Generating a Core Set of Outcomes for Hospital-Based Violence Intervention Programs

Abstract

Hospital-based violence intervention programs (HVIPs) engage individuals who have experienced violent victimization in postmedical care programming, with the goal of reducing the incidence and impact of future injuries. Although there is some empirical support for HVIPs' impact on violence and crime-related outcomes, proper impact assessment is limited by a lack of systematized research on outcomes that relate to the proximal goals and activities of the programs themselves. To address this critical gap, we conducted a two-stage Delphi method to elicit and prioritize these outcomes using the wisdom and experience of those who are engaged in service delivery (i.e., HVIP community-based practitioners, program coordinators, and embedded researchers; N = 79). Through this process, respondents prioritized outcomes related to posttraumatic stress symptoms, beliefs about aggression, coping strategies, and emotional regulation, which have not been consistently measured using validated or standardized tools. Results suggest that, rather than limiting program outcomes to those related to repeat violent injury or criminality, hospital- and community-based violence prevention programs seek to improve and measure mental health and socioemotional outcomes as a benchmark for healing and recovery after a violent injury. Prioritization of these outcomes broadens the definition of recovery to include psychosocial health and well-being. In addition, inclusion of these outcomes in effectiveness studies will serve to bolster the relevance of findings, and provide support for continued development and refinement of HVIP practice.

Utilization of mental health services in pediatric patients surviving penetrating trauma resulting from interpersonal violence

“…18 HVIPs have the goal of utilizing a unique window of opportunity to effectively engage with victims while they are initially hospitalized after their injury 11 and provide support in the community context following the violent event. 19 Studies have demonstrated that HVIPs show promise in decreasing repeat victimization. 11,17 Traditionally, HVIPs have focused on case management and, while CVRT has institutional partnership with VIAP (our HVIP), its focus is on providing ongoing mental health services independent of insurance status to both patients and their families.…”

Hospital-based violence intervention: strategies for cultivating internal support, community partnerships, and strengthening practitioner engagement

“…Preliminary evidence shows that HVIPs can be effective in reducing repeat victimizations within communities (Chong et al , 2015). There is also evidence to suggest that HVIPs help to improve the mental and physical health of victims, increase their rates of employment and housing and improve relationships by increasing closeness to supportive friends, family and community members and decreasing involvement in gangs (Juillard et al , 2016; Monopoli et al , 2018). HVIPs may also decrease costs to the victims by way of lowering rates of incarceration and future hospitalizations (Evans and Vega, 2018).…”

Shook Ones: Understanding the Intersection of Nonfatal Violent Firearm Injury, Incarceration, and Traumatic Stress Among Young Black Men

“…HVIPs frequently incorporate cognitive behavioral therapy (CBT) into service models that guide care for survivors of violence while prioritizing varied psychosocial health outcomes ( Karraker et al, 2011 ; Monopoli et al, 2018 ). However, HVIPs have no common therapeutic model or set of outcomes that have been consistently developed, measured, or validated using standardized tools ( Monopoli et al, 2018 ). No comprehensive, evidence-based, and trauma-specific therapeutic model has been developed to ameliorate traumatic stress among violently injured young Black men ( Monopoli et al, 2018 ).…”

“…However, HVIPs have no common therapeutic model or set of outcomes that have been consistently developed, measured, or validated using standardized tools ( Monopoli et al, 2018 ). No comprehensive, evidence-based, and trauma-specific therapeutic model has been developed to ameliorate traumatic stress among violently injured young Black men ( Monopoli et al, 2018 ). In the absence of the appropriate population-specific model, the HVIP in the study used the Men’s Trauma Recovery Empowerment Model (M-TREM).…”