Purpose The American College of Surgeons’ Rural Trauma Team Development Course (RTTDC) was designed to help rural hospitals optimize a team approach to trauma management recognizing the need for early transfer. Little literature exists on the success of RTTDC achieving its objectives. The purpose of this study was to determine the impact of RTTDC on rural trauma team members. Methods RTTDC was hosted at seven rural hospitals. A pre‐course 30‐question Likert survey gauging confidence managing trauma patients was administered to participants. Four weeks following, participants received a post‐course survey with corresponding Likert questions and 11 trauma knowledge‐based questions. Chi‐square, Fisher's exact tests and general linear models were utilized. Statistical significance is set as p < 0.05. Results 111 participants completed the pre‐course survey; 53 (48%) completed the post‐course survey. Results presented on a 5‐point Likert scale with 1 = “not at all comfortable” to 5 = “extremely comfortable.” Participants knowing their role in the trauma team improved by 16% (p = 0.02). Familiarity with the roles of other trauma team members was significantly improved (3.4 vs. 4.15; p < 0.01). Participants comfort with resuscitating trauma patients and managing traumatic brain injury significantly improved (3.29 vs. 3.69; p = 0.01 and 2.62 vs. 3.14; p = 0.004, respectively). Comfortability communicating with the regional trauma center improved significantly (3.64 vs. 4.19; p = 0.004). Participant decision to transfer trauma patients within 15 min of arrival improved by 3.2%. Participants answered 82% of the knowledge‐based questions correctly. Conclusion RTTDC instills confidence in providers at rural hospitals. The information taught is well retained, allowing for quality care and timely patient transfer to the nearest trauma center.
The objectives of the present study were to measure and describe the baseline participant needs of a hospital-based violence intervention 1-year pilot program, assess differences in expected hospital revenue based on changes in health insurance coverage resulting from program implementation and discuss the program’s limitations. Methods: Between September 2020 and September 2021 Encompass Omaha enrolled 36 participants. A content analysis of 1199 progress notes detailing points of contact with participants was performed to determine goal status. Goals were categorized and goal status was defined as met, in process, dropped, or participant refusal. Results: The most frequently identified needs were help obtaining short-term disability assistance or completing FMLA paperwork (86.11%), immediate financial aid (86.11%), legal aid (83.33%), access to food (83.3%), and navigating medical issues other than the primary reason for hospitalization (83.33%). Conclusions: Meeting the participants’ short-term needs is critical for maintaining their engagement in the long-term. Further, differences in expected hospital revenue for pilot participants compared with a control group were examined, and this analysis found a reduction in medical and facility costs for program participants. The pilot stage highlighted how complex the needs and treatment of victims of violence are. As the program grows and its staff become more knowledgeable about social work, treatment, and resource access processes, the program will continue to improve.
Success of youth violence intervention and prevention effects, particularly for gun violence, will be enhanced when efforts are appropriately informed by the antecedents and context of violence. Youth violence is guided by social and cultural norms that are shifting with the rise of technology. Bullying, gang violence, and self-directed violence is increasingly found to occur in the online space influencing peer groups across contexts. Through focus groups with youth at risk for violence and victimization, this study finds three themes emerge as common precursors to violence: defense of self or others, disrespect of self or family occurring in traditional community-based interactions, and threats or disrespect occurring through social media platforms. Youth violence prevention programs should consider how using social cognitive intervention framework could build knowledge, attitudes, and skills needed for violence intervention and prevention informed by precursors to violence found in this analysis.
BACKGROUND Historically, youth violence prevention strategies used deterrence-based programming with limited success. We developed a youth violence prevention program, Dusk to Dawn (D2D), intended to improve youths' recognition of high-risk situations and teach new skills in conflict resolution. The aim of this study was to evaluate the effect of D2D on youths' perceptions of personal risk factors and high-risk situations. METHODS Youth ages 12 years to 18 years were referred to D2D by community-based organizations, probation, or youth detention center. The youth completed a self-report survey before and after participating in D2D. RESULTS One hundred eight youth participated in D2D. Pretest and posttest results for self-reported personal risk factors and high-risk situations for violence are presented. For personal risk factors, a statistically significant increase in the perception that family (p < 0.01) and other issues (p < 0.05), and a decrease in the perception that school problems (<0.05) were seen as important personal risk factors. For high-risk situations, increases in the perception that peer violence and substance use as high-risk situations were seen as significant at the trend level (p < 0.10). Of the 60% of participants who answered questions regarding satisfaction with D2D, 83.3% agreed or strongly agreed that D2D helped them to better understand violence and 83.3% would recommend D2D to others. CONCLUSION Youth violence prevention programming including an explicit discussion of how violence is learned and the role of family, friends, school, and a community in shaping youths' attitudes toward violence can effectively raise awareness of one's own risk factors. Risk factors for youth violence are often preventable or modifiable, making awareness of one's own risk factors a realistic target for youth violence prevention programs. LEVEL OF EVIDENCE Therapeutic/Care Management, Level III.
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