Assessing an Adolescent Violence Screening Tool Longitudinally for Primary Care

描述（由申请人提供）：这个K奖将是西格尔博士职业发展的一部分，他的职业重点是初级保健环境中的青少年暴力检测和干预。西格尔博士将在特伦斯·索恩伯里博士的主要指导下，与研究和预防暴力中心合作。要成为该领域的独立研究人员，候选人已经确定了需要提高的几项技能，包括：提高对筛选工具的心理测量特性的了解，提高进行纵向随机对照干预试验的能力，学习评估方案实施的技能，增加对干预青少年暴力的了解，了解作为公共卫生问题的暴力与如何利用医疗环境来解决这一问题之间的联系。在CSPV工作，参加教学课程，与社区互动，以及实施拟议的研究项目将实现这一目标。长期职业目标包括：1)成为青少年暴力评估与干预领域的独立临床研究者；2)在初级保健层面研究和实施基于证据的干预措施，以降低青少年暴力的发病率和死亡率；3)与社区伙伴合作，建立一个青少年暴力评估和治疗的卓越中心。研究项目是：评估初级保健暴力伤害、保护和风险筛查工具1年和2年的预测效度。具体目标：确定暴力伤害、保护和风险筛查（VIPRS）工具在一年和两年的预测效度，该工具可识别未来有暴力参与风险的青少年（侵略、暴力犯罪、暴力受害和暴力伤害）。方法：选取165名青少年和131名家长作为研究对象，对该量表的信度和效度进行横断面评估。本研究将通过评估青少年和父母的初始队列，从初始入组开始的1年和2年随访，来检验VIPRS未来的预测有效性。评估侵略和受害的问卷将被管理，以及重复的VIPRS。图表审查将在一年和两年的随访中进行，以确定初级保健医生是否诊断出任何与暴力有关的行为，或任何与暴力有关的伤害。使用多元线性或逻辑回归分析来检验VIPRS的预测效度，以确定：1)VIPRS基线得分与基线和1年和2年随访访谈之间的暴力行为发生是否相关；2)根据基线VIPRS得分调整后，1年随访访谈和2年随访访谈期间，VIPRS得分从基线到1年的变化与暴力行为发生有关。项目说明/相关性：该项目对青年暴力的公共卫生问题至关重要。初级保健保健专业人员没有积极参与处理青少年暴力问题，主要是因为识别有风险的青少年既耗时又具有挑战性。通过创建一种易于管理的筛查工具，卫生专业人员将能够识别并最终在青年遭受暴力后果之前进行干预。

DESCRIPTION (provided by applicant): This K award will be integral in the development of Dr. Sigel's career, which is focused on youth violence detection and intervention in the primary care setting. Dr. Sigel will work with the Center for the Study and Prevention of Violence, under the primary mentorship of Dr. Terence Thornberry. To become an independent researcher in this field, the candidate has identified several skill sets that need enhancement, including: improving knowledge of psychometric properties of screening tools, improving ability to conduct longitudinal, randomized control intervention trials, learning skills to evaluate program implementation, increasing understanding of what interventions work for youth violence intervention, and understanding the interface between violence as a public health problem and how the medical setting can be used to address this issue. A combination of working at the CSPV, taking didactic classes, interfacing with the community, and carrying out the proposed research project will accomplish this. Long term career goals include: 1) becoming an independent clinical investigator in the field of youth violence assessment and intervention; 2) studying and implementing evidence-based interventions at the primary care level to decrease morbidity and mortality from youth violence and 3) establishing a center of excellence in youth violence assessment and treatment, in collaboration with community partners. The research project is: Assessing Predictive Validity at 1 and 2 Years of the Violence Injury, Protection and Risk Screening Tool for Primary Care. Specific Aim: Determine the predictive validity at one and two years of the Violence Injury, Protection and Risk Screening (VIPRS) Tool that identifies youth at risk for future violence involvement (aggression, violence perpetration, violence victimization, and injury from violence).Methods: An initial cohort of 165 youth, and 131 parents have been enrolled to evaluate the reliability and validity of the VIPRS cross-sectionally. This proposed study will examine the future predictive validity of the VIPRS by assessing the initial cohort of youth and parents at one and two year follow-up from initial enrollment. Questionnaires evaluating aggression and victimization will be administered, as well as repeating the VIPRS. Chart review will be done at one and two year follow-up to determine whether the primary care practitioner diagnosed any behavior related to violence involvement, or any violence related injury. Analysis The predictive validity of the VIPRS will be examined using multivariate linear or logistic regression analysis to determine whether:1) the VIPRS baseline scores are associated with violent behavior occurring between baseline and the one-year and two year follow-up interview; and 2) change in VIPRS scores from baseline to one-year is associated with violent behavior occurring between the one-year follow-up interview and the two-year follow-up interviews, adjusted for baseline VIPRS scores. Project Narrative/Relevance: This project is vital to the public health issue of youth violence. Primary care health professionals have not been actively involved in treating youth violence, mostly because it is time consuming and challenging to recognize youth at risk. By creating an easy to administer screening tool, health professionals will be able to recognize, and ultimately intervene before youth suffer the consequences of violence involvement.