The effectiveness of an ED-based violence prevention program

Youth violence continues to be a problem in the United States, most prominent in the inner-city minority youth population. The recurrence rate for repeat violence has been reported from 6% to 44% with a 5-year mortality of 20%. This study describes the results of a program to reduce violence recurrence based in the ED.

Patients aged 10 to 24 years who were victims of interpersonal violence (excluding child abuse, sexual assault, and intimate partner violence) were randomly enrolled in the study in level 1 trauma center. The control group was given a written list of services, and the treatment group received an assessment and case management for 6 months. Both groups were evaluated 6 and 12 months after enrollment in the study. The primary indicators of the success of the intervention were reduction of self-reported revictimization or arrest and state-reported incarceration and reinjury. The study was approved by the institutional review board. The results compared the change in treatment and control groups over the time using a combination of chi(2) and analysis of covariance.

One hundred eighty-eight victims of interpersonal violence met the criteria and had the initial evaluation completed. By chi(2) analysis, the treatment group (96 subjects) and the control group (92 subjects) were similar in age, sex, and racial composition. The average age was 18.6 years (range, 11-24), and 82.5% were boys. Most youth were African Americans (65.4%), followed by Hispanic (31.4%), whites (1.6%), or others (1.5%). A reduction in the self-reported reinjury rate was significantly reduced over time in the treatment group (chi(2) 3.87, P = .05). There were no differences between the groups in the number of self-reported arrests, state-reported reinjuries via the trauma registry, or state-reported incarcerations (P < .05).

The results of this study demonstrated a reduction in self-reported reinjury rate in the intervention group. Further research is needed to confirm if ED-based violence prevention programs are effective in reducing other determinants for revictimization.