The public health approach to violence reduction: A process evaluation of a UK inner-city serious youth violence strategy

To examine the opportunities and challenges of applying a public health approach to violence prevention within a ten-year youth violence reduction strategy in an inner-London region. Multi method study within a process evaluation. The study investigated: (a) the influence of a public health approach on strategy design through documentary analysis and two focus groups with local government staff and community leaders (n = 11); (b) contextual factors shaping engagement with the approach via two actor-mapping workshops (n = 18) and narrative interviews (n = 7); (c) implementation of the public health approach in strategy delivery through four focus groups and one interview with staff and community leaders (n = 19), and interviews with participating young people or their carers (n = 10); and (d) a review of key performance indicators and a focus group discussion (n = 9). The public health approach supported an evidence-based strategy but was inconsistently articulated and understood, creating implementation challenges. Despite a complex violence-reduction landscape, the voluntary and community sector sustained productive relationships with the strategy. Data challenges included limited outcome measurement, with mostly quantitative indicators largely focused on tracking intervention activity. While the public health approach remains the dominant model for violence prevention, challenges persist in shared understanding, inter-agency collaboration, and data generation and sharing. Findings highlight the need to engage with local complexity through a place- and asset-based approach to youth violence narratives.