Psychosocial Needs of African American Youth Presenting to a Pediatric Emergency Department With Assault-related Injuries

McCart, Michael R.; Davies, W. Hobart; Phelps, Lori F.; Heuermann, Wendi; Melzer-Lange, Marlene

doi:10.1097/01.pec.0000202453.42108.f1

Cited by 16 publications

(12 citation statements)

References 24 publications

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“…The study also found that intervention may reduce aggression and problem behavior and increase self efficacy. Literature suggests that these youth are at high risk for repeated visits and injury,5 have significant psychosocial needs,36,37 and are less likely to have advised follow-up after ED treatment 38. The ED may be an important access point to these high risk youth and provides an opportunity to intervene.…”

Section: Commentmentioning

confidence: 99%

Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial

Haynie²,

et al. 2008

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Context-The emergency department has been described as a promising setting to initiate interventions with assault-injured youth to reduce the risk of re-injury and reactive perpetration. Efforts to intervene have received little study.Objective-To assess the impact of a mentor-implemented violence prevention intervention on reducing aggression, fighting and re-injury among assault-injured youth. Design-Randomized controlled trial Setting-Two large urban hospital emergency departmentsParticipants-Youth age 10-15 presenting with peer assault injury were recruited and randomly assigned to intervention and comparison groups.Intervention-Intervention youth received a mentor who implemented a 6 session problem-solving curriculum while parents received 3 home visits with a health educator to discuss family needs and facilitate service use and parental monitoring. The comparison group received a list of community resources with 2 follow-up phone calls to facilitate service use.Main Outcome Measures-Youth and parents were interviewed at baseline and 6 months to assess attitudes about violence, risk factors, fighting and repeat injury.Results-227 families were recruited with 23% refusing participation and 4% partial interview completion. 166 families were enrolled with 87 randomized to the intervention group and 79 in the comparison group; 118 (71%) completed both youth and parent follow-up interviews and 113 had usable data. Intervention and comparison groups were not significantly different at baseline on demographics or risk factors except for increased knife carrying and less deviant peers in the intervention group. After adjustment for baseline differences, there was a trend toward significant program effect including reducing misdemeanor activity (rate ratio 0.29, confidence interval 0.08- Conclusions-A community-based, mentor-implemented program with assault-injured youth presenting to the ED trended in the direction of decreased violence with reduced misdemeanors and increased self efficacy. The ED may be an important contact location, and injuries an important context, for augmenting self efficacy for violence prevention.

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Section: Commentmentioning

confidence: 99%

Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial

Haynie²,

et al. 2008

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“…6–18 The few ED-based studies of youth with acute assault-injuries have reported high levels of depressive symptoms, 19–23 post-traumatic stress symptoms, 22,24 and alcohol/substance use. 19,22,25 Nonetheless, prior studies have been limited by: 1)the use of convenience samples; 2) the inclusion of only those with biological markers of substance use, alone; 3) interviewing patients long after the assault event took place; 4) the lack of use of diagnostic criteria for substance use/mental health disorders; 5) the lack of a non-injured comparison group of drug using youth.…”

Section: Introductionmentioning

confidence: 99%

Understanding the service needs of assault-injured, drug-using youth presenting for care in an urban Emergency Department

Bohnert

Walton

Ranney

et al. 2015

Addictive Behaviors

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Background Violence is a leading cause of injury among youth 15–24 years and is frequently associated with drug use. To inform optimal violence interventions, it is critical to understand the baseline characteristics and intent to retaliate of drug-using, assault-injured (AI) youth in the Emergency Department (ED) setting, where care for violent injury commonly occurs. Methods At an urban ED, AI youth ages 14–24 endorsing any past six-month substance use (n=350), and a proportionally-sampled substance-using comparison group (CG) presenting for non-assault-related care (n=250), were recruited and completed a baseline assessment (82% participation). Medical chart review was also conducted. Conditional logistic regression was performed to examine correlates associated with AI. Results Over half (57%) of all youth met criteria for drug and/or alcohol use disorder, with only 9% receiving prior treatment. Among the AI group, 1 in 4 intended to retaliate, of which 49% had firearm access. From bivariate analyses, AI youth had poorer mental health, greater substance use, and were more likely to report prior ED visits for assault or psychiatric evaluation. Based on multivariable modeling, AI youth had greater odds of being on probation/parole (AOR=2.26; CI=1.28, 3.90) and having PTSD (AOR=1.88; CI=1.01, 3.50) than the CG. Conclusions AI youth may have unmet needs for substance use and mental health treatment, including PTSD. These characteristics along with the risk of retaliation, increased ED service utilization, low utilization of other health care venues, and firearm access highlight the need for interventions that initiate at the time of ED visit.

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“…(1)(2)(3)(4)(5)(6)(7)(8)(9) Beyond the physical trauma, violence carries significant lifelong implications for psychosocial development as evidenced by increased psychological and behavioral problems. (3,5,6,10) Obtaining adequate psychosocial, educational, and physical health resources for survivors of violent injury is difficult and many victims return to stressful home environments, making their recovery even more complex.…”

Section: Introductionmentioning

confidence: 99%

Improvement in quality of life among violently injured youth after a brief intervention

Levas

Boyle

Melzer-Lange

2016

Journal of Trauma and Acute Care Surgery

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Psychosocial Needs of African American Youth Presenting to a Pediatric Emergency Department With Assault-related Injuries

Cited by 16 publications

References 24 publications

Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial

Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial

Understanding the service needs of assault-injured, drug-using youth presenting for care in an urban Emergency Department

Improvement in quality of life among violently injured youth after a brief intervention

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