Violence prevention advocacy in surgery: Strategies across the socioecological spectrum

At the frontlines of the violence epidemic, surgeons are poised to advocate for violence prevention strategies across multiple levels. Using the socioecological model which states that individuals are influenced by their intrinsic personal characteristics, interpersonal relationships, institutional practices, community norms, and societal policies, this manuscript describes effective strategies for advocacy from the individual to the societal level. Advocacy at the individual level includes practicing trauma-informed care, screening for social drivers of health, and linking individuals to services and organizations that provide social and economic resources to improve their health. Acknowledging and mitigating social drivers by using case managers and needs based assessments foster sound relationships, whereas partnerships with community-based organizations, faith groups, schools, and influential leaders may provide innovative solutions to mitigate risks of violence and simultaneously shift narratives and community norms. Hospital-based violence intervention programs encompass all facets of the socioecological spectrum. Further, surgeons can seek opportunities for violence prevention advocacy through national surgical or public health organizations that facilitate surgeon participation in informing policy recommendations, white coat advocacy days on Capitol Hill, and direct engagement with congressional or senate members or their staff.