A Multi-Center Randomized Trial of Mentoring to Prevent Youth Violence...

项目总结(见说明)： 美国最大的资源是年轻人，但这一资源日益受到暴力的威胁，并对少数族裔社区造成了不成比例的影响。暴力伤害是青少年发病和死亡的主要原因。一个积极的成年人榜样的存在是防止青年中的暴力和其他适应不良后果的一个公认的保护因素。美国老大哥大姐妹(BBBS)是美国最大的辅导组织，也是唯一得到暴力蓝图认可的此类计划 预防，因为它被证明是有效的。然而，该方案对与暴力有关的结果的影响的大小和一致性留下了改进的空间，还需要研究新的通信和信息技术(IT)的整合。此外，急诊部为卫生部门提供了一个重要机会，将高危青年联系起来，开展预防暴力活动。 在急性创伤护理中表现为暴力损伤的年轻人有很高的重复损伤风险。加强辅导的两个关键的基于研究的机会是纳入针对导师和青少年的结构化活动以及增加家长的参与。这些做法都是掌管的重点！(TC)，一种导师和专业实施的干预措施，由10-15岁的被殴打受伤的青少年向急诊室介绍。一个 该建议的PI随机试验表明，TC提高了避免暴力的自我效能感，减少了攻击性和轻罪。这项建议的目标是进一步提高TC-BBBS干预的有效性，以预防多地点随机试验中高危、受攻击受伤的青年中的暴力和犯罪。目标：a)融入信息和通信技术，进一步完善、完成和实现可扩展的、研究知情的方案TC的活动，该方案旨在提高BBBS社区方案模式的有效性；B)进行随机试验，将从两个城市(巴尔的摩特区)的急救中心招募的被攻击受伤的青年随机分配到标准ED护理或TC-BBBS干预，评估18个月期间与暴力相关的结果(打斗、战斗伤害、攻击、携带武器和问题行为)、心理健康和教育结果；以及C)准确衡量与TC-BBBS模型相关的方案成本。

PROJECT SUMMARY (See instructions): America's greatest resource is its youth, but that resource is increasingly threatened by violence and disproportionately affects minority communities. Violent injury is a major cause of morbidity and mortality among adolescents. The presence of a positive adult role model is a well-established protective factor against violence and other maladaptive outcomes among youth. Big Brothers Big Sisters of America (BBBS) is the largest U.S. mentoring organization and is the only such program recognized by Blueprints for Violence Prevention for its demonstrated effectiveness. However, the magnitude and consistency of the program's effects on violence-related outcomes leave room for improvements and study of the integration of new communication and information technology (IT) is also needed. Further, the emergency department (ED) offers a critical opportunity for the health sector to link youth at high risk for violence prevention activities. Youth presenting with violent injury for acute trauma care are at high risk for repeat injury. Two key research-based opportunities for mentoring enhancement are incorporating structured activities for mentors and youth and increasing parent involvement. These practices are a focus of Take Charge! (TC), a mentor and professional-implemented intervention with 10-15 year old assault-injured youth presenting to EDs. A randomized trial by the PI of this proposal demonstrated that TC improved perceived self efficacy for avoiding violence, decreased aggression and misdemeanors. The goal of this proposal is to further enhance the effectiveness of a TC-BBBS intervention to prevent violence and crime among high-risk, assault-injured youth in a multi-site randomized trial. Aims: A) To incorporate information and communication technology and further refine, finalize and manualize activities of a scalable, research informed program, TC that is designed to enhance the efficacy ofthe BBBSxommunity program model; B) To conduct a randomized trial in which assault-injured youth recruited from EDs in two cities (Baltimore, DC) are randomly assigned to standard ED care or TC- BBBS intervention with assessment of violence-related outcomes (fighting, fight injury, aggression, weapon carrying and problem behavior), mental health and educational outcomes over an 18 month period; and C) To accurately measure the programmatic costs associated with the TC-BBBS model.