Hospital-based violence intervention

Smith, Randi N.; Dobbins, Sarah; Evans, Abigail; Balhotra, Kimen; Dicker, Rochelle

doi:10.1097/ta.0b013e31828586c9

Cited by 90 publications

(54 citation statements)

References 9 publications

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“…Interventions to reduce traumatic event reexposure in this population or at least to ameliorate the negative effects of reexposure on treament participation might be very beneficial. We are not aware of any such interventions under development or in use in SUD treatment settings, although some have been tested in emergency medicine settings or post-disaster mental health care (e.g., Smith et al, 2013; Walton et al, 2010). Interventions such as Psychological First Aid (National Child Traumatic Stress Network and National Center for PTSD, 2006) could be adapted for provision in substance abuse treatment settings where new traumatic events seem common and patients may be less able to cope effectively with them on their own.…”

Section: Discussionmentioning

confidence: 99%

Effect of traumatic event reexposure and PTSD on substance use disorder treatment response

Peirce

Brooner

King

et al. 2016

Drug and Alcohol Dependence

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Background A remarkably high rate of traumatic event reexposure has been demonstrated in community-based substance users which negatively impacts their substance use disorder (SUD). The rate and effect of such reexposure in treatment is unknown. Despite increasing evidence that a diagnosis of posttraumatic stress disorder (PTSD) has little influence on long-term SUD treatment outcomes, it is possible that PTSD symptom fluctuations could have effects. Methods This prospective longitudinal study examined the rate and effect of traumatic event reexposure and PTSD symptoms in 169 male and female methadone maintenance patients with a comorbid psychiatric disorder who were participating in a parent study. Traumatic events and PTSD symptoms were tested for association with drug use, treatment interruption, and counseling adherence in the same month, one month later, and two months later. Results Approximately 18% of patients were reexposed to a traumatic event each month during the 12-month study. Reexposure was associated with about twice the risk of treatment interruption in the same month and one month later. Every 10% increase in PTSD symptom severity was associated with a 36% increased risk of treatment interruption two months later. No effects were seen on drug use or counseling adherence. Conclusions SUD patients have a relatively high rate of traumatic event reexposure. Both traumatic events and PTSD symptoms are associated with increased risk of treatment interruption, resulting in SUD patients leaving treatment at precisely the time they could benefit from treatment support.

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Section: Discussionmentioning

confidence: 99%

Effect of traumatic event reexposure and PTSD on substance use disorder treatment response

Peirce

Brooner

King

et al. 2016

Drug and Alcohol Dependence

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“…They have shown that an HVIP can reduce re-injury rates two to three-fold and have demonstrated HVIP effectiveness. 13,17,21,22 Qualitative focus groups and individual interviews were carried out with key informants for two HVIPs, who were identified through snowball-sampling until no new thematic information arose during interviews (theoretic saturation). 23 Informants had diverse backgrounds and included HVIP directors (2), HVIP case managers (6), a trauma nurse practitioner, social workers (2), psychotherapists (3), violence intervention specialists (2), community leaders (2).…”

Section: Methodsmentioning

confidence: 99%

“…This has been immensely useful to new and emerging programs, as a greater understanding of the key points of success for established programs is crucial to their ongoing funding and success. 13,14 …”

Section: Introductionmentioning

confidence: 99%

Violent reinjury risk assessment instrument (VRRAI) for hospital-based violence intervention programs

Kramer

Dodington

Hunt

et al. 2017

Journal of Surgical Research

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Background Violent injury is the second most common cause of death among 15–24 year-olds in the US. Up to 58% of violently injured youth return to the hospital with a second violent injury. Hospital-based violence intervention programs (HVIP) have been shown to reduce injury recidivism through intensive case management. However, no validated guidelines for risk assessment strategies in the HVIP setting have been reported. We aimed to use qualitative methods to investigate the key components of risk assessments employed by HVIP case managers and to propose a risk assessment model based on this qualitative analysis. Materials and Methods An established academic hospital-affiliated HVIP served as the nexus for this research. Thematic saturation was reached with 11 semi-structured interviews and 2 focus groups conducted with HVIP case managers and key informants identified through snowball-sampling. Interactions were analyzed by a four-member team using Nvivo 10, employing the constant comparison method. Risk factors identified were used to create a set of models presented in 2 follow-up HVIP case managers and leadership focus groups. Results Eighteen key themes within seven domains (environment, identity, mental health, behavior, conflict, indicators of lower risk, case management) and 141 potential risk factors for use in the risk assessment framework were identified. The most salient factors were incorporated into eight models that were presented to the HVIP case managers. A 29-item algorithmic structured professional judgment model was chosen. Conclusions We identified four tiers of risk factors for violent re-injury that were incorporated into a proposed risk assessment instrument, VRRAI.

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“…Brief interventions shortly after the injury have been shown to halve the risk of renewed alcohol-related injury (Schermer et al 2006 ; Gmel et al 2007 ). Violence intervention programs has showed a fourfold to sixfold decrease of trauma recidivism and with good cost-effectiveness (Cooper et al 2006 ; Smith et al 2013 ; Juillard et al 2015 ). Other examples of successful intervention are fall prevention in geriatric care and fracture prevention programs (Lih et al 2011 ; Sach et al 2012 ; Van der Kallen et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

“…Other examples of successful intervention are fall prevention in geriatric care and fracture prevention programs (Lih et al 2011 ; Sach et al 2012 ; Van der Kallen et al 2014 ). Intervention programs seem to working better if implemented shortly after the injury event (Gentilello et al 1995 ; Smith et al 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Trauma recidivism at an emergency department of a Swedish medical center

et al. 2016

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BackgroundTo inform targeted prevention, we studied patterns of trauma recidivism and whether a first injury predicts the risk for a recurrent injury.MethodsIn a population-based study of 98,502 adult injury events 1999–2012, at the emergency department of Umeå University Hospital, Sweden, we compared non-recidivists with recidivists in terms of patients’ sex, age, type of injury and severity of the injury.ResultsThirty-six percent of all patients suffered recurrent injuries, which were associated with a higher proportion of inpatient care and more hospital days. Young men and elderly women were at the highest risk for trauma recidivism. At 20 to 24 years, men had a 2.4 (CI 95 % 2.3–2.5) higher risk than women, a 90 years old woman had almost a 10-fold higher risk for another moderate/severe injury than a 20 years old one. A fracture were associated with a hazard ratio of 1.28 (CI 95 % 1.15–1.42) among men younger than 65 years and 1.31 (CI 95 % 1.12–1.54) for men older than 65 years for a subsequent moderate/severe injury. For women younger than 65 years a fracture was associated with a hazard ratio of 1.44 (CI 95 % 1.28–1.62) for a subsequent moderate/severe injury. A sprain carries a higher risk for a new moderate/severe injury for both men and women and in both age groups; the hazard ratio was 1.13 (CI 95 % 1.00–1.26) for men younger than 65 years, 1.42 (CI 95 % 1.01–1.99) for men older than 65 years, 1.19 (CI 95 % 1.05–1.35) for women younger than 65 years and 1.26 (CI 95 % 1.02–1.56) for women older than 65 years. A higher degree of injury severity was associated with a higher risk for a new moderate/severe injury.ConclusionTrauma recidivism is common and represents a large proportion of all injured. Age and sex are associated with the risk for new injury. Injury types and severity, also have implications for future injury.

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Hospital-based violence intervention

Abstract: Care management study, level III.

Cited by 90 publications

References 9 publications

Effect of traumatic event reexposure and PTSD on substance use disorder treatment response

Effect of traumatic event reexposure and PTSD on substance use disorder treatment response

Violent reinjury risk assessment instrument (VRRAI) for hospital-based violence intervention programs

Trauma recidivism at an emergency department of a Swedish medical center

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