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Turning Point: Rethinking Violence—Evaluation of Program Efficacy in Reducing Adolescent Violent Crime Recidivism

Scott, Kamela K. PhD; Tepas, Joseph J. III, MD; Frykberg, Eric MD; Taylor, Pamela M. RN; Plotkin, A. J. JD

Journal of Trauma and Acute Care Surgery: July 2002 - Volume 53 - Issue 1 - p 21-27
Original Articles

Background  The link between medicine and violence prevention is self-evident, yet the literature reveals few studies that scientifically document effective interventions. The Turning Point: Rethinking Violence (TPRV) program is a unique multiagency program developed to expose, educate, and remediate first-time violent offenders and their parents regarding the real-world consequences of violence. Four key components are integrated into a 6-week, court-ordered program (14 total contact hours): the Trauma Experience (tour, video, discussions), the Victim Impact Panel (presented by parent survivors), Group Process, and Community Networking (individualized mental health referral). We hypothesize that TPRV delivers lower outcomes regarding violence recidivism (VR) when compared with standard court sentencing options (100 hours of community service) for first-time violent offenders.

Methods  The study group subjects (n = 38) met inclusion criteria and were blindly and randomly sentenced to attend the TPRV program. The control group (n = 38) were pulled from a subject pool of first-time offenders who received standard sentencing options, met the same inclusion criteria with regard to age and types of offenses, and were matched by race to the study group. Both groups were studied for VR within the year after the first violent conviction, and comparison was performed by a (2 analysis of recidivism rates.

Results  Results reveal a statistically significant difference between the study group and the control group for VR (p ≤ 0.05). The study group revealed a recidivism rate of 0.05 within the year after program completion, whereas the control group revealed a recidivism rate of 0.33. The lower recidivism rate also occurred with a shorter overall time investment (14 hours vs. 100 hours).

Conclusion  The TPRV program decreases VR when compared with standard sentencing options. The broad-spectrum approach (real-world exposure, parental involvement, peer support, follow-up) appears successful in addressing recidivism, and could potentially reduce the epidemic in adolescent violence and the subsequent impact on trauma care.

From the Department of Surgery, University of Florida Health Science Center (K.K.S., J.J.T., E.F.), Shands Jacksonville Medical Center (P.M.T.), and the State Attorney’s Office (A.J.P.), Fourth Judicial Circuit, Jacksonville, Florida.

Submitted for publication October 4, 2001.

Accepted for publication January 29, 2002.

This study was supported by grant funding from the Jacksonville Jaguars Foundation, Jacksonville, Florida.

This work was scheduled for presentation at the 61st Annual Meeting of the American Association for the Surgery of Trauma, which was canceled because of the terrorist attacks of September 11, 2001.

Address for reprints: Kamela K. Scott, PhD, Department of Surgery, University of Florida Health Science Center, 655 West 8th Street, Jacksonville, FL 32209; email:

© 2002 Lippincott Williams & Wilkins, Inc.