Preventing Retaliatory Gun Violence in Violently Injured Adults: A RCT of a Hospital-Based Intervention

防止遭受暴力伤害的成年人遭受报复性枪支暴力：医院干预的随机对照试验

• 批准号: 10162262
• 负责人: Nicholas David Thomson
• 金额: $ 64.97万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2023-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10162262
• 关键词: Preventing; Retaliatory; Gun; Violence; Violently

Abstract In the United States, firearm-related violence has reached epidemic proportions and has become a major public health problem. To help prevent the high rates of firearm-related deaths, most violence intervention programs have targeted youth (<18 years old) in the hope to slow the rapid increase of violence seen in early adulthood. However, most victims of firearm-related violence are adults (>18 years old), and national statistics show young adults (18-35 years) in particular are the most likely to die from firearm-related violence. It is important to recognize that this risk is not evenly shared among subpopulations of adults, and it is young African American men who come from economically disadvantaged communities with high rates of exposure to violence that are the most vulnerable to firearm-related violence. Unfortunately, they are difficult to engage in community-based intervention efforts. More recently, however, hospital-based violence intervention programs have become increasingly popular because of their success at engaging individuals who have suffered a violent injury. Violently injured adults are not only victims in the present, but 40% will be violently re-injured and 20% will be killed within 5 years; these patients are also 88 times more likely to commit retaliatory violence (Cunningham et al., 2009). It is clear that these adults are in dire need of effective violence intervention. At Virginia Commonwealth University (VCU) Health, we have developed Bridging the Gap (BTG), a promising violence intervention strategy that includes a hospital-based violence intervention, a firearm counseling program, and 6-months of community case management to victims of violence. BTG was originally developed for violently injured youth and results indicate it is effective for reducing youth violence. However, it is yet to be established if it is effective for reducing firearm- related violence in adults. It is also yet to be established if BTG is a cost effective strategy for reducing firearm- related violence and injury. The present study addresses Objective Two of this funding announcement; to rigorously evaluate the effectiveness of innovative and promising strategies to keep individuals safe from firearm- related injuries, deaths, and crime. This research proposal falls under Funding Option B; which supports research projects that collect new data. The goal of the present study is to assess the efficacy of BTG using a randomized control trial design in a large sample of 616 adult victims of violence over a 1-year follow-up period. Efficacy will be assessed using multiple sources of data for firearm-related violence (e.g., criminal arrest records, self-report, semi-structured clinical assessment of non-convicted firearm-related violence) and firearm-related re-injury and mortality (e.g., hospital records). To improve our understanding of the impact BTG has on firearm-related violence, we will test for psychosocial mediators linking BTG to reductions in firearm-related violence. We also aim to understand what psychosocial vulnerabilities may weaken the impact of BTG on firearm-related violence. Lastly, a cost-benefit analysis will determine the economic benefits of implementing BTG. Collectively, results from this study may support the use of BTG as a firearm-related violence intervention for adult victims of violence.

抽象的 在美国，与枪支有关的暴力已达到流行病，并已成为主要公众 健康问题。为了防止高度与枪支相关的死亡率，大多数暴力干预计划 已经针对青年（<18岁），希望减缓成年初期暴力的迅速增加。 但是，大多数与枪支相关暴力的受害者是成年人（> 18岁），国家统计数据显示年轻 特别是成年人（18 - 35年）最有可能死于与枪支有关的暴力。重要的是 认识到这种风险在成年人的亚群中没有均匀分享，这是年轻的非裔美国人 来自经济弱势社区的男性，暴露率高的人 最容易遭受与枪支有关的暴力。不幸的是，他们很难从事基于社区的 干预工作。但是，最近，基于医院的暴力干预计划已经成为 越来越受欢迎，因为他们成功地吸引了遭受剧烈伤害的人。暴力 受伤的成年人不仅是目前的受害者，而且有40％的人将受到猛烈造成的伤害，并且20％将被杀 5年；这些患者犯下报复性暴力的可能性也高出88倍（Cunningham等，2009）。它 很明显，这些成年人迫切需要有效的暴力干预。在弗吉尼亚联邦大学 （VCU）健康，我们已经开发了弥合差距（BTG），这是一种有希望的暴力干预策略， 包括基于医院的暴力干预，枪支咨询计划和6个月的社区案件 管理暴力受害者。 BTG最初是针对受伤的年轻人开发的，结果表明 这对于减少青年暴力是有效的。但是，如果有效地减少枪支 - 成人相关的暴力。如果BTG是减少枪支 - 相关的暴力和伤害。本研究涉及此资助公告的两个目标；到 严格评估创新和有前途的策略的有效性，以确保个人免受枪支的安全 相关伤害，死亡和犯罪。该研究提案属于资助选项B；支持研究 收集新数据的项目。本研究的目的是使用随机的 在1年的随访期内，在616名成人暴力受害者的大量样本中进行了对照试验设计。功效会 使用多种与枪支相关暴力的数据来源进行评估（例如，刑事逮捕记录，自我报告， 与枪支相关的暴力的半结构化临床评估）和与枪支有关的重新受伤和 死亡率（例如医院记录）。为了提高我们对BTG对枪支相关的影响的理解 暴力，我们将测试将BTG与枪支相关暴力的减少联系起来的社会心理调解人。我们也是 旨在了解哪些社会心理脆弱性可能会削弱BTG对枪支相关暴力的影响。 最后，成本效益分析将决定实施BTG的经济利益。总体上，结果 从这项研究中可以支持将BTG用作与枪支有关的暴力暴力干预措施的使用。