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Prioritizing Core Factors Needed to Sustain Hospital-Based Violence Intervention Programs: A Delphi Study
Lars Erik Almquist1, Sarah Cusworth Walker2, Ali Rowhani-Rahbar3
1Department of Health Systems and Population Health, University of Washington School of Public Health, 3980 15th Ave NE, Fourth Floor, Box 351621, Seattle, WA, 98195, USA. larsalmq@uw.edu.
Summary
Sustaining hospital-based violence intervention programs (HVIP) requires prioritizing frontline professional support, with funding and administrative factors being moderately important. Long-term HVIP success depends on adapting strategies over time.
Area of Science:
- Public Health
- Violence Prevention
- Program Sustainability
Background:
- Hospital-based violence intervention programs (HVIP) are crucial for public health by interrupting violence cycles.
- Existing guidance focuses on launching HVIPs, but lacks strategies for long-term program sustainability.
- Limited evidence exists on critical factors for sustaining established HVIPs.
Purpose of the Study:
- To identify and prioritize factors essential for the long-term sustainability of hospital-based violence intervention programs.
- To fill the gap in knowledge regarding HVIP sustainability strategies.
Main Methods:
- A three-round Delphi study was conducted with 32 leaders and founders of established HVIPs.
- Initial candidate factors (n=108) were synthesized into 28 unique factors.
- Maximum-difference (MaxDiff) scaling with hierarchical Bayes estimation ranked sustainability priorities.
Main Results:
- Support for frontline violence prevention professionals emerged as a top priority, comprising six of the top nine factors.
- Funding sources and allocation received moderate to above-average priority.
- Administrative and community stakeholder factors were prioritized lower, with external systems like law enforcement ranked lowest.
Conclusions:
- Sustainability priorities for HVIPs differ significantly from initial program launch blueprints.
- HVIP leaders must be prepared to adapt their strategies and skillsets over time for sustained impact.
- Focusing on frontline professional support is critical for long-term program viability.
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