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Caught in the Crossfire (Oakland)



Comprehensive; Ages 12–25


(Read the criteria for this rating)

Effective gang program


Caught in the Crossfire (Oakland) is a youth violence intervention program managed by Youth ALIVE! Launched at the Oakland Highland Hospital in 1994, the program has been replicated in many other cities. Considered a flagship program by the National Network of Hospital-based Intervention Programs, Caught in the Crossfire strives to close the “revolving door” of violence. Shortly after a young person is admitted to the hospital with a violence-related injury, an Intervention Specialist typically arrives to help the injured patient, family and friends cope with the injury and begin considering alternatives to retaliation. Intervention Specialists are young adults from the same communities as the clients they serve who have overcome violence in their own lives. They provide emotional support, work to prevent retaliation, promote alternative strategies for dealing with conflicts, identify short-term needs, and develop a plan for staying safe. Following hospital discharge, Intervention Specialists continue to provide case management and mentoring for six months. Successful completion of the program was defined as a minimum of three contacts with a Crisis Intervention Specialist within six months of injury, at least one of these being an in-person contact.

Risk Factors

Exposure to firearm violence
Few social ties (involved in social activities, popularity)
Gang involvement in adolescence
High alcohol/drug use
High drug dealing
Illegal gun ownership/carrying
Physical violence/aggression
Violent victimization
Delinquent siblings
Family history of problem behavior/criminal involvement
Family poverty/low family socioeconomic status
Family violence (child maltreatment, partner violence, conflict)
Living in a small house
Poor parental supervision (control, monitoring, and child management)
Frequent truancy/absences/suspensions; expelled from school; dropping out of school
Low school attachment/bonding/motivation/commitment to school
Poor school attitude/performance; academic failure
Poorly organized and functioning schools/inadequate school climate/negative labeling by teachers
Availability and use of drugs in the neighborhood
Availability of firearms
Community disorganization
Economic deprivation/poverty/residence in a disadvantaged neighborhood
Exposure to violence and racial prejudice
Feeling unsafe in the neighborhood
High-crime neighborhood
Neighborhood physical disorder
Neighborhood youth in trouble
Association with antisocial/aggressive/delinquent peers; high peer delinquency
Association with gang-involved peers/relatives
Gang membership
Peer alcohol/drug use


Caught in the Crossfire has been evaluated in a retrospective case-control study. A total of 112 violently injured youth (ages 12-20) were included in the program evaluation. On average, members of the treatment group had 5 in-person contacts and 11 telephone contacts with a Crisis Intervention Specialist during the six-month period. The results showed that the youth who were treated were 70% less likely to be arrested for any offense 6 months post-injury, and 60% less likely to have any criminal involvement than the control group (Becker, Hall, Ursic et al., 2004). The proportion of gang members in the sample was not noted. In addition, hospital-centered violence intervention programs are generally cost-effective (Chong, Smith, Garcia et al., 2015; Purtle, Rich, Bloom et al., 2015).

National Gang Center: Effective gang program


Primary Contact Person

Anne Marks, Executive Director
Caught in the Crossfire Program Manager
Youth ALIVE!
3300 Elm Street
Oakland, CA 94609
Phone: (510) 594-2588, ext: 306
Web site: http://www.youthalive.org/caught-in-the-crossfire/

National Network of Hospital-based Intervention Programs
Web site: http://nnhvip.org/


Becker, M. G., Hall, J. S., Ursic, C. M.; Jain, S.; Calhoun, D. (2004). Caught in the Crossfire: the effects of a peer-based intervention program for violently injured youth. Journal of Adolescent Health, 34(3), 177-83.

Chong, V.E.; Smith, R.; Garcia, A.; Lee, W.S.; Ashley, L.; Marks, A.; Liu, T.H. (2015). Hospital-centered violence intervention programs: A cost-effectiveness analysis, American Journal of Surgery, 209, 597-603.

Purtle, J.; Rich, L.J.; Bloom, S.L; Rich, J.A.; Corbin, T.J. (2015). Cost-benefit analysis simulation of a hospital-based violence intervention program. American Journal of Preventive Medicine, 48, 162-169.

Date Created: April 7, 2021