Evaluation of a Region-Wide Hospital-Based Violence Intervention Program : A Pilot Cohort Study

区域性医院暴力干预项目评估:一项试点队列研究

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Abstract

BACKGROUND: Violent injury survivors are at risk for revictimization. The St. Louis area hospital-based violence intervention program (HVIP), Life Outside of Violence (LOV), is the first multisystem, region-wide HVIP in the United States. OBJECTIVE: To describe the LOV program during its pilot phase and evaluate violent reinjury 1 year after index injury among LOV participants. DESIGN: Pilot observational cohort study of violently injured patients. SETTING: Data were queried from the program's multisystem data repository, which contains individual encounter-level data for all violent injury visits from the 2 adult and 2 pediatric LOV-partner level 1 trauma hospitals. PARTICIPANTS: Patients eligible for LOV who were violently injured between 15 August 2018 and 31 December 2022 and enrolled in LOV, matched to control participants of nonenrolled LOV-eligible patients selected from the data repository using propensity score matching. INTERVENTION: Participation in the LOV program. MEASUREMENTS: Sociodemographic characteristics, predictors of LOV enrollment, and returning to a LOV partner hospital with a violent reinjury within 1 year of index injury. The probability of violent reinjury and 95% CIs were compared between LOV participants and control participants using Kaplan-Meier estimates. RESULTS: 233 of 3744 eligible patients enrolled in LOV. Of 198 LOV-enrolled participants matched to 388 nonenrolled control participants, Kaplan-Meier estimates for 1-year probability of reinjury were 7.6% (95% CI, 3.8% to 11.2%) among LOV participants and 7.4% (CI, 4.8% to 10.0%) in control participants. LIMITATION: This pilot study cannot provide precise estimates of LOV intervention efficacy. CONCLUSION: Although no informative evidence of differences in reinjury probability for LOV participants was seen, findings suggest that the overwhelming risk in which our patients are immersed cannot be overcome by an approach scaled for individual-level impact. PRIMARY FUNDING SOURCE: Missouri Foundation for Health.

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