Harmonizing Hospital-Based Violence Intervention Programs with a Novel Medical-Legal Partnership for Equity in the Social and Structural Determinants of Health – the HVIP-MLP Model -- Supplement

项目摘要： 家长补助：创伤中心验证需要伤害预防努力，通常是以医院- 基于暴力干预方案(HVIP)。它们在解决结构和 导致暴力的社会健康决定因素(SSDOH)。医疗-法律伙伴关系(MLP)解决 通过联系法律和医疗专家改善健康结果，为患者提供SSDOH。没有MLP可用于 在创伤中心的约会，纳入到HVIP活动中。在我们的两阶段提案中，我们的UG3目标是 在创建和实施HVIP-MLP模型后识别我们的火器伤患者的SSDOH 南区创伤中心。我们的UH3旨在检查实施情况和临床结果，包括创伤再治疗 受伤。这种新的HVIP-MLP方法可以增强创伤中心的HVIP损伤预防模式，以更好地 支持患者、家庭和社区的康复和预防未来的枪伤。建议 补充：我们的HVIP-MLP模型的一个挑战是对所有患者进行标准化筛查， 无论年龄大小。我们的初步数据表明，受枪伤的青少年有独特的SSDOH 与成人的不同。这是一个至关重要的区别，因为枪伤是 青春&lt；20年。如果我们不了解我们年轻人独特的SSDOH，我们的HVIP-MLP干预可能会 对受影响最脆弱的群体的影响有限。同样，职业倦怠也是我们的一个重要问题 在我们的HVIP工作的暴力恢复专家(VR)。同样受到创伤史的影响，VRS是 来自受暴力影响社区的可信信使，在以下情况下经常经历替代创伤 照顾来自同一社区的暴力伤害患者。MLP复原力和赋能能力可能 对抗VRS经历的职业倦怠，但这还没有被研究过。在这份副刊中，我们建议 用混合方法确定我们的HVIP-MLP模型对火器伤的影响 青年和我们的VRS，代表患者和提供者领域的弱势群体 关心。在目标1中，我们将了解与成年人相比，枪伤青少年的特定SSDOH。在目标2中， 我们将衡量HVIP-MLP模式对替代创伤、恢复力和授权的影响 我们的录像机。意识到上游的SSDOH与枪支暴力有关，目标3将集中在 从事从研究到行动的政策转变。连同最初的一年补助金(延长至第二年 UH3过渡)我们的候选人将获得混合方法研究的技能，并使用Pilot提交K申请 本附录中的数据。

Project Abstract: Parent Grant: Trauma center verification requires injury prevention efforts, often in the form of Hospital- based Violence Intervention Programs (HVIPs). Limitations exist in how well they address the Structural & Social Determinants of Health (SSDOH) that lead to violence. Medical-Legal Partnerships (MLPs) address the SSDOH of patients, by connecting legal & medical experts to improve health outcomes. No MLP exists to date in a trauma center, incorporated into HVIP activities. In our biphasic proposal, our UG3 aims are to identify the SSDOH of our firearm injured patients after creating & implementing the HVIP-MLP model into our South Side trauma center. Our UH3 aims examine implementation & clinical outcomes, including trauma re- injury. This novel HVIP-MLP approach may enhance the HVIP injury prevention model in trauma centers to better support patients, families & communities in their recovery & prevention of future firearm injury. Proposed Supplement: One challenge with our HVIP-MLP model is the standardized screening of all patients, regardless of age. Our preliminary data indicate that firearm- injured youth have unique SSDOHs that are different from those of adults. This is a crucial distinction since firearm injury is the #1 cause of mortality for youth <20 years. If we do not understand the unique SSDOH of our youth, our HVIP-MLP intervention may be of limited impact in the most vulnerable group affected. Similarly, burnout is a significant concern for our Violence Recovery Specialists (VRS) who work in our HVIPs. Also affected by a history of trauma, VRS are credible messengers from violence-affected communities, and often experience vicarious trauma when caring for violently-injured patients from the same communities. MLP resilience & empowerment may counteract burnout experienced by VRS, but this has not yet been studied. In this Supplement we propose a mixed-methods approach to determine the impact that our HVIP-MLP model has on firearm-injured youth and our VRS, representing vulnerable populations in both the patient & provider spheres of care. In Aim 1, we will understand the specific SSDOH of firearm-injured youth compared to adults. In Aim 2, we will measure the impact of the HVIP-MLP model on the vicarious trauma, resilience & empowerment of our VRS. Appreciating that the upstream SSDOH are related to firearm violence, Aim 3 will center on engaging in research-to-action policy change. With the initial 1-year Supplement (extending into year 2 after UH3 transition) our candidate will gain skills in mixed-methods research & submit a K application using pilot data from this Supplement.