Evaluating outcomes for youth receiving hospital-based violence prevention with and without a community-level initiative

项目摘要 青年暴力的后果对社会造成巨大的经济损失，并造成长期的心理社会影响。 对受害者和社区的身体影响。暴力行为人也面临许多挑战， 心理和身体健康问题，学校表现，就业，参与和维持 健康的关系。毫无疑问，青年暴力对每个参与者都有巨大影响。 幸运的是，青年暴力是一种可以预防的流行病。然而，高风险青年往往难以接触和参与 在预防战略中。解决这一问题的一个办法是预防医院暴力。每天超过1300人 青少年因暴力受伤被送往急诊室。这次创伤性事件 作为变革的有力推动者。基于医院的暴力预防计划，如弥合差距 (BTG)利用这一催化剂，让这些高危青年参与进来。不幸的是，这些年轻人中有许多人 来自贫困社区，那里资源匮乏，保护因素稀少， 暴力是高的。如果没有社区一级的预防战略， 这些方案在防止青少年一旦离开医院就从事暴力方面可能有限。因此， 综合办法是预防高风险暴力行为的最佳战略， 受伤的年轻人使用的样本120暴力受伤的青年（12-17岁）从弗吉尼亚州联邦招募 大学创伤中心（VCUTC），我们的目标是评估是否BTG青年有更大的减少，在多种形式 如果青年来自接受社区护理预防系统的社区， 步行者-谈话者/坦率谈话社区参与模式（BTG+CTC Plus）与来自社区的BTG青年 没有CTC Plus。此外，我们的目的是评估BTG和BTG+CTC Plus的经济效率， 监视数据。最后，我们的目标是测试可能将早期逆境联系起来的调解人的存在和力量 与在CTC Plus社区接受BTG的青少年相比， 没有CTC Plus的社区中的BTG。为了实现这些目标，候选人和导师团队（沙利文博士 和法雷尔）已经制定了一个全面的培训计划，概述了一系列的培训和研究目标。 这些目标包括在多种形式暴力的风险/保护因素方面的培训，医院-和社区- 基于暴力的方案，方案评估和经济效益评估。K 01提案将 充分利用候选人现有的专业知识。这项研究对促进 了解在暴力受伤的青年中预防跨领域暴力的工作。体制 环境被CDC认可为预防青少年暴力的卓越学术中心， 导师们在指导和实施预防暴力研究方面取得了长期的成功。的 制度环境增强了候选人的发展研究独立性的目标，作为一个训练有素的 科学家，最终目的是减少和防止暴力，符合NCIPC的研究重点。

Project Summary The consequences of youth violence have a massive financial toll on society, as well as long-term psychosocial and physical effects on the victim and communities. Perpetrators of violence also face many challenges, such as problems with mental and physical health, school performance, employment, and engaging and maintaining healthy relationships. Without a doubt, youth violence has a tremendous impact on everyone involved. Fortunately, youth violence is a preventable epidemic. Yet, high-risk youth are often difficult to reach and engage in prevention strategies. A solution to this problem is hospital-based violence prevention. Each day over 1,300 youths are admitted to the emergency department for violence-related injuries. This traumatic event can serve as a powerful precipitant for change. Hospital-based violence prevention programs, such as Bridging the Gap (BTG), capitalize on this catalyst and engage these high-risk youth. Unfortunately, many of these youths come from impoverished communities, where resources are low, protective factors are sparse, and community-levels of violence are high. Without a community-level prevention strategy, hospital-based violence prevention programs may be limited in keeping youth from engaging in violence once they leave the hospital. Thus, it may be that an integrative approach is the best strategy for cross-cutting violence prevention for high-risk violently injured youth. Using a sample of 120 violently injured youth (12-17 years) recruited from Virginia Commonwealth University Trauma Center (VCUTC), we aim to evaluate if BTG youth have greater reductions in multiple forms violence when the youth comes from a community receiving Communities that Care Prevention System and Walker-Talker/Plain Talk Community Engagement Model (BTG+CTC Plus) versus BTG youth from communities without CTC Plus. Also, we aim to evaluate the economic efficiency of BTG and BTG+CTC Plus using surveillance data. Lastly, we aim to test the presence and strength of mediators that may link early adversities to violent behavior for youth who receive BTG in communities with CTC Plus as compared to youth who receive BTG in communities without CTC Plus. To achieve these aims, the candidate and mentorship team (Drs. Sullivan and Farrell) have developed a comprehensive training plan outlining a series of training and research goals. These goals include training in risk/protective factors for multiple forms of violence, hospital-and community- based violence programs, program evaluation, and economic efficiency evaluation. This K01 proposal will capitalize on the existing expertise of the candidate. The research represents an important contribution towards understanding what works for cross-cutting violence prevention in violently injured youth. The institutional environment is recognized by the CDC as an Academic Center of Excellence in Youth Violence Prevention, and the mentors have shown longstanding success mentoring and implementing violence prevention research. The institutional environment enhances the candidate's goal of developing research independence as a highly trained scientist, with the ultimate aim to reduce and prevent violence, consistent with NCIPC's research priorities.