Preventing Gun Violence Among Youth: An RCT of a Virtual Reality Intervention.

摘要 与枪支有关的暴力是美国的一个主要公共卫生问题。2020年，超过4万人死亡 与枪支有关的暴力除了人类生命的重大和毁灭性代价之外，与枪支有关的暴力 对美国来说是一个巨大的经济负担，每年花费数百亿美元。暴力率 在这一流行病期间，艾滋病毒/艾滋病感染率上升，青年受到暴力上升的沉重打击。凶案组是 非裔美国年轻男性（10-19岁; CDC，2019）的死亡原因， 该医院收治的枪支相关受伤者均为袭击受害者。一旦出院， 暴力事件中，暴力报复的可能性是暴力事件的88倍，40%的人将在五年内再次受伤，因此， 使暴力循环永久化因此，医院已成为防止报复的关键资源。 高风险青年的枪支暴力。然而，高危青少年往往难以进行干预，这是 为什么需要新的和创新的战略，以满足青年的利益。目前的目标是 一项提案是扩大一项有前途的虚拟现实（VR）暴力预防计划的开发， 虚拟现实，以防止青年人中发生与火器有关的暴力行为和受害事件。Elevate VR是 简短的基于医院的暴力干预，使暴力受伤的青年参与文化相关的沉浸式 故事和游戏，同时教授青少年心理教育技能（即，积极的青年发展，在线 和面对面的降级培训，情绪调节技能建设，创伤管理，枪支安全 意识等）。Elevate VR提供了沉浸式个人层面干预与 接触到适合当地青年社区的社区资源。本研究将进行一项随机 对照试验包括360名暴力伤害青少年及其照顾者（N=720），以评估 提升VR，以防止高风险暴力受伤青年中与枪支有关的暴力，伤害和死亡。的 研究还旨在确定最具可塑性的风险和保护因素（介质），以应对变化 提升VR。这一知识对于通过更有效地瞄准风险和 保护性因素。最后，我们的目标是评估Elevate VR作为一个简短的医院为基础的经济效益， 预防枪支暴力战略。这项研究的结果可能支持使用Elevate VR作为 一项具有成本效益的战略，以防止与枪支有关的暴力，伤害，和死亡的青年受害者， 暴力

Abstract Firearm-related violence is a major public health problem in the United States. In 2020, over 40,000 people died from firearm-related violence. Beyond the significant and devastating cost of human life, firearm-related violence is an enormous economic burden to the US costing tens of billions of dollars every year. The rates of violence have risen during the pandemic, and youth have been hit hard by the rise in violence. Homicide is the leading cause of death for African American young males (10-19 years; CDC, 2019), and 7 out of 10 people treated in the hospital for firearm-related injuries were victims of assault. Once discharged from the hospital, victims of violence are 88 times more likely to violently retaliate and 40% will be reinjured within five years, thus, perpetuating the cycle of violence. Therefore, hospitals have become a critical resource to prevent retaliatory firearm violence in high-risk youth. However, high-risk youth are often difficult to engage in intervention, which is why new and innovative strategies are needed to meet youth where their interests are. The goal of the present proposal is to expand the development of a promising virtual reality (VR) violence prevention program, Elevate VR, to prevent incidents of firearm-related violence perpetration and victimization among youth. Elevate VR is a brief hospital-based violence intervention that engages violently injured youth in culturally relevant immersive stories and gameplay, all while teaching youth psychoeducational skills (i.e., positive youth development, online and in-person de-escalation training, emotion regulation skill building, trauma management, gun safety awareness, etc.). Elevate VR provides the connection between an immersive individual-level intervention and exposure to community resources tailored to the youths’ local community. This study will conduct a randomized control trial including 360 violently injured youth and their caregivers (N=720) to assess the effectiveness of Elevate VR for preventing firearm-related violence, injury, and mortality in high-risk violently injured youth. The study also aims to identify risk and protective factors that are most malleable (mediators) to change in response to Elevate VR. This knowledge is critical for improving the intervention by more efficiently targeting risk and protective factors. Lastly, we aim to assess the economic efficiency of Elevate VR as a brief hospital-based firearm-related violence prevention strategy. The results from this study may support the use of Elevate VR as a cost-effective strategy for preventing firearm-related violence, injury, and mortality among youth victims of violence.