U.S. flag

An official website of the United States government, Department of Justice.

Caught in the Crossfire (Oakland)



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