The HVIP+ Community Model: A Community Violence Prevention Program in a Southern State

项目摘要和摘要 阿肯色州是一个农村的南部州，与其总人口相比，杀人案负担很高(AR排名 枪支凶杀率在全国排名第六)。此外，阿肯色州的大多数县都被认为是农村和 严重限制了适用于暴力袭击幸存者的医疗服务(例如物理治疗， 创伤-知情护理、行为健康服务等)。阿肯色大学医学分校 (UAMS)，拟议研究的牵头机构，是该州唯一的一级创伤中心， 为几乎每个县的阿肯色州人提供医疗保健，主要是通过地区卫星诊所和 远程医疗服务。重要的是，UAMS最近与小石城和其他 社区机构支持首个也是唯一一个基于医院的暴力干预计划(HVIP) 阿肯色州。虽然这项HVIP的重点是小石城的居民，但我们提议的研究将扩大 UAMS计划的覆盖范围包括阿肯色州中部地区的县，其中许多县 受社区暴力影响不成比例的相当大的农村人口。重要的是，我们的 拟议的研究扩展了我们小石城的努力范围，并结合了多个 加强，使其成为解决社区暴力问题的更全面的方法。在这 应用程序，我们建议让整个阿肯色州中部的社区合作伙伴参与多层次、多层次的 多方面干预，以减轻暴力攻击对个人和社区的负担。我们的建议将 在每个阶段吸引社区参与，使其在文化上合适、社区知情和 以社区为主导。我们将测试我们的多层次的可行性和可接受性，以及初步的效果 干预措施，明确侧重于通过医院-社区伙伴关系进行二级暴力预防 防止居住在美国各县的非裔美国人因枪支暴力而升级或再次受害 阿肯色州中部，该州暴力袭击最严重的地区。我们还将整合密钥 实施科学指标，以评估我们提议的干预措施的覆盖范围和可持续性。

PROJECT SUMMARY AND ABSTRACT Arkansas is a rural southern state with a high burden of homicide relative its total population (AR ranks 6th nationally in firearm homicide rates). Furthermore, most counties in Arkansas are considered rural and have severely limited healthcare services appropriate for survivors of violent assault (e.g. physical therapy, trauma-informed care, behavioral health services, etc.). The University of Arkansas for Medical Sciences (UAMS), the lead institution for the proposed research, is the only Level-1 trauma center in the state and provides healthcare to Arkansans in nearly every county, largely through regional satellite clinics and telemedicine services. Importantly, UAMS has recently partnered with the City of Little Rock and other community agencies to stand up the first and only hospital based violence intervention program (HVIP) in the state of Arkansas. While the focus of this HVIP is on residents of Little Rock, our proposed study will extend the reach of the UAMS program to include counties within the Central Arkansas region, many of which have sizable rural populations which are disproportionately impacted by community violence. Importantly, our proposed research extends the reach of our City of Little Rock based efforts and incorporates multiple enhancements such that it is a more comprehensive approach to addressing community violence. In this application, we propose to engage community partners throughout Central Arkansas in a multi-level, multi- faceted intervention to reduce the burden of violent assault on individuals and communities. Our proposal will engage community at every stage such that it will be culturally appropriate, community-informed and community led. We will test the feasibility and acceptability, as well as preliminary efficacy, of our multi-level intervention with an explicit focus on secondary violence prevention through hospital-community partnerships to prevent escalation or revictimization from firearm violence among African Americans living in counties in Central Arkansas, the region of the state where violent assault is greatest. We will also incorporate key implementation science metrics to evaluate the reach and sustainability of our proposed intervention.