Cultural Diversity and Conformity Guided Reading Section 2

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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Proceedings of a Workshop


IN BRIEF

April 2018

Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence

Proceedings of a Workshop—in Brief

INTRODUCTION

Social and cultural norms are rules or expectations of behavior and thoughts based on shared beliefs within a specific cultural or social group. While often unspoken, norms offer social standards for appropriate and inappropriate behavior that govern what is (and is not) acceptable in interactions among people (WHO, 2009). Social and cultural norms are highly influential over individual behavior in a broad variety of contexts, including violence and its prevention, because norms can create an environment that can either foster or mitigate violence and its deleterious effects.

Different social and cultural norms influence how individuals react to violence. Researchers have hypothesized that the social and cultural norms that lead to the tolerance of violence are learned in childhood, wherein a child experiences corporal punishment or witnesses violence in the family, in the media, or in other settings (Abrahams and Jewkes, 2005; Brookmeyer et al., 2005; Lansford and Dodge, 2008; WHO, 2009). Witnessing violence in childhood creates norms that can lead to the acceptance or perpetration of a multitude of violent behaviors or acts, but it also may provide a potent point of intervention for violence prevention efforts. Although research in this area is limited, many preliminary studies show promise in actively influencing or altering existing social norms in order to reduce the occurrence of violence within a given population (WHO, 2009).

To better understand how social and cultural norms are related to violence and violence prevention, the Forum on Global Violence Prevention convened a workshop1 on October 29–30, 2015, to explore the social and cultural norms that underlie the acceptance of violence, with a focus on violence against women across the lifespan, violence against children, and youth violence. The workshop addressed causes, effects, characteristics, and contextual variations related to social and cultural norms related to violence; what is known about the effectiveness of efforts to alter those norms in order to prevent and mitigate such violence; and the role of multiple sectors and stakeholders in the prevention of this violence. Invited speakers and workshop discussions drew from a broad variety of disciplines and perspectives, including the public health, social sciences, technology, public safety, human rights, policy, and legal sectors. Sheldon Greenberg, the chair of the Forum on Global Violence Prevention, noted that the forum has adopted the definition of violence put forward by the World Health Organization: the intentional use of physical force or power, threatened or actual, against one's self, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation (Krug et al., 2002).

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1 To learn more about the workshop, view the agenda, and see videos and slides of the presentations, visit the workshop's webpage: http://nationalacademies.org/hmd/Activities/Global/ViolenceForum/2015-OCT-29.aspx (accessed April 2, 2018).


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Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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WHAT ARE SOCIAL NORMS AND HOW DO THEY OPERATE IN RELATION TO VIOLENCE?

The Scientific and Theoretical Grounding of Social Norms

Cristina Bicchieri of the University of Pennsylvania explained that people have certain expectations that come from well-established scripts of how things are (and should be) in the world, and these scripts include shared social norms. Referring to work at the UNICEF Innocenti Research Centre (Bicchieri and Penn Social Norms Training and Consulting Group, 2016), she defined social norms as rules of behavior that individuals conform to because they believe that most people in their reference group either think they ought to conform to them (normative expectations) or conform to them as a norm (empirical expectations). She explained that expectations are derived from schemata and scripts, with schemata being the generic knowledge of event sequences, roles, and rules that can affect our social expectations (as legitimate and normal); our perception (recall, the inference, and causal attributions of an event); and our emotions. Event schemata are known as scripts, and social norms are part of a script. Bicchieri said that changing violent behavior requires the ability to understand what the script is, to diagnose and measure the social norms that are part of the script, and then to change the script by adjusting the expectation associated with that script. Bicchieri has measured norms by evaluating consensus (i.e., consensus within a community that a behavior is acceptable) and compliance (the conditions under which one would use the behavior). This is implemented through measuring normative expectations (what the responder believes others think he/she should do), empirical expectations (what the responder believes others do), personal normative beliefs (what the responder believes he/she should do), and actual behavior (what the responder does).

A Public Health and Anthropological Perspective of Social Norms

Rebecka Lundgren of Georgetown University began her presentation by noting that there is general agreement that the causes of violence are related to power, the normative use of violence, and the meaning of being a man or a woman in a society. She suggested that understanding the meaning of a specific act of violence requires looking holistically at the ways in which power is played out in society and taking into account culture and cultural context. She highlighted the effects and roles of systemic actors (schools, religious institutions, community, and family), the setting (where we live, work, and play), and the processes of how we learn (mentoring, discipline, peer influence, etc.). Referencing the results of several programs in the violence prevention field, she described interventions and pathways that have influenced and transformed social norms and changed behaviors. Examples of the interventions she referenced include using a life-course approach that starts early, harnessing acculturation processes to form and transform gender norms and roles, using multiple interventions at key transition points, and actively addressing structural barriers such as inequality in girls' education and in women's access to resources.

Social Norms in the Context of Violence Against Women

Lori Heise of STRIVE Research Consortium said that her work at the Center for Gender Violence and Health has shown that behaviors may be held in place by a matrix of norms, beliefs, and schemas, and she emphasized the need to recognize the opportunity to transform behaviors by creating a new positive norm. She said that, here, a schema includes deeply ingrained cognitive structures that drive the use of violence and that are often linked to norms of family privacy. Heise said that cross-sectional studies suggest that norms are an important community- and individual-level risk factor and that the myriad of complex elements that sustain harmful behaviors includes not just norms but also structural drivers such as migration, globalization, and conflict as well as the material realities of economics and infrastructure. She described the SASA! project, an intervention designed to reach communities, individuals, and systems to affect norm change (Raising Voices, 2013). Heise concluded that community-level norm change holds great promise for substantially reducing victimization and the perpetration of interpersonal violence (IPV) in low-resource settings, that community norms have a significant role in mediating violence, and that addressing and challenging specific attitudes toward IPV have the potential to reduce gender inequality and to prevent violence.

The Community Cares Program: Operationalizing Social Norms

Nancy Glass of the Johns Hopkins University School of Nursing discussed the Communities Care (CC) program, which was implemented by UNICEF in partnership with local and global organizations in South Sudan and Somalia. The CC program focuses on strengthening the positive social norms that protect women and girls from violence and on working to change the social norms that support or hide gender-based violence (Read-Hamilton and Marsh, 2016). Glass described how the program strengthens both formal and informal community-based multi-sectoral response services and reinforces positive

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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social norms of service providers and institutions through mapping multisector services to see where gaps and bottlenecks in services exist, performing process and impact evaluations, and building the capacity of service providers in the health, psychosocial, education, police, justice, and peace-building sectors. She stressed that community engagement is facilitated by identifying key informants, community discussions, and building the capacity of community discussion leaders to promote the prevention of gender-based violence (GBV) with the intervention using a 15-week program led by a trained community member. Glass said that social norms are measured in the following four areas: sexual violence/GBV, family honor, gender equality, and husband's rights. She described how the impact evaluation found a change in social norms toward sexual violence and other forms of GBV within the communities as well as an increased level of satisfaction among women seeking health care services, including an increase in specific questions related to GBV.

Discussion

Following the panel's presentations, Patrick Kelley from the National Academies of Sciences, Engineering, and Medicine asked about how social norms are changing as the world becomes increasingly globalized and about the ability to scale up interventions to the national or global level. Gretchen Bachman from the U.S. Agency for International Development (USAID) pointed out the importance of looking at the issue of violence more holistically and suggested that doing so creates an opportunity to address violence against children by parents and violence against women at the same time.

Addressing the social norms question, Heise described a review that she carried out of 88 comparable studies across time that looked at social norms as predictors of violence as well as at changes in social norms causing a possible decrease in the prevalence of violence. She found, for example, lower levels of violence in the women's paid labor force (not just any work) and in places where family law traditions were more equitable. Bicchieri said that change must come from the bottom up, adding that the most important question to ask is "What are the drivers of script change?" With regard to scaling up, Lundgren stressed that it is critical to have stakeholder engagement from the very start. Her program included stakeholders in the preliminary research and in the design, implementation, and evaluation. She stressed that currently, these same leaders are in the process of scaling the program up without additional funds by transitioning the programs into the hands of the local government.

BREAKOUT SESSION

In the next session forum members, invited speakers, and public participants split up into small working groups. In each group the participants, facilitated by a forum member, discussed how their own violence-prevention activities currently do or could address social and cultural norms. Groups also discussed the impact of social norms on women, inequality associated with age, and gender equity, including sexual orientation and gender identity. Evelyn Tomaszewski from the National Association of Social Workers presented a review of the ideas discussed by individual participants during the breakout session, including the impact of exposure to violence through media (television, the Internet, and social media generally) and the concern that responding to the "issue of the day" results in losing focus on violence prevention. She also mentioned the importance of communities working together to build collaborations through cross-sector awareness and promoted integrated approaches.

INTERSECTION OF NORMS AND TECHNOLOGY, COMMUNICATIONS, AND MEDIA

Overview of the Mediums of Technology, Communications, and Media and Their Interaction with Violence and Violence Prevention Efforts

Suruchi Sood of the Drexel University Dornsife School of Public Health began by asking the question: What are the effects of communication for development (C4D) approaches, in which individuals share ideas and knowledge on a chosen subject, used for addressing violence against children? He then presented findings based on a systemic review of 302 C4D manuscripts to assess the use of a conceptual model to predict change. Sood said an understanding of where individuals are in the stages of change helps to build the knowledge base needed to promote positive social norms. Creating change requires addressing the diverse needs of the entire social norms environment (e.g., individuals, families, policy) through advocacy, interpersonal communications, community, and social mobilization.

How News Media Shapes Our Understanding of Youth Violence and Sexual Assault

Lori Dorfman of the Berkeley Media Studies Group said that news is often reported as a series of individual events without adequate context, making it difficult to see the full story that can help identify what needs to be prevented as well as what

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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can be done to promote the prevention of violence. She said that not having the full story generates misinformation synergy, creating distorted views of crime and race, and limits the opportunity to have a real conversation about what is going on. Dorfman identified how the news media set agendas that define how viewers understand violence. This understanding, in turn, reaches the decision makers responsible for deciding what will (or will not) be done about the issue. She said that despite many strengths of news reporting, criminal justice perspectives dominate the news, and prevention is largely absent. She said that there is a need to reframe the news by moving beyond the individual to the landscape, emphasizing public values in order for viewers to understand why violence prevention matters and to recognize a solution, and using communications to support action. She stressed that more complete news coverage would inform decision makers and the public about prevention, what it means, and why it matters.

Examples of Innovative Approaches in Intervention Efforts

Mallika Dutt spoke about Breakthrough, an organization that uses innovative prevention strategies to address the underlying causes of violence through changing culture. She described the program Bell Bajao (Ring the Bell), a campaign that engages men in challenging domestic violence through a neighbor- or peer-based intervention of "ringing the bell" of a household where there is domestic violence or IPV. After showing a brief video, Dutt said that people today live in a culture where the threat of violence is an integral part of how certain norms are maintained. She said that Bell Bajao takes the idea of the private space (one's home) and breaks down cultural manifestations of violence by "ringing the bell" to make the home a public site of intervention. She described how Bell Bajao uses media arts and technology to have both local conversations and conversations at scale.

Discussion

Following the panel, multiple participants asked about using entertainment for educational purposes, including the evidence base underlying its use and its cost effectiveness. Sood said that evidence has demonstrated that educational entertainment is a communication form that works; for example, soap operas illustrate positive social norms and are a cost-effective health intervention.

Brigid McCaw from Kaiser Permanente brought up the "No More Campaign," which addresses both domestic violence prevention and sexual assault prevention by connecting activists, schools, providers, organizations, survivors, and community members. Arturo Cervantes from Anáhuac University in Mexico said that it is important to use an ecological framework, be evidence based, and use a multi-sector comprehensive approach, given the need for social mobilization to address the underlying causes and the social determinants of the current global pandemic of violence.

THE ROLE OF RELIGION IN INFLUENCING SOCIAL AND CULTURAL NORMS

An Overview of the Intersection of Religion and Social Norms and How Those Norms Affect Gender Equality

Pauline Muchina, a member of the Future African Leaders Project and a theologian, defined religion as an organized collection of beliefs, cultural systems, and world views that relate to humanity and an order of existence. Reflecting on research based on African cultures, she said that religion shapes cultures and social, political, and economic lives and is a powerful force influencing social norms. Muchina said that social norms and religious moral values and beliefs are intertwined and that when social norms and religious traditions and practices come together, they significantly affect the way men and women interact in society, homes, and institutions. As an example, she explained that due to cultural and religious gender norms, African women and girls lack the social and economic power to control their own bodies. She said that all religions today maintain male social dominance within social structures, with religious texts encouraging the exclusion of women from leadership in the family, church, and society, influencing the way people behave toward each other and how women are treated in their homes, in society, and at work. Muchina stressed the need to promote theology to change religious institutions in a manner that ends the negative effects on women and girls. She noted that religious leaders have a platform to address two critical areas: teaching men and boys to promote gender equality and ending GBV.

Religion in the Context of Sexual Identity and Identity Politics

Kapya John Kaoma, a pastor, human rights activist, and visiting researcher at Boston University, spoke about the global impact of religion and the significance of religion in the human experience. He said that while religious beliefs are diverse across the globe, there is a common disregard for and discrimination toward lesbian, gay, bisexual, and transgender

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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(LGBT) persons. Another challenge he mentioned is the assumption (in America) that religion does not play a large role in everyday life, although it is a part of all cultures and communities. To bring about social change, he said, there is a need to understand the role of religion and its influence on certain actions and to understand how to transform these actions and make positive changes within the confines of a specific religion. He said that one can find various sacred texts that demand respect and human rights for all people; however, LGBT persons are not always included in the conversation about human rights. Kaoma stressed the need to speak out against violence experienced globally by LGBT persons and the need for an increased number of women in leadership positions in faith communities.

COMMUNITY-BASED APPROACHES IN CHANGING SOCIAL NORMS

Engaging Men and Boys in the Fight for Gender Equity

Magaly Marques of Promundo's Pioneer Project, Program H (for Hombre), provided an overview of that program, which is being implemented in 22 countries across 5 continents. He said that through using group education, Program H focuses on critical reflections about gender norms combined with youth-led activism or campaigns. He explained how Program H helps men and boys (1) learn about gender norms and attitudes and develop new attitudes and skills, (2) rehearse within the safe environment of group education, (3) internalize attitudes and norms, (4) live in a gender-equitable way in life and relationships, and (5) achieve positive outcomes in gender equity and their own health. Marques described how this is rooted in supportive influences and structure on the individual level (using peer support, role modeling, and action through advocacy) and the systems level (policy, services, institutions) and how the outcomes from nine quasi-experimental impact evaluations (in 8 countries over a 10-year period) found that systematically, after the intervention, there was less support for gender-inequitable attitudes and increased support for gender-equitable attitudes. The study also found that changes in attitudes were strongly associated with changes in self-reported behaviors and that gender-equitable attitudes were associated with a greater knowledge and awareness of health risks.

Reducing the Cultural Practices That Harm Women and Girls

Gannon Gillespie of Tostan provided an overview of the Community Empowerment Program (CEP), a 3-year, locally driven, community-engaged education program that is rooted in human rights. He said that the CEP facilitator is local, trained in the curriculum, and culturally congruent with the community and is responsible for creating a space safe for dialogue and for how the host community agrees to host the facilitator, participate, and build or repurpose a classroom. Based on the use of social norms change, he said, the curriculum takes into account the values of respect, peace, family and social networks, and fulfilling one's role in society, while the content is focused on building self-confidence and democracy and on supporting respect for human rights and responsibilities. He explained that in years 2 and 3, the program expands to include lessons in literacy, math, micro-credit, management, and small projects. The model grows as each classroom participant adopts another learner outside of the class and creates a community-based learning environment.

Discussion

Starting off the discussion, Heise said that there is a need to create partnerships in which people understand the imperatives of working together with researchers to optimize programs and then evaluate them. Concerning partnerships, Marques said that this is an opportunity to look at the intersection of public health and the social justice field; the evidence exists, she said, to demonstrate changing attitudes and beliefs, which can, to some extent, affect health and behavior. Marques added that this is an opportunity for nongovernmental organizations and researchers to say that here is a viable alternative, a new way to approach research by community engagement and leadership. Concerning evaluation data, Gillespie said that the CEP participants are talking about human rights in concrete ways and that he has found increased participation of women in the various levels of decision making.

IMPACT OF ENVIRONMENT AND EXPOSURE TO VIOLENCE ON CULTURAL NORMS AND SOCIAL RELATIONS

The Impact of Chronic Exposure to Violence on Human Development and Social Relations

Chronic violence is a complex problem affecting at least one-quarter of the global population, said Tani Adams, coordinator of the International Working Group on Chronic Violence and Human Development. She said that exposure to chronic violence weakens the capacity of individuals and families to develop and live healthy lives, including having a negative

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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impact on the capacity to develop and maintain constructive social relations. Adams described a literature review that she conducted on the impact of long-term violence, mapping the findings of that survey using Bronfenbrenner's ecological systems theory model. The resulting Chronic Violence and Human Development Framework that she developed reframes the view of violence from a diverse array of discrete problems to a systemic phenomenon with multiple causes and effects and transforms methods for dealing with violence from "siloed" approaches to holistic strategies, from "violence reduction" to "strengthening human development." Adams suggested that strengthening human development will require replacing isolated, siloed approaches with holistic strategies that are intersectoral, interdisciplinary, and relational. She also proposed the following new approaches to violence prevention: strengthen primary networks, enhance the capacity of community through collective learning and strength-based strategies, address chronic and collective trauma through a range of programmatic efforts, focus on human responsibilities over human rights, implement efforts to protect those working to end violence, and identify opportunities for real structural change by looking at political reform and economic development.

The Lived Experience: Overcoming a Culture of Violence

Damian Hutchinson from Jamaica's Ministry of National Security spoke about the lived experience, in which individuals and communities live within multiple cycles of violence, including normalizing violence as a rite of passage for youth, high rates of abuse toward children and women, low school attendance, and overall poor health practices. He added that due to the high levels of exposure to violence, many communities are de-sensitized to violence. He provided a description of the Peace Management Initiative (PMI), which works in Jamaica to interrupt community violence and reduce trauma through community safety planning and empowerment, gang demobilization, healing and reconciliation, and community engagement to change values. He explained how PMI is setting up an incentive-based framework composed of rules and terms of agreement between groups in conflict that also uses incentive-based awards to encourage a community (and groups within the same community) to reduce levels of violence in their own local spaces. He also described how PMI actively engages the community to address community safety planning and empowerment, getting the wider community to be part of the process and the solution. Hutchinson described the successful work in Browns Town, where deaths due to gang violence dropped from 50 between 2004 and 2005 to fewer than 25 between 2005 and 2015. He credited the community for taking charge of its own safety and for being more open and accessible to development work.

Combating the Epidemic of Violence Against Indigenous Women

Karla General of the Indian Law Resource Center provided an overview of the high level of violence against American Indian and Alaska Native women. They are two and a half more times more likely to be sexually assaulted or raped than other women, General said, and Alaska Native women report rates of domestic violence up to 10 times the national average and physical assault victimization rates up to 12 times higher. General added that the murder rate on some reservations is 10 times the national average and that native women and children are especially vulnerable to human trafficking. These disproportionately high rates of violence are due in part, she said, to a U.S. legal system that severely limits the authority of Indian and Alaska Native nations to protect their women and girls from violence.

General then described the Safe Women Strong Nations project, which works to end the epidemic levels of violence against Indian and Alaska Native women and children by raising awareness of this issue nationally and internationally, by strengthening the capacity of Indian and Alaska Native nations and native women to prevent violence, and by assisting national native women's organizations and Indian and Alaska Native nations to restore tribal criminal authority. She outlined advocacy efforts to ensure that the decisions and commitments outlined within the United Nations Declaration on the Rights of Indigenous Peoples (2007), which includes the right of self-determination and the rights and special needs of indigenous women and children, are fulfilled. She said that international advocacy is critical and that the international community must respond to the epidemic of violence against indigenous women in the United States and everywhere, including advocating for mechanisms to ensure that perpetrators of violence against indigenous women and children are brought to justice.

Discussion

In the discussion following the panel's presentations, McCaw asked how to measure informal and formal education techniques in a way that reflects what has been documented in communities. Tomaszewski asked how one could use the idea of community connection to engage youth and encourage them to listen and connect to others in the community. Cervantes commented on the role of the arms trade and illegal trafficking of guns as a critical element of the cycle of violence. Gun trafficking, according to Adams, needs a systems-level change in how data are collected. Referencing the

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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arms trade, which, Adams says, is part of a broader system of illicit trade, she suggested that one could map the role of the illicit economy to better understand this "invisible" motor of violence. Referring to the importance of community connection, Hutchinson stressed having communities make interventions. Hutchison said that PMI uses a trauma response unit that goes into a community to the scene of violence and treats the victims and perpetrators and community as part of that same response while treating the whole community.

SOCIAL NORMS, VIOLENCE, AND LGBT YOUTH

LBGTQ Youth: The Legal and Practice Frameworks

Elliot Kennedy from the Substance Abuse Mental Health Services Administration (SAMHSA) presented an overview of the effects that discrimination, heterosexism, and violence can have on the health and mental health of lesbian, gay, bisexual, and transgender (LGBT) youth, and those who are questioning their sexual orientation or gender identity (LGBTQ). He presented evidence that LGBTQ youth in the United States face higher instances of family rejection, bullying and mistreatment in school, victimization, and criminalization and are disproportionately represented in the child welfare and juvenile justice systems; they also make up as much as 40 percent of the homeless youth population. Kennedy offered highlights of the 2015 SAMHSA publication Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth (SAMHSA, 2015). Kennedy explained that conversion therapy is the use of therapy and other interventions in an effort to change a person's sexual orientation, gender identity, or gender expression; however, the consensus report's key findings included that variations in sexual orientation, gender identity, and gender expression are normal and that conversion therapy is not effective, reinforces harmful gender stereotypes, and is not an appropriate treatment. He added that there is overwhelming scientific evidence that demonstrates that conversion therapy, especially when it is practiced on young people, is neither medically nor ethically appropriate, and can cause substantial harm. Kennedy outlined several approaches that could help end the use of conversion therapy, such as ending discrimination against and negative social attitudes toward LGBTQ individuals and identities; training and educating behavioral health providers; and using legislative, regulatory, and other legal efforts to stop conversion therapy as well as discrimination based on sexual orientation, gender, or gender identity.

Violence Against LGBT Youth: The Global Perspective

Richard Burzynski of the Joint United Nations Programme on HIV/AIDS (UNAIDS) spoke about the importance of identifying the origins of violence and discrimination toward LGBT adults and youth. He described how at UNAIDS the discussion is framed through the lens of HIV, as the work to prevent violence and discrimination throughout the HIV outbreak has provided lessons that can be applied in efforts to improve health and well-being. Burzynski referred to a mapping exercise, which UNAIDS calls Towards a Free and Equal World, that provides a global picture of human rights violations of LGBT persons. According to the map there are 75 countries in which adult same-sex consensual sexual conduct is considered a crime or an LGBT person has been criminally prosecuted under other laws; in 7 of these countries same-sex sexual conduct is punishable by death. Doing the mapping exercise, Burzynski said, provided a number of lessons about the impact of and response to violence and discrimination aimed at LGBT persons: social transformation is under way in all countries; discussions about same-sex sexual relations are occurring globally; there are multi-layered and complex relationships among LGBT people; conflation of misinformation and fact must be confronted, or else misinformation becomes reality and truth; criminalization of LGBT behaviors matters; humanizing LGBT people makes a difference; allies, partnerships, and collaborators are critical; and leadership matters. Burzynski referred to the historic United Nations statement on ending violence and discrimination against LGBT and intersex people.

Discussion

Regarding creating connections among and within communities, Kennedy urged that more opportunities be created for communities to seek out dialogues on these issues, as it takes some time to unlearn discrimination and misinformation and to learn new behaviors. Kennedy then highlighted the Family Acceptance Project, an evidence-based practice that works with LGBTQ youth who experience family rejection and with their family members to create a supportive family environment.

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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GENDER AND CONFLICT

The Role of Women as Peacebuilders and in Countering Violent Extremism

Susan Markham of USAID spoke about the stereotypes, history, and current situation for women as victims and also about the role of women as perpetrators of violence, fighters, mediators, and peacemakers. Markham said that there is often a combination of factors that drive people toward considering engaging in violent extremism, including deficiencies in governance. She said that USAID is examining how targeted investments in women, peace, and security can address security-related objectives by strengthening the role of women and youth in political and peace processes at the community level. Markham highlighted two critical documents. The first was the National Action Plan on Women, Peace, and Security,2 and she emphasized its commitment to community level engagement. She described how the National Action Plan brings voices from civil society to talk to government and the security sector to describe the realities of women's lives, with the intention of identifying ways to empower women that do not put them at greater risk and that move them into places of leadership. The second document was the USAID Gender Equality and Women's Empowerment Policy,3 which has three overarching goals: to reduce gender disparities, reduce gender-based violence and mitigate its harmful effects, and increase the capability of women and girls to realize their rights, determine their life outcomes, and influence decision making in households, communities, and societies. Markham stressed that to meet these goals it will be necessary to work on the social norms and attitudes that people have about women's fundamental rights in these three areas.

Naureen Chowdhury Fink of the Global Center on Cooperative Security spoke remotely on counter-terrorism (CT) and countering violent extremism (CVE), and she noted that CT is much more associated with large responses to terrorism, while CVE is more involved with prevention and working with communities and relies on a combination of hard power and soft power. A major change in the approach to CVE, Fink said, has been the inclusion of community engagement, of gender, the development of preventive approaches that use education and strategic communication, and the shift in viewing civil society activism as a means of developing a much more sustainable and locally resonant approach to terrorism prevention. She described how the Global Center on Cooperative Security has been trying to deter CVE via a twin approach that focuses on designing specific projects or initiatives that look at women and CVE, while also ensuring that CVE is mainstreamed into all of the organization's work. She said that at the policy level she has noticed the twin approach getting more positive responses.

Discussion

Workshop participant Markham began the panel discussion by asking about the pros and cons of having CT separate from CVE instead of having them together and also asking if there is any specific gender impact from separating them. Fink said that combining CT and CVE is beneficial, as CT requires a balanced approach, but he also noted a potential drawback of pairing them: when the two are not done in a coordinated manner, there is a danger that CT will negatively affect CVE. For example, she said, a real concern is that when CT and CVE efforts are present in the same community (and may or may not be known to one another) and, at the same time, community members are encouraged to come forward to share their knowledge and expertise and share the threats they might identify, there can be a response from law enforcement that is disproportionate and discourages further engagement and cooperation from community members.

USING SOCIAL NORMS APPROACHES IN VIOLENCE PREVENTION

The Global Partnership to End Violence Against Children

Susan Bissell of the Global Partnership to End Violence Against Children explained that her organization is composed of stakeholders from governments, civil society and nongovernmental organizations, leaders of faith-based organizations, foundations, United Nations "family," academics and researchers, and the private sector. She stressed that the partnership offers a unique opportunity to unite a global grassroots coalition to keep children safe, and she noted that 5 of the 17 United Nations' Sustainable Development Goals address violence against children. Bissell said that the partnership is committed to, yet challenged by, having children and youth engaged in a way that is transparent and democratic and that ensures that participants are safe while addressing some very dangerous issues.

She provided an overview of what the partnership hopes to do over the next 5 years: ensure that violence

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2 The National Action Plan on Women, Peace, and Security is available here: https://www.usaid.gov/what-we-do/gender-equality-andwomens-empowerment/national-action-plan-women-peace-security (accessed April 2, 2018).

3 The USAID Gender Equality and Female Empowerment Policy is available here: https://www.usaid.gov/sites/default/files/documents/1865/GenderEqualityPolicy_0.pdf (accessed April 2, 2018).

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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prevention is a policy priority globally, create a virtuous cycle in which measurable reductions in violence create political will for greater prevention and response, strengthen the investment case, and increase the capacity to implement evidence-based strategies. Next, Bissell outlined the necessary building blocks of effective policies, programs, and evidence-based interventions to reduce violence, including addressing social norms, ensuring legal protections, building relationships through supporting families and careers, building resilience via increasing children's life skills, offering services that provide care and support, establishing early intervention, promoting risk reduction, and securing data and evidence. She said that the partnership has a sharp focus on ending violence against children.

OPEN DISCUSSION

Following Bissell's presentation, there was a panel discussion among Bissell, Burzynski, Heise, and Muchina. McCaw, the moderator, opened the discussion by noting the life burden of violence and the intersectionality of all forms of violence across communities and suggesting that there are opportunities to think through strategies that are being applied with a specific community that might provide ideas or information transferable to another setting or community.

Several panelists addressed faith communities. Heise said that researchers may be reluctant to engage faith communities due to discomfort or uncertainty about how to challenge religious ideas and concerns about bigotry. Muchina added that there is a need for additional research on social norms, and she said that the research must include the community if one is to understand the impact of religion on social norms.

Panelists also discussed the power of the lived experience, community-level engagement, and meeting the growing needs of communities affected by violence. Burzynski spoke of working with people who experience violence and discrimination daily and of the importance of breaking down silos and finding local solutions, while Adams stressed the importance of supporting an intersectoral approach. Muchina said that the greatest challenge right now is providing mental services for young people because some of them are living with HIV and they are becoming young adults with very few agencies dealing with mental health or the impact of violence (for either the perpetrators or victims of violence). Michele Maloney-Kitts of UNAIDS agreed that it is important to use evidence to create policy change and educate funders. She added that measurement is important and that using similarly defined measurements is key.♦♦♦

REFERENCES

Abrahams, N., and R. Jewkes. 2005. Effects of South African men's having witnessed abuse of their mothers during childhood on their levels of violence in adulthood. American Journal of Public Health 95:1811–1816.

Bicchieri, C., and Penn Social Norms Training and Consulting Group. 2016. Why people do what they do: A social norms manual for Viet Nam, Indonesia and the Philippines. Innocenti Toolkit Guide from the UNICEF Office of Research, Florence, Italy.

Brookmeyer, K. A., C. C. Henrich, M. Schwab-Stone. 2005. Adolescents who witness community violence: Can parent support and prosocial cognitions protect them from committing violence? Child Development 76:817–829.

Krug, E. G., L. L. Dahlberg, J. A. Mercy, A. B. Zwi, and R. Lozano. 2002. World violence report on health. Geneva, Switzerland: World Health Organization.

Lansford, J. E., and K. A. Dodge. 2008. Cultural norms for adult corporal punishment of children and societal rates of endorsement and use of violence. Parenting: Science and Practice 8:257–270.

Raising Voices. 2013. Raising voices: 2012–2016 strategy. http://raisingvoices.org/wp-content/uploads/2013/03/downloads/RV_Strategy.pdf (accessed on January 17, 2018).

Read-Hamilton, S., and M. Marsh. 2016. The Communities Care programme: Changing social norms to end violence against women and girls in conflict-affected communities. Gender & Development 24(2):261–276.

SAMHSA (Substance Abuse and Mental Health Services Administration). 2015. Ending conversion therapy: Supporting and affirming LGBTQ youth. HHS Publication No. (SMA) 15-4928. Rockville, MD: Substance Abuse and Mental Health Services Administration.

WHO (World Health Organization). 2009. Changing cultural and social norms supportive of violent behaviour (Series of briefings on violence prevention: The evidence). Geneva, Switzerland: World Health Organization.

Suggested Citation:"Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop - in Brief." National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. doi: 10.17226/25075.

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DISCLAIMER: This Proceedings of a Workshop—in Brief was prepared by Evelyn Tomaszewski as a factual summary of what occurred at the workshop. The statements made are those of the rapporteur or individual workshop participants and do not necessarily represent the views of all workshop participants; the planning committee; or the National Academies of Sciences, Engineering, and Medicine.

Planning Committee for Workshop on Addressing the Social and Cultural Norms That Underlie the Acceptance of Violence**

Valerie Maholmes, National Institutes of Health; Vikki Stein, U.S. Agency for International Development; Evelyn Tomaszewski, National Association of Social Workers; and Elizabeth Ward, Violence Prevention Alliance.

**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—in Brief rests with the institution.

REVIEWERS: To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop—in Brief was reviewed by Nancy Glass, Johns Hopkins University, and Brigid McCaw, Kaiser Permanente. Lauren Shern, National Academies of Sciences, Engineering, and Medicine, served as the review coordinator.

SPONSORS: This workshop was partially supported by AB InBev; Administration for Community Living; Archstone; Avon Foundation; Becton, Dickinson and Company; Catholic Health Initiative; Department of Labor; Felix Foundation; Insituto Nacional para la Evaluación de la Educación; JSI Research & Training Institute, Inc. (USAID); Kaiser Permanente; Leading Age; National Institutes of Health; New Venture Fund; Oak Foundation; and Robert Wood Johnson Foundation.

For additional information regarding the workshop, visit nationalacademies.org/hmd/Activities/Global/ViolenceForum/2015-OCT-29.aspx.

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Addressing the social and cultural norms that underlie the acceptance of violence: Proceedings of a workshop—in brief. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25075.

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Cultural Diversity and Conformity Guided Reading Section 2

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