Spreading LOV: Developing a Plan to Improve Engagement in the Life Outside Violence Program

传播爱：制定计划以提高对暴力之外生活的参与度计划

• 批准号: 10588633
• 负责人: Kristen Mueller
• 金额: $ 17.85万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588633
• 关键词: Accident and Emergency department; Address; Adult; Affect; Age; Area; Award; Black race; Caring; Cessation of life; Characteristics; Child; Childhood; Communities; Counseling; Data; Death Rate; Development; Development Plans; Education; Effectiveness; Electronic Mail; Elements; Eligibility Determination; Employment; Enrollment; Family; Firearms; Geography; Goals; Group Interviews; Gun injury; Health; Hospitals; Incidence; Individual; Injury; Inpatients; Institutional Racism; Intervention; Interview; K-Series Research Career Programs; Letters; Life; Master of Science; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Mission; Missouri; Modeling; Morbidity - disease rate; Murder; National Institute of Child Health and Human Development; Nonpenetrating Wounds; Not Hispanic or Latino; Outcome; Participant; Pathway interactions; Patient Recruitments; Patients; Penetration; Persons; Pilot Projects; Positioning Attribute; Program Evaluation; Public Health; Recurrence; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Risk; Role; Sampling; Services; Structural Racism; Structure; Telephone; Testing; Training; Training Programs; Trauma; Traumatic injury; United States; Universities; Violence; Violent injury; Washington; acceptability and feasibility; aged; black patient; career; career development; case-based; clinical investigation; clinically relevant; community based participatory research; data repository; data sharing; design; dissemination science; healing; high risk; implementation barriers; implementation determinants; implementation facilitators; implementation science; improved; injury prevention; innovation; insight; intervention mapping; intervention program; male; member; mortality; multilevel analysis; novel; participant enrollment; partner violence; preference; prevent; programs; prospective; research and development; research study; response; revictimization; scale up; service delivery; skills; social; social health determinants; sociodemographics; success; violence prevention; violent crime; ward; young adult

My training goals outlined in this K23 Career Development Award include to: (1) develop the skills to effectively conduct high-quality, clinically-relevant, mixed-methods analyses of barriers and facilitators of hospital-based violence intervention program (HVIP) enrollment; and (2) complete an individually-tailored training program centered in Community Based Participatory Research (CBPR) and Dissemination and Implementation (D&I) Science. This will support my long-term career goal to become an independent investigator of firearm injury prevention by developing, testing, implementing, and continually refining HVIPs. HVIPs share common outcome goals (decreasing reinjury and death rates among participants), and are, by design, individualized programs that provide counseling and social- and case-based services to achieve additional goals that are unique to each participant. For this reason, I will train in mixed methods study design that supports real-world applicability and adaptability of our findings. I will use this award to study CBPR and D&I science to develop the skills necessary to become a leader in HVIP innovation. My career development plan includes a: (1) robust mentoring plan that provides specific details on mentorship roles and development milestones to capitalize on the complementary areas of expertise among mentorship team members; and (2) didactic training plan through the Master of Science in Clinical Investigation program. My research project is a multi-center, mixed-method analysis of barriers and facilitators of enrollment in Life Outside Violence (LOV), the St. Louis region-wide HVIP. The cycle of violence is an under addressed public health threat that disproportionately affects Black patients, especially in St. Louis, which has a very high rate of violent crime. LOV's mission is to facilitate healing and decrease incidences of retaliation, criminal involvement, reinjury, and death. In early analysis of 158 LOV enrolled patients, three (2%) have suffered a recurrent violent reinjury— well below the national rate (up to 77%). However, only 13% of eligible patients enrolled in the LOV program. To address this enrollment gap, I will investigate the following specific aims, to: (1) Apply multilevel regression models to the STL-HVIP-DR to identify sociodemographic, service delivery, organization, and geographic characteristics associated with LOV program enrollment; (2) Assess barriers and facilitators of enrollment in the LOV program through individual and group interviews with a purposive sample (n~45) of LOV mentors, community members, and patients who enrolled in LOV and those who did not; and (3) Use CBPR methods to design and assess an improved engagement pathway to approach violently injured patients for enrollment in the LOV program. My proposed career development and research plan will address actionable HVIP implementation barriers and facilitators in real-world conditions. We will disseminate our findings to other HVIPs through subsequent R01 applications to scale up the new engagement pathway and identify implementation factors that are consistent across communities to decrease mortality among high-risk patients.

我在这个K23职业发展奖中概述的培训目标包括：（1）发展技能 有效地进行高质量的，临床上与障碍的混合方法分析 基于医院的暴力干预计划（HVIP）入学； （2）完全定制了 培训计划以社区参与性研究（CBPR）和传播为中心 实施（D＆I）科学。这将支持我成为独立的长期职业目标 通过开发，测试，实施和连续精炼HVIP来预防枪支伤害的研究者。 HVIPS共有共同的结果目标（降低参与者的重伤和死亡率），并且是由 设计，个性化计划，提供咨询和社会和基于案例的服务以实现 每个参与的其他目标。因此，我将在混合方法研究设计中训练 这支持现实世界的适用性和我们发现的适应性。我将使用这个奖项来研究CBPR和 D＆I科学发展成为HVIP创新领导者所需的技能。我的职业发展 计划包括：（1）强大的心理计划，提供有关Mentalship角色和发展的特定细节 在Mentalship Team成员中利用专业知识的完整领域的里程碑； （2） 通过临床调查计划的理学硕士培训计划。我的研究项目是 多中心，混合方法分析暴力外生活的障碍和促进者（LOV）， 圣路易斯地区范围内的HVIP。暴力周期是一种应对的公共卫生威胁， 不成比例地影响黑人患者，尤其是在圣路易斯的暴力犯罪率很高的圣路易斯。 LOV的使命是促进康复并减少报复，犯罪参与，重伤和 死亡。在对158名LOV入学患者的早期分析中，3名（2％）遭受了反复发生的暴力重伤 - 远低于国家利率（高达77％）。但是，只有13％的合格患者参加了LOV计划。 要解决此注册差距，我将调查以下特定目的，以：（1）应用多级 对STL-HVIP-DR的回归模型，以识别社会人口统计学，服务交付，组织和 与LOV计划入学有关的地理特征； （2）评估障碍和促进者 通过与LOV的实用样本（n〜45）进行个人和小组访谈参加LOV计划 导师，社区成员和参加LOV的患者以及那些没有参加的患者； （3）使用CBPR 设计和评估一种改进的参与途径，以接近暴力受伤的患者 参加LOV计划的注册。我提出的职业发展和研究计划将解决可行的 在现实情况下，HVIP实施障碍和促进者。我们将把我们的发现传播给其他 通过随后的R01应用程序进行HVIPS，以扩大新的参与途径并确定 在社区之间保持一致的实施因素，以降低高危患者的死亡率。