Applying the Public Health Approach to Prevent Targeted Violence in the United States.

Objective: Targeted violence (i.e., violence against a preidentified target intended to influence the broader population and/or generate publicity for the perpetrator or their grievance) is a national security threat and an urgent public health problem affecting individual and community well-being. Drawing on decades of experience and examples from the U.S. Centers for Disease Control and Prevention and the public health field, this article illustrates how the four-step public health approach to violence prevention (i.e., define and monitor the problem; identify risk and protective factors; develop and test prevention strategies; ensure widespread adoption) can be applied to accelerate advancements in evidence-based practice for the primary prevention of targeted violence. Method: In this narrative review, examples of risk and protective factors and evidence of what works to prevent violence and suicide are compared with the targeted violence literature to identify shared risk and protective factors, promising prevention approaches, and key research gaps. Results: This article highlights opportunities to enhance consistency in measurement and expand public health data systems, identifies an initial set of 20 shared risk and protective factors, highlights evidence-based violence and suicide prevention approaches with potential for preventing targeted violence, and suggests focus areas for advancing research. Select ongoing efforts by the Department of Homeland Security illustrate the public health model in action. Conclusion: Applying the Centers for Disease Control and Prevention's public health approach to violence prevention can bridge efforts by the Centers for Disease Control and Prevention, Department of Homeland Security, and communities to build a violence prevention infrastructure connecting science and action across multiple forms of violence, including targeted violence.