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Passing the torch: evaluating exportability of a violence intervention program
Randi Smith1, Abigail Evans, Christy Adams
1Department of Surgery, University of California San Francisco, San Francisco General Health, 1001 Potrero Avenue, Building 3A, Box 0807, San Francisco, CA 94143, USA. randinsmith@yahoo.com
American Journal of Surgery
|July 23, 2013
Summary
Exporting a violence intervention program (VIP) to a new trauma center showed challenges in patient recruitment and enrollment. While the program model was effective, infrastructure and cultural factors hindered successful implementation.
Area of Science:
- Trauma surgery and public health interventions.
- Program evaluation and implementation science.
Background:
- A developed violence intervention program (VIP) at a trauma center reduced injury recidivism from 16% to 4%.
- Investigated the feasibility of exporting this VIP to another trauma center.
- Examined recruitment, enrollment, and impact to identify potential barriers.
Purpose of the Study:
- To determine the feasibility of exporting a successful violence intervention program (VIP).
- To assess barriers to recruitment, enrollment, and impact at a new trauma center.
- To test the hypothesis that the VIP is feasible and meets risk reduction needs.
Main Methods:
- Introduced the VIP to a second trauma center in January 2010.
- Utilized the Centers for Disease Control and Prevention's model for program evaluation (process and impact).
- Compared patient and case manager characteristics, and recruitment/enrollment rates using Wilcoxon rank-sum and chi-square tests.
Main Results:
- Lower patient approach (44% vs. 92%) and enrollment (21% vs. 55%) rates at the exported site.
- Missed patients due to weekend injuries (40%) and short hospital stays (<=48 hours, 70%).
- Significantly lower cultural match between clients and case managers (47% vs. 91%) at the exported site.
Conclusions:
- The VIP model (case management) showed success at the export site.
- Program infrastructure, including case manager cultural match, was not successfully exported.
- Program exportation requires replication of both model and infrastructure for full success.
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