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Published on: July 4, 2013
Hospital-based violence intervention programs may positively influence mental health outcomes
Nathaniel Pinkes1, Molly P Jarman, Saba Ilkhani
1From the Department of Surgery (N.P., M.P.J., S.I., A.S., J.P.H.-E., G.A.A.), Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts; UConn Health (N.P.), University of Connecticut, UConn Health, School of Medicine, Farmington, Connecticut; Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery (N.P., A.S., J.P.H.-E., G.A.A.), Brigham and Women's Hospital; Department of Health Sciences (F.N.), Bouvé College of Health Sciences, Northeastern University; and Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (G.V.), Massachusetts General Hospital, Boston, Massachusetts.
Background:
Hospital-based violence intervention programs (HVIPs) are interdisciplinary teams and interventions designed to improve outcomes for violently injured patients. There is a lack of literature showing longitudinal assessment of mental health outcomes among survivors of violence who use HVIPs. This study examines whether HVIP engagement by survivors of community violence improves long-term mental health-related quality of life. We hypothesize that victims of violence who engaged with HVIP programming will show better mental health-related quality of life scores 6 to 12 months following their injury.
Methods:
In this prospective nested cohort study, adult survivors of community violence with moderate to severe injuries (Injury Severity Score, ≥9) admitted to two level I trauma centers between December 2015 and July 2020 were interviewed 6 to 12 months after injury. Short Form-12 mental and physical health component score data were collected. Multivariable linear regression was used to estimate the adjusted mean difference in component scores given HVIP engagement.
Results:
Of 98 patients with a violent injury, 17 (17.3%) had true HVIP use. Using an as-treated approach, patients who engage with an HVIP have a greater mean mental health component score compared with patients who do not engage with an HVIP (54 [95% confidence interval, 49-75] vs. 41 [95% confidence interval, 32-52]; p = 0.002). There is no significant difference in physical health component score, all-cause, and trauma-related readmission between patients who do and do not engage with an HVIP following violent injury.
Conclusion:
This study demonstrates that HVIPs may be associated better long-term mental health outcomes among patients who suffer violent injuries. These findings should encourage further implementation, funding, and evaluation of HVIPs that may help mitigate the sequelae of violent injury.
Level Of Evidence:
Prognostic and Epidemiological; Level III.
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