PROJECT SUMMARY Community gun violence kills more than 15,000 people each year who are disproportionately younger, Black men. In addition, people living in communities with high rates of gun violence experience long-term negative physical and mental health effects from persistent trauma. At the root of neighborhood conditions that allow this violence and trauma to persist are generations of structural racism, including redlining policies and mass incarceration, which contribute to systemic disinvestment in these neighborhoods and disruption of community bonds. This proposal challenges long-standing structurally racist policies that limit resources and addresses the social context that stymies positive relationships by permitting and normalizing trauma after exposure to gun violence by applying a counteracting positive, systemic community-level approach to change the context within which intergenerational cycles of gun violence, trauma, and incarceration persist. Dr. Brita Roy, MD, MPH, MHS, Director of Population Health at Yale Medicine and core faculty at the Yale Center for Research Engagement, and Virginia Spell, CEO of Urban League of Southern Connecticut, a civil rights organization, have partnered with stakeholders across New Haven, Connecticut, to design and test a program to reduce gun violence by addressing structural racism. TRUE HAVEN: TRUsted rEsidents and Housing Assistance to decrease Violence Exposure in New Haven is a multi-level, multi-component, assets-based intervention to increase the stability, wealth, and well-being of neighborhoods affected by gun violence by: (1) setting up a citywide community stakeholder-led governance structure to oversee the program and identify and address racist policies, (2) increasing housing stability by enrolling 400 families affected by incarceration each year in a program that couples comprehensive financial education with rental assistance or down-payment and loan assistance, and (3) providing greater support for mental health and well-being by training trusted community members (e.g., barbers, educators, faith leaders, youth mentors) in trauma-informed counseling techniques to recognize and support those affected by the trauma of gun violence. We will target implementation of this intervention package to individuals and families affected by incarceration residing within six New Haven neighborhoods with high rates of gun violence. We will perform a hybrid type 1 effectiveness/implementation study to assess the effects of TRUE HAVEN on neighborhood rates of incident gun violence using a stepped wedge study design and identify organizational and policy factors that act as key barriers and facilitators to TRUE HAVEN implementation. We will also track the number and types of racist policies addressed and project their community-wide impact using a simulation model that can be adapted by other communities aiming to tackle structural racism. This study will yield a roadmap for how cities can effecti...