RFA-CE-23-006, A Virtual Reality Brief Violence Intervention: Preventing gun violence among violently injured adults

摘要 与枪支有关的暴力是美国的一个主要公共卫生问题。从2019年到2020年，枪支- 与枪支有关的凶杀案增加了近35%，2021年是自1993年以来最高的与枪支有关的凶杀案。 这一流行病的影响影响了暴力的发生率，我们可以期待看到这些持久的影响 多年来在全国范围内，年轻人（18-35岁）最有可能死于与枪支有关的疾病。 暴力这是一个风险，是不均匀的成年人，与非洲裔美国人的亚群之间的共享 死于与枪支有关的凶杀案的可能性是白人男性的20倍。此外，一旦出院， 从医院，暴力受伤的成年人在暴力再次伤害和死亡的风险增加，以及88 进行报复性暴力的可能性要高一倍医院已经成为暴力的关键地点 预防不幸的是，那些最有可能遭受报复性暴力的患者往往很难从事 干预，这就是为什么需要新的和创新的战略，以满足患者的利益， 需求是。本提案的目标是开发和评估虚拟现实（VR）暴力干预， 简短的暴力干预VR（BVI-VR），以防止与枪支相关的暴力犯罪、再伤害事件， and mortality. BVI-VR为患者提供与文化相关的沉浸式故事和游戏， 通过心理教育和干预，提高他们对与枪支有关的报复性暴力的复原力， 五个步骤：（1）情绪调节和创伤管理，（2）冲突解决和非暴力替代方案，（3） 枪支安全，（4）未来的目标和愿望，以及（5）社区资源连接。这将是第一个VR 针对成人枪支相关暴力、伤害和死亡的干预措施。BVI-VR提供连接 沉浸式个人层面的干预和接触/连接到社区资源之间的关系， 病人的社区。本研究涉及本资助公告的资助方案B， 它支持收集新数据和/或实施预防活动的研究项目。本研究将 进行一项随机对照试验，包括220名暴力受伤的成年人，以评估BVI-VR的有效性 防止枪支相关的暴力伤害和死亡该研究还旨在确定风险和保护 最具可塑性的因素（介质）对BVI-VR的反应发生变化。最后，我们将评估经济 BVI-VR作为一种简短的医院枪支暴力预防策略的有效性。本研究结果可 支持使用BVI-VR作为预防与枪支有关的暴力，伤害和 暴力受害者的死亡率。

Abstract Firearm-related violence is a major public health problem in the United States. Between 2019 and 2020, firearm- related homicide increased by nearly 35%, and 2021 saw the highest gun-related homicide rates since 1993. The effects of the pandemic have impacted the rates of violence, and we can expect to see these lasting effects for many years. Nationally, young adults (18-35 years old) are the most at risk to die from firearm-related violence. This is a risk that is not evenly shared among subpopulations of adults, with African American men being 20 times more likely to die from firearm-related homicide than Caucasian men. Further, once discharged from a hospital, violently injured adults are at an increased risk of violent re-injury and mortality, as well as 88 times more likely to engage in retaliatory violence. The hospital has become a critical location for violence prevention. Unfortunately, patients who are most at risk of retaliatory violence are often difficult to engage in intervention, which is why new and innovative strategies are needed to meet patients where their interests and needs are. The goal of the present proposal is to develop and evaluate a virtual reality (VR) violence intervention, Brief Violence Intervention VR (BVI-VR), to prevent incidents of firearm-related violence perpetration, re-injury, and mortality. BVI-VR provides patients with culturally relevant immersive stories and gameplay while providing them with psychoeducation and intervention to increase resiliency to retaliatory firearm-related violence across five steps: (1) emotion regulation and managing trauma, (2) conflict resolution and non-violent alternatives, (3) gun safety, (4) future goals and aspirations, and (5) community resource connection. This will be the first VR intervention targeting adult firearm-related violence, injury, and mortality. BVI-VR provides the connection between an immersive individual-level intervention and exposure/connection to community resources tailored to the patient’s local community. The present study addresses Funding Option B of this funding announcement, which supports research projects that collect new data and/or implement prevention activities. This study will conduct a randomized control trial including 220 violently injured adults to assess the effectiveness of BVI-VR for preventing firearm-related violence, injury, and mortality. The study also aims to identify risk and protective factors that are most malleable (mediators) to change in response to BVI-VR. Lastly, we will assess the economic efficiency of BVI-VR as a brief hospital-based gun violence prevention strategy. The results from this study may support the use of BVI-VR as a cost-effective strategy for preventing firearm-related violence, injury, and mortality among victims of violence.