Incorporation of a Health Equity Approach to Hospital Violence Intervention Programs: The Integration of a Community and Hospital Based Initiatives to Reduce Gun Violence in a Large Metropolitan Area

将健康公平方法纳入医院暴力干预计划：整合社区和医院举措以减少大都市区的枪支暴力

• 批准号: 10812032
• 负责人: Sandra McKay
• 金额: $ 155.54万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10812032
• 关键词: Academic Training; Accounting; Address; Adult; Advocate; African American population; Area; Caring; Case Management; Case Manager; Cause of Death; Cities; Collaborations; Color; Communities; Community Health; Complex; County; Data; Disparity; Education; Effectiveness; Enrollment; Equity; Ethnic Origin; Evaluation; Evaluation Studies; Event; Firearms; Funding Mechanisms; Goals; Gun injury; Health; Health Personnel; Health Sciences; Health Services Accessibility; Healthcare Systems; Homicide; Hospitalization; Hospitals; Incidence; Individual; Injury; Interpersonal Violence; Intervention; Interview; Law Enforcement; Leadership; Measurement; Measures; Medical; Medical center; Mental Health; Methods; Participant; Patient Self-Report; Patients; Phase; Play; Population; Preparation; Prevention; Prevention Research; Program Acceptability; Program Effectiveness; Protocols documentation; Public Health; Public Health Schools; Race; Randomized, Controlled Trials; Recording of previous events; Recurrence; Reporting; Research; Research Design; Risk; Risk Factors; Risk Reduction; Role; Services; Specialist; Surveys; Testing; Texas; Trauma; United States; United States National Institutes of Health; Urban Hospitals; Victimization; Violence; Violent injury; Voice; arm; behavioral health; community based service; community engagement; community violence; comparison group; design; dosage; ethnic disparity; experience; feasibility testing; follow-up; group intervention; gun violence; health care settings; health equity; health inequalities; holistic approach; improved; injury prevention; interdisciplinary approach; intervention program; medical schools; metropolitan; mortality; multidisciplinary; neighborhood safety; novel; programs; racial disparity; racial minority population; racism; recidivism; recruit; response; revictimization; service programs; social health determinants; success

PROJECT SUMMARY Firearm violence is a leading cause of death in the United States and disproportionately impacts minoritized racial groups, given its high concentration in communities of color that have experienced decades of racism and health inequity. Victims of firearm violence are often stuck in a cycle of violence, as they are twice as likely to die or be hospitalized from a violent event compared to those without a history of violent victimization. Therefore, hospital-based intervention programs (HVIPs) can be crucial to provide holistic services and connections to critical community-based violence interventions that support firearm violence victims and reduce reinjury risk. Developing interventions to impact firearm violence requires a transdisciplinary approach with community–city–hospital interventions. The lack of a current HVIP in the greater Houston area– the fourth largest city in the United States–highlights the need to develop and implement this program as a critical community-based intervention to reduce firearm violence. Therefore, the current study aims to create the Houston-Hospital-Based Violence Intervention program at Memorial Hermann Hospital in the Texas Medical Center in Houston, Texas, as a community-level response to firearm violence. In Aim 1, during the UG3 phase, we will develop a coalition of internal and external stakeholders to advise on the formation and oversee the implementation of the Houston-HVIP. We an during effectiveness will create the culture prime for the reception of the HVIP by developing inter-professional, trauma-informed care educational platform with a health equity lens. In our second aim, the UG3 phase, we will implement and evaluate the Houston-HVIP program to determine the of reducing repeat violent events by a program participant. The Houston-HVIP will feature a clustered randomized controlled trial, with a fully immersive hospital violence intervention program and an enhanced case manager program tailored to the firearm victim's needs. The program is guided by critical stakeholders, including hospital leadership, public health advocates, law enforcement, community and city leaders, and a multidisciplinary team of experts in injury prevention, health science analysis, and mixed methods evaluations. This intervention will be rigorously evaluated to understand program effectiveness and acceptability, the impact of reinjury on those enrolled in each arm of the program, and the role of social determinants of health on firearm injury to the participant and the community. Also, we will examine the program's impact on racial and ethnic disparities in those impacted by firearm violence.

项目摘要 枪支暴力是美国死亡的主要原因，对少数群体的影响不成比例。 种族群体，因为它高度集中在经历了几十年种族主义的有色人种社区， 健康不平等。枪支暴力的受害者往往陷入暴力循环，因为他们是暴力的两倍。 与没有暴力事件史的人相比， 受害因此，以医院为基础的干预计划（HVIP）对于提供全面的 支持枪支暴力受害者的关键社区暴力干预措施的服务和联系 降低再伤害风险。制定干预措施以影响枪支暴力需要跨学科的 采取社区-城市-医院干预措施。大休斯顿地区目前缺乏HVIP- 美国第四大城市--强调了制定和实施这一计划的重要性 以社区为基础的干预措施，以减少枪支暴力。因此，本研究旨在创建 德克萨斯州纪念赫尔曼医院的休斯顿医院暴力干预计划 中心在得克萨斯州休斯顿，作为社区一级的枪支暴力的反应。在目标1中，在UG 3阶段， 我们将建立一个由内部和外部利益相关者组成的联盟，就成立和监督 实施休斯顿HVIP。我们 一个 期间 有效性 将通过发展， 跨专业、了解创伤的护理教育平台，具有健康公平透镜。我们的第二个目标， 在UG 3阶段，我们将实施和评估休斯顿HVIP计划，以确定 减少暴力事件的重复发生。休斯顿HVIP将采用 群集随机对照试验，具有完全沉浸式的医院暴力干预计划和 根据枪支受害者的需要量身定制的增强型案件管理程序。该计划是由关键的指导 利益相关者，包括医院领导层、公共卫生倡导者、执法部门、社区和城市 领导人和一个多学科的专家小组，在伤害预防，健康科学分析，和混合方法 评价。将对这种干预措施进行严格评估，以了解方案的有效性和可接受性， 再损伤对参加该计划每个分支的人的影响，以及健康的社会决定因素的作用 对参与者和社区造成的火器伤害。此外，我们还将研究该计划对种族和 受枪支暴力影响的族裔差异。