A mixed methods protocol to implement universal firearm injury risk screening and intervention among youth and adults in emergency departments across a large US health system.
A mixed methods protocol to implement universal firearm injury risk screening and intervention among youth and adults in emergency departments across a large US health system.
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DOI：
10.1186/s43058-022-00371-6
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发表时间：
2022-11-24
影响因子：
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在美国，火器伤害是可预防死亡的主要原因。医疗保健提供者特别关注火器安全和伤害预防，从一个非政治性的伤害减少透镜;但是，在此情况下，少数提供者和医疗机构将火器伤害预防策略纳入常规护理。我们概述了第一个协议，以确定如何实施普遍的火器伤害和死亡预防（FIMP）这些战略将确定和解决医疗机构中的枪支获取和暴力风险，作为常规护理的一部分，使用实施研究综合框架（CFIR）为实施和评估提供信息。我们的FIMP战略的组成部分，包括普遍筛查，对风险患者的干预和资源，将从现有的枪支获取和暴力风险（干预特征）的循证战略中发展出来。实施过程将包括筛查、短暂干预和药物使用转介治疗（SBIRT）的组成部分，并根据FIMP（实施过程）进行调整。为了让利益相关者参与进来，统一语言，并获得支持，将成立一个执行咨询委员会（EAB），由现场和系统层面的利益相关者（内部环境）和社区利益相关者组成，包括有影响力的人物，如当地宗教和精神领袖、有生活经验的个人和社区组织（外部环境）。实施前调查将确定个人的特点，并在实施前指导教育的发展。将分析患者水平的筛选数据以确定风险因素，将使用混合方法评估实施情况，并进行有限有效性研究以评估策略是否成功推动行为改变。这项研究方案具有突破性和方法上的创新，通过将FIMP作为常规护理的一部分，直接减轻青少年，成年人和家庭成员（例如，儿童），并通过使用严格的方法，为医疗保健行业实施FIMP战略提供信息。本研究方案的预期结果将为更广泛的儿科和成人医疗环境中的实施、有效性和可用性的大规模传播和评价提供坚实的基础。该项目将推进实施科学，并通过预防火器伤害和死亡，并通过公共卫生透镜改变范式来看待FIMP，对我们的病人和社区的健康产生积极影响。
Firearm injury is a leading cause of preventable death in the USA. Healthcare providers are uniquely poised to focus on firearm safety and injury prevention from an apolitical harm reduction lens; however, few providers and healthcare settings incorporate firearm injury prevention strategies into usual care. We outline the first protocol to determine how to implement universal Firearm Injury and Mortality Prevention (FIMP) strategies that identify and address firearm access and violence risk in healthcare settings as part of routine care using the Consolidated Framework for Implementation Research (CFIR) to inform implementation and evaluation. The components of our FIMP strategy, including universal screening, intervention for patients at risk, and resources, will be developed from existing evidence-based strategies for firearm access and violence risk (intervention characteristics). The implementation process will include components of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use, adapted to FIMP (implementation process). To engage stakeholders, harmonize language, and garner support, an Executive Advisory Board (EAB) will be formed, consisting of the site- and system-level stakeholders (inner setting) and community stakeholders, including influential figures such as local religious and spiritual leaders, individuals with lived experience, and community-based organizations (outer setting). Pre-implementation surveys will identify the characteristics of individuals and guide the development of education prior to implementation. Patient-level screening data will be analyzed to identify the risk factors, implementation will be evaluated using mixed methods, and a limited-efficacy study will evaluate whether strategies were successful in driving behavior change. This study protocol has breakthrough and methodological innovations, by addressing FIMP as part of usual care to directly mitigate firearm injury risk among youth, adults, and household members (e.g., children) and by using rigorous methods to inform healthcare industry implementation of FIMP strategies. The expected outcomes of this study protocol will provide a solid basis for larger-scale dissemination and evaluation of implementation, effectiveness, and usability across broader pediatric and adult healthcare settings. This project will advance the implementation science and have a positive impact on the health of our patients and communities by preventing firearm injury and mortality and shifting the paradigm to view FIMP through a public health lens.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
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作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
3.5
作者：
Bernstein, Edward;Bernstein, Judith;Owens, Patricia
通讯作者：
Owens, Patricia
DOI：
10.3122/jabfm.16.1.40
发表时间：
2003-01-01
期刊：
JOURNAL OF THE AMERICAN BOARD OF FAMILY PRACTICE
影响因子：
--
作者：
Albright, TL;Burge, SK
通讯作者：
Burge, SK
影响因子：
8
作者：
Cunningham, Rebecca M.;Chermack, Stephen T.;Walton, Maureen A.
通讯作者：
Walton, Maureen A.
DOI：
10.1177/23821205221077647
发表时间：
2022-01
影响因子：
2.8
作者：
Dobscha SK;Clark KD;Karras E;Simonetti JA;Newell S;Kenyon EA;Elliott V;Boster J;Gerrity M
通讯作者：
Gerrity M