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。在2019至2020年间，枪支- 与枪支有关的凶杀案增加了近35%，2021年出现了自1993年以来与枪支有关的凶杀率最高的一年。 大流行病的影响影响了暴力发生率，我们可以预期看到这些持久的影响。 多年来。在全国范围内，年轻人(18-35岁)死于与枪支有关的风险最大。 暴力。这一风险在非裔美国人的成年亚群中并不平均分担。 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， 在医院，受暴力伤害的成年人再次受到暴力伤害和死亡的风险增加，88 更有可能从事报复性暴力。这家医院已经成为暴力事件的关键地点。 预防。不幸的是，最有可能遭受报复性暴力的病人往往很难接触到。 干预，这就是为什么需要新的和创新的战略来满足患者的兴趣和 需求才是。本提案的目标是开发和评估虚拟现实(VR)暴力干预， 简要暴力干预VR(BVI-VR)，以防止与枪支有关的暴力行为、再伤害、 和死亡率。BVI-VR为患者提供与文化相关的身临其境的故事和游戏，同时提供 为他们提供心理教育和干预，以提高他们对与枪支有关的报复性暴力的适应能力 五个步骤：(1)情绪调节和处理创伤，(2)冲突解决和非暴力替代，(3) 枪支安全，(4)未来目标和抱负，以及(5)社区资源联系。这将是第一个虚拟现实 针对与成人枪支有关的暴力、伤害和死亡的干预。BVI-VR提供了连接 在身临其境的个人级别干预和对社区资源的暴露/连接之间 病人的当地社区。本研究涉及本供资公告的供资备选方案B， 它支持收集新数据和/或实施预防活动的研究项目。这项研究将 对220名遭受暴力伤害的成年人进行随机对照试验以评估BVI-VR的有效性 防止与枪支有关的暴力、伤害和死亡。这项研究还旨在确定风险和保护措施 对BVI-VR最具可塑性的因素(调节因子)的变化。最后，我们将评估经济 BVI-VR作为一种以医院为基础的简短枪支暴力预防策略的有效性。这项研究的结果可能 支持使用BVI-VR作为一种具有成本效益的战略，以防止与枪支有关的暴力、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.