Background Firearm-related injuries remain a heavy public health and clinical burden in the United States. Extreme Risk Protection Order (ERPO) laws, which create a path through a civil court process to temporarily remove firearms from individuals deemed to be at risk of harming themselves or others and are one strategy designed to reduce firearm violence. Maryland was the first state to authorize clinicians as ERPO petitioners. Objective We aim to document a sample of Maryland physicians’ perspectives about the utility of, any barriers to, and other thoughts on clinicians as ERPO petitioners. Design A series of semi-structured interviews with Maryland physicians identified through a combination of purposive and snowball sampling. We coded the transcribed interviews and analyzed the coded transcripts for themes using deductive content analysis. Setting/Participants 13 Maryland-based physicians interviewed over Zoom in and around Baltimore City, Maryland. Results The interviewees had overall positive feedback about ERPO as a gun violence prevention tool in the clinical setting. They identified several barriers to effective implementation such as time spent on paperwork and in court, a lack of awareness among clinicians about ERPO, threats to therapeutic alliance, and a sense of futility in a culture where firearms are easy to obtain. Solutions such as providing clinician education about ERPO laws, allowing for virtual court testimony, and creating a consult service with ERPO specialists to manage ERPO petitions were discussed. Limitations This study includes a small sample of Maryland-based physicians. Conclusions The physicians we interviewed expressed interest in knowing more about ERPO laws and emphasized education as an important tool for improving implementation. Addressing physicians’ concerns about ERPO implementation will improve their ability to be effective and efficient petitioners.
Introduction The health, well-being and psychological development of children in urban areas is threatened by exposure to interpersonal violence. Violence intervention programs, such as Project Ujima, provide children with comprehensive treatment following exposure to violence. Services focus on the interruption of the violence cycle, mental health, and developing resiliency. The collection of patient-reported outcomes (PROs) from youth victims of violence informs community-based, programmatic, and individual participant interventions. Although the collection of PROs throughout treatment has been demonstrated to be feasible, youth and crime victim specialist preferences for data presentation is unknown. We sought to determine patient and crime victim specialist preferences regarding which PROs are of interest and how best to visually display them for optimal engagement. Results Fifteen youth and nine crime victim specialists consented to participate. Both preferred visuals with the highest level of color-shading and descriptions. The domains with the highest level of interest among both youth and case workers were social, anger, emotional, school, physical, peer relations, and psychosocial well-being. Youth and crime victim specialists expressed low interest in positive affect, meaning/purpose, physical stress experience, and depression domains. Youth wanted to see their scores compared to others in the program, while crime victim specialists did not think such comparisons would be beneficial. In contrast to youth, crime victim specialists believed youth should see their physical functioning and PTSD scores. Conclusion Youth participants and their crime victim specialists in a violence intervention program desired to see their PROs in a graphical form and agreed on their preference for many of the domains except for PTSD and physical functioning. Both groups preferred visuals with the highest level of shading and descriptions. Further investigation is needed to determine how to implement PRO visuals with the desired domains into regular violence intervention programming. Methods Participants in Project Ujima’s 8-week summer camp, ages 7–18 years, who were either a victim of violent injury, a direct relative of a violent injury victim, or a homicide survivor were recruited for this qualitative study. Crime victim specialists, who work directly with these youth throughout the year, were also recruited to participate. We conducted structured interviews to determine which parameters and visual formats were of highest interest and best understood by youth participants and crime victim specialists.
Objective The primary purpose of this study is to determine if there is an association between proximity to protective community assets and youth well-being following exposure to violence. Methods This study is a retrospective data analysis using existing data from 471 participants in a violence intervention program. Street addresses of participants were mapped using ArcMap version 10.8.1 mapping software and a buffer analysis was conducted to determine the association between victim well-being and proximity to green space. Results Living close to a green space is associated with decreased fatigue at 1000 ft (p=0.3), 1500 ft (p=0.01), and 2000ft (p=0.008). Proximity to green space is associated with increased overall psychosocial well-being at 1500ft (p=0.004) and 2000ft (p<0.001). Living close to green space was also associated with increased anxiety in youth victims of violence at 1000ft (p=0.027). Conclusions A relationship exists between proximity to green space and youth fatigue and overall well-being following exposure to violence. However, those victims of violence who live closest to green spaces report higher anxiety scores. Subsequent research should focus on determining why proximity to green space differentially impacts youth well-being in the face of violence.
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