Assessing an Adolescent Violence Screening Tool Longitudinally for Primary Care

描述（由申请人提供）：这个K奖将是西格尔博士职业生涯发展的一个组成部分，该职业生涯的重点是在初级保健环境中发现和干预青少年暴力。西格尔博士将在特伦斯·索恩伯里博士的主要指导下与暴力研究和预防中心合作。为了成为该领域的独立研究人员，候选人已经确定了几项需要提高的技能，包括：提高对筛查工具的心理测量特性的认识，提高进行纵向随机对照干预试验的能力，学习评估方案执行情况的技能，增加对青年暴力干预措施的了解，以及了解暴力作为一个公共卫生问题与如何利用医疗环境来解决这一问题之间的联系。在CSPV工作，参加教学课程，与社区互动，并开展拟议的研究项目的组合将实现这一目标。长期职业目标包括：1）成为青年暴力评估和干预领域的独立临床调查员; 2）在初级保健层面研究和实施循证干预措施，以减少青年暴力的发病率和死亡率; 3）与社区合作伙伴合作，建立青年暴力评估和治疗卓越中心。该研究项目是：评估初级保健暴力伤害、保护和风险筛查工具在1年和2年的预测有效性。具体目标：确定的预测效度在一年和两年的暴力伤害，保护和风险筛查（VIPRS）工具，确定青年在未来的暴力参与（侵略，暴力犯罪，暴力受害，并从暴力伤害）的风险。方法：一个初始队列的165名青年，和131名家长已被招募到评估的VIPRS的跨部门的可靠性和有效性。这项拟议的研究将通过评估初始队列的青年和父母在一年和两年的随访，从最初的登记检查未来的预测有效性的VIPRS。将管理评估攻击和受害情况的问卷，并重复VIPRS。将在一年和两年随访时进行图表审查，以确定初级保健医生是否诊断出任何与暴力有关的行为或任何与暴力有关的伤害。将使用多变量线性或逻辑回归分析来检查VIPRS的预测有效性，以确定：1）VIPRS基线评分是否与基线与一年和两年随访访谈之间发生的暴力行为相关;和2）VIPRS评分从基线到一年的变化是否与一年随访访谈和两年随访访谈之间发生的暴力行为相关，针对基线VIPRS评分进行调整。项目叙述/相关性：该项目对青年暴力的公共卫生问题至关重要。初级保健卫生专业人员没有积极参与处理青年暴力问题，主要是因为识别处于风险中的青年既费时又具有挑战性。通过创建一个易于管理的筛查工具，卫生专业人员将能够识别，并最终在青年遭受暴力参与的后果之前进行干预。

DESCRIPTION (provided by applicant): This K award will be integral in the development of Dr. Sigel's career, which is focused on youth violence detection and intervention in the primary care setting. Dr. Sigel will work with the Center for the Study and Prevention of Violence, under the primary mentorship of Dr. Terence Thornberry. To become an independent researcher in this field, the candidate has identified several skill sets that need enhancement, including: improving knowledge of psychometric properties of screening tools, improving ability to conduct longitudinal, randomized control intervention trials, learning skills to evaluate program implementation, increasing understanding of what interventions work for youth violence intervention, and understanding the interface between violence as a public health problem and how the medical setting can be used to address this issue. A combination of working at the CSPV, taking didactic classes, interfacing with the community, and carrying out the proposed research project will accomplish this. Long term career goals include: 1) becoming an independent clinical investigator in the field of youth violence assessment and intervention; 2) studying and implementing evidence-based interventions at the primary care level to decrease morbidity and mortality from youth violence and 3) establishing a center of excellence in youth violence assessment and treatment, in collaboration with community partners. The research project is: Assessing Predictive Validity at 1 and 2 Years of the Violence Injury, Protection and Risk Screening Tool for Primary Care. Specific Aim: Determine the predictive validity at one and two years of the Violence Injury, Protection and Risk Screening (VIPRS) Tool that identifies youth at risk for future violence involvement (aggression, violence perpetration, violence victimization, and injury from violence).Methods: An initial cohort of 165 youth, and 131 parents have been enrolled to evaluate the reliability and validity of the VIPRS cross-sectionally. This proposed study will examine the future predictive validity of the VIPRS by assessing the initial cohort of youth and parents at one and two year follow-up from initial enrollment. Questionnaires evaluating aggression and victimization will be administered, as well as repeating the VIPRS. Chart review will be done at one and two year follow-up to determine whether the primary care practitioner diagnosed any behavior related to violence involvement, or any violence related injury. Analysis The predictive validity of the VIPRS will be examined using multivariate linear or logistic regression analysis to determine whether:1) the VIPRS baseline scores are associated with violent behavior occurring between baseline and the one-year and two year follow-up interview; and 2) change in VIPRS scores from baseline to one-year is associated with violent behavior occurring between the one-year follow-up interview and the two-year follow-up interviews, adjusted for baseline VIPRS scores. Project Narrative/Relevance: This project is vital to the public health issue of youth violence. Primary care health professionals have not been actively involved in treating youth violence, mostly because it is time consuming and challenging to recognize youth at risk. By creating an easy to administer screening tool, health professionals will be able to recognize, and ultimately intervene before youth suffer the consequences of violence involvement.