Exploring programme implementation of a US paediatric hospital-based violence intervention programme by injury mechanism.

IF 2.5 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Injury Prevention Pub Date : 2025-05-24 DOI:10.1136/ip-2024-045570

Hillary M Kapa, Julianna Berardi, Zijing Liu, Joel A Fein, Rachel K Myers

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引用次数: 0

Abstract

Background: Hospital-based violence intervention programmes (HVIPs) support recovery following interpersonal violence, with most patients participating following firearm injuries. There remains insufficient understanding of who HVIPs serve and how programmes are implemented, especially among paediatric patients. We sought to describe the implementation of a paediatric HVIP and examine relationships between HVIP implementation metrics and mechanism of injury (firearm vs non-firearm).

Methods: We conducted a retrospective cohort study using HVIP records from 2018 to 2023, identifying 2021 patients (8-18 years) treated at our urban paediatric trauma centre in the northeastern USA, 416 of whom enrolled in our HVIP. We conducted bivariate and multivariate regression analyses examining differences in patient-level characteristics and HVIP implementation by injury mechanism.

Results: Most patients (94%) experienced non-firearm injuries. Firearm-injured patients were more likely to enrol in our HVIP (adjusted OR=4.01, 95% CI 2.64 to 6.14) than non-firearm-injured patients, though non-firearm-injured patients represented 85% of HVIP participants. In comparison to non-firearm-injured patients, firearm-injured patients had longer programme duration (adj_B=43.73, 95% CI 4.84 to 82.63 days), more documented encounters (adj_B=16.30, 95%CI 3.44 to 29.16) and more recovery goals (adj_B=3.37, 95%CI 1.21 to 5.52). HVIP goal resolution and graduation rates did not significantly differ by mechanism.

Conclusion: Our study identified metrics to describe HVIP implementation among paediatric patients with diverse injury types and documented consistent HVIP engagement, retention and outputs for those with firearm and non-firearm injuries alike. Our work suggests the relevance, and acceptability of HVIPs for paediatric patients with diverse injuries and offers a framework for process measurement in future implementation, outcome and impact evaluations.

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探索美国儿科医院基于伤害机制的暴力干预方案的方案实施。

背景：以医院为基础的暴力干预方案（HVIPs）支持人际暴力后的康复，大多数患者在火器伤害后参与。人们对hvip服务对象以及规划如何实施，特别是在儿科患者中，仍然了解不足。我们试图描述儿科HVIP的实施情况，并检查HVIP实施指标与伤害机制（火器与非火器）之间的关系。方法：我们使用2018年至2023年的HVIP记录进行了一项回顾性队列研究，确定了在美国东北部城市儿科创伤中心接受治疗的2021例患者（8-18岁），其中416例参加了我们的HVIP。我们进行了双变量和多变量回归分析，通过损伤机制检查患者水平特征和HVIP实施的差异。结果：大多数患者（94%）经历非火器性损伤。火器伤患者比非火器伤患者更有可能加入我们的HVIP（调整后OR=4.01, 95% CI 2.64至6.14），尽管非火器伤患者占HVIP参与者的85%。与非火器伤患者相比，火器伤患者有更长的疗程（adj_B=43.73, 95%CI 4.84至82.63天），更多记录的遭遇（adj_B=16.30, 95%CI 3.44至29.16）和更多的恢复目标（adj_B=3.37, 95%CI 1.21至5.52）。HVIP目标解决和毕业率在机制上无显著差异。结论：我们的研究确定了描述HVIP在不同伤害类型的儿科患者中实施的指标，并记录了枪支和非枪支伤害患者的HVIP参与、保持和输出的一致性。我们的工作表明了hvip对不同损伤的儿科患者的相关性和可接受性，并为未来实施、结果和影响评估的过程测量提供了一个框架。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Injury Prevention 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.30

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Since its inception in 1995, Injury Prevention has been the pre-eminent repository of original research and compelling commentary relevant to this increasingly important field. An international peer reviewed journal, it offers the best in science, policy, and public health practice to reduce the burden of injury in all age groups around the world. The journal publishes original research, opinion, debate and special features on the prevention of unintentional, occupational and intentional (violence-related) injuries. Injury Prevention is online only.