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Youth delinquency and incarceration rates have steadily declined in recent years, yet referrals to the criminal-legal system increasingly involve more serious offenses and greater mental health treatment needs. In parallel, youth delinquency and violence prevention interventions have proliferated rapidly. This paper presents a mixed-methods study of a school-based nonprofit operating in the violence prevention space. Drawing on systems and system effects theories which emphasize the emergent and often unintended outcomes that arise from complex interactions within a system, I examine how program implementation and service provision have evolved amid broader systemic uncertainties. Further, I analyze program curricula, training protocols, historical documents, semi-structured interviews, and ethnographic data to compare program design and implementation and illustrate how they have changed over time and in relation to each other. Findings reveal that there is an uncoupling of program design and delivery, whereby program design remains rooted in theories of criminology that locate causes in individual behavior, while program implementation has increasingly focused on the systemic drivers of violence, trauma, and issues related to youth mental health. The findings of this work build on prior literature by investigating how system effects shape organizational perspectives on delinquency and the provision of youth prevention programs over time.