Implementation of an emerging hospital-based violence intervention program: a multimethod study.

Area of Science:

• Trauma Surgery
• Public Health
• Health Services Research

Background:

• Assaultive firearm injury survivors face high risks of reinjury and adverse health outcomes.
• Hospital-based violence intervention programs (HVIPs) offer intensive case management to mitigate these risks.

Purpose of the Study:

• To evaluate an emerging HVIP using the RE-AIM framework.
• To assess recruitment, violent reinjury outcomes, and service provision.
• To identify facilitators and barriers to HVIP enrollment and effectiveness.

Main Methods:

• A multimethod evaluation incorporating qualitative interviews and clinician surveys.
• Analysis of 319 HVIP-eligible individuals from 2020-2022.
• Application of the RE-AIM framework to assess Reach, Effectiveness, Adoption, Implementation, and Maintenance.

Main Results:

• HVIP enrollment was 12% (39/319), with inpatient admission being an independent predictor (OR 2.6).
• Facilitators included credible messengers and personal relationships; a barrier was fear of police disclosure.
• Enrollment did not significantly reduce reinjury (OR 0.70), with unmet needs in housing and mental health identified.

Conclusions:

• Credible messengers enhance engagement, while police involvement is a barrier.
• Inpatient settings offer opportunities for patient engagement and recruitment.
• Increased program intensity and addressing social determinants of health are recommended for HVIPs.