Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health, 2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children's chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research.

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This study provided an experimental test of a drug abuse treatment enrollment and retention intervention in a sample of 103 Black mothers of substance-exposed infants. Significantly more women assigned to the Engaging Moms Program enrolled into drug abuse treatment than did women assigned to the control condition (88% vs. 46%). Sixty-seven percent of participants in the Engaging Moms Program received at least 4 weeks of drug abuse treatment compared with 38% of the control women. However, there were no differences between the groups 90 days following treatment entry. Logistic regressions revealed that readiness for treatment predicted both short-term and long-term treatment retention. The Engaging Moms Program has considerable promise in facilitating treatment entry and short-term retention, but it did not influence long-term retention.

Resumen. La investigación sobre la exposición a la violencia crónica en la comunidad se centra en las minorías étnicas y en los colectivos más pobres y azotados por la delincuencia, mientras que los programas de tratamiento y prevención se centran en los perpetradores de la violencia, y no en los adolescentes, que son sus víctimas directas o indirectas. Las intervenciones de tratamiento y prevención en el ámbito escolar son necesarias en el caso de menores con un alto riesgo de exposición a la violencia en su comunidad. En este trabajo se describe el proyecto Multiple Opportunities to Reach Excellence (MORE), un estudio epidemiológico longitudinal centrado en las comunidades y que ha sido puesto en práctica en la actualidad para comprender mejor el impacto de la exposición a la violencia crónica en el vecindario sobre el funcionamiento emocional, conductual, de consumo de drogas y académico de los menores y adolescentes, con el objetivo último de identificar los factores maleables de riesgo y protección en los que se puede incidir mediante programas de prevención e intervención. Palabras clave: consumo de drogas, externalización, internalización, niños y adolescentes, prevención, rendimiento académico.