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

项目总结和摘要 阿肯色州是一个南部的农村州，相对于其总人口而言，谋杀负担很高（阿肯色州排名 全国第六大枪支犯罪案件（）此外，阿肯色州的大多数县被认为是农村， 严重限制了适合暴力袭击幸存者的医疗保健服务（例如物理治疗， 创伤知情护理、行为健康服务等）。阿肯色州医学科学大学 （UAMS）是拟议研究的牵头机构，是该州唯一的1级创伤中心， 为阿肯色州几乎每个县的人提供医疗保健，主要是通过区域卫星诊所， 远程医疗服务。重要的是，UAMS最近与小石城和其他 社区机构支持第一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，我们建议的研究将扩大 UAMS计划的范围包括阿肯色州中部地区的县，其中许多县 大量的农村人口受到社区暴力的不成比例的影响。重要的是我们的 拟议的研究扩展了我们的小石城为基础的努力，并结合了多个 这是一个更全面的解决社区暴力问题的方法。在这 应用程序，我们建议在整个阿肯色州中部的社区合作伙伴参与多层次，多， 多方面的干预，以减少暴力袭击对个人和社区的负担。我们的建议将 让社区参与每一个阶段，使其在文化上适当，了解社区情况， 社区领导。我们将测试我们的多层次的可行性和可接受性，以及初步疗效， 通过医院-社区伙伴关系，明确侧重于二级暴力预防的干预措施 为了防止生活在美国各州的非裔美国人枪支暴力升级或再次受害， 阿肯色州中部，该州暴力袭击最严重的地区。我们还将把关键 实施科学指标，以评估我们提出的干预措施的范围和可持续性。

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.