

ERIC C. BLANK, Senior Director of Public Health Programs and Systems, Association of Public Health Laboratories

KATHRYN BRINSFIELD, Assistant Secretary of Health Affairs and Chief Medical Officer, U.S. Department of Homeland Security/Office of Health Affairs (until January 2017)

BROOKE COURTNEY, Senior Regulatory Counsel of the Office of Counterterrorism and Emerging Threats, U.S. Food and Drug Administration

RICHARD DANILA, Epidemiology Program Manager and Deputy State Epidemiologist at Minnesota Department of Health, Council for State and Territorial Epidemiologists

BRUCE EVANS, Fire Chief at Upper Pine River Fire Protection District, National Association of Emergency Medical Technicians

JOHN L. HICK, Medical Director for Emergency Preparedness and Deputy Chief EMS Medical Director, Hennepin County Medical Center

CLAUDIA M. KELLY, Senior Director, Value Access and Policy, Seqirus

THOMAS KIRSCH, Director of the National Center for Disaster Medicine and Public Health (NCDMP) and Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, U.S. Department of Defense

___________________

¹ The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

MICHAEL G. KURILLA, Director, Office of Biodefense Research Affairs and Associate Director for BioDefense Product Development, National Institutes of Health/National Institute of Allergy and Infectious Diseases

DREW E. LEWIS, Meridian Medical Technologies (since February 2017)

EMILY LORD, Executive Director, Healthcare Ready

NICOLE LURIE, Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services/Office of the Assistant Secretary for Preparedness and Response (until January 2017)

FREDA LYON, Vice President of Emergency Services at WellStar Health System, Emergency Nurses Association

NICOLE McKOIN, Senior Business Partner, Target Corporation

AUBREY K. MILLER, Senior Medical Advisor, Captain U.S. Public Health Service, Office of the Director, National Institutes of Health/National Institute of Environmental Health Sciences

JOHN OSBORN, Operations Manager, Assistant Professor of Health Care Systems Engineering, Mayo Clinic College of Medicine

TARA O’TOOLE, Senior Fellow, IQT

ANDREW T. PAVIA, Professor, Chief Division Pediatric Infectious Diseases, University of Utah, Infectious Diseases Society of America

JENNIFER PIPA, Senior Director of Recovery Operations, American Red Cross

ALONZO PLOUGH, Vice President, Research-Evaluation-Learning and Chief Science Officer, Robert Wood Johnson Foundation

STEPHEN C. REDD, Director, Office of Public Health Preparedness and Response, U.S. Centers for Disease Control and Prevention/Office of Public Health Preparedness and Response

MARY J. RILEY, Director, Office of Human Services Emergency Preparedness Response (OHSEPR)/Captain U.S. Public Health Service, U.S. Department of Health and Human Services/Administration for Children and Families (until February 2017)

ANDREW R. ROSZAK, Senior Director of Emergency Preparedness, Child Care Aware of America (until February 2017)

SARAH E. ROSZAK, Director of Research for National Association of Chain Drug Stores (NACDS) and NACDS Foundation

ROSLYNE SCHULMAN, Senior Associate Director, American Hospital Association

RICHARD A. SERINO, Distinguished Visiting Fellow and Senior Advisor, Harvard University School of Public Health

MONCEF M. SLAOUI, Chairman, Global Vaccines, GlaxoSmithKline

DAVID J. SMITH, Deputy Assistant Secretary of Defense for Health Readiness, Policy and Oversight, U.S. Department of Defense

W. CRAIG VANDERWAGEN, Co-founder and Director, East West Protection, LLC

JENNIFER WARD, President, Trauma Center Association of America

JOHN WIESMAN, Secretary of Health, Washington State Department of Health, Association for State and Territorial Health Officials

GAMUNU WIJETUNGE, EMS Specialist, Office of Emergency Medical Services, U.S. Department of Transportation/National Highway Traffic Safety Administration

MATTHEW K. WYNIA, Director, Center for Bioethics and Humanities, University of Colorado Denver

Health and Medicine Division Staff

JUSTIN SNAIR, Senior Program Officer, Forum Director (from August 2016)

JACK HERRMANN, Senior Program Officer (until August 2016)

CLAIRE GIAMMARIA, Associate Program Officer (from February 2017)

ALEXA EDMIER, Research Assistant

ALEX REPACE, Senior Program Assistant

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

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Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published Proceedings of a Workshop as sound as possible and to ensure that the Proceedings of a Workshop meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this Proceedings of a Workshop:

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the Proceedings of a Workshop before its release. The review of this Proceedings of a Workshop was overseen by BRUCE ALTEVOGT, Pfizer Inc. He was

responsible for making certain that an independent examination of this Proceedings of a Workshop was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this Proceedings of a Workshop rests entirely with the rapporteurs and the institution.

Contents

ACRONYMS AND ABBREVIATIONS

1 INTRODUCTION AND OVERVIEW

Workshop Objectives

Countering Violent Extremism

Public Health and CVE

Topics Highlighted During Presentations and Discussions

Proceedings Structure

2 UNDERSTANDING VIOLENT EXTREMISM

Radicalization and Violent Extremism: Characteristics and Empirical Data

The Hypothesized Root Causes of Violent Extremism

3 CONTEMPORARY APPROACHES TO COUNTERING VIOLENT EXTREMISM

Comparative Evaluation of First- and Second-Wave CVE Programs

Approaches to Countering Radicalization: International and Domestic Perspectives

4 THE CHALLENGES AND OPPORTUNITIES OF COUNTERING VIOLENT EXTREMISM

Perceptions of CVE

The Unintended Consequences of Working in a Precriminal Space

Strengthening Resilience at the Individual and Community Levels

Partnering to Support CVE

5 APPLYING PUBLIC HEALTH MODELS AND APPROACHES TO COUNTERING VIOLENT EXTREMISM

The Public Health Approach to Addressing Threats

Public Health Models for Evaluating CVE Programs

The Role of Health Professionals in CVE: Legal and Ethical Issues

6 WAYS FORWARD IN COUNTERING VIOLENT EXTREMISM

REFERENCES

APPENDIXES

A Workshop Agenda

B Workshop Statement of Task

C Biographical Sketches of Workshop Speakers and Moderators

Acronyms and Abbreviations