Incorporation of a Health Equity Approach to Hospital Violence Intervention Programs: The Integration of a Community and Hospital Based Initiatives to Reduce Gun Violence in a Large Metropolitan Area

将健康公平方法纳入医院暴力干预计划：整合社区和医院举措以减少大都市区的枪支暴力

• 批准号: 10812032
• 负责人: Sandra McKay
• 金额: $ 155.54万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10812032
• 关键词: Academic Training; Accounting; Address; Adult; Advocate; African American population; Area; Caring; Case Management; Case Manager; Cause of Death; Cities; Collaborations; Color; Communities; Community Health; Complex; County; Data; Disparity; Education; Effectiveness; Enrollment; Equity; Ethnic Origin; Evaluation; Evaluation Studies; Event; Firearms; Funding Mechanisms; Goals; Gun injury; Health; Health Personnel; Health Sciences; Health Services Accessibility; Healthcare Systems; Homicide; Hospitalization; Hospitals; Incidence; Individual; Injury; Interpersonal Violence; Intervention; Interview; Law Enforcement; Leadership; Measurement; Measures; Medical; Medical center; Mental Health; Methods; Participant; Patient Self-Report; Patients; Phase; Play; Population; Preparation; Prevention; Prevention Research; Program Acceptability; Program Effectiveness; Protocols documentation; Public Health; Public Health Schools; Race; Randomized, Controlled Trials; Recording of previous events; Recurrence; Reporting; Research; Research Design; Risk; Risk Factors; Risk Reduction; Role; Services; Specialist; Surveys; Testing; Texas; Trauma; United States; United States National Institutes of Health; Urban Hospitals; Victimization; Violence; Violent injury; Voice; arm; behavioral health; community based service; community engagement; community violence; comparison group; design; dosage; ethnic disparity; experience; feasibility testing; follow-up; group intervention; gun violence; health care settings; health equity; health inequalities; holistic approach; improved; injury prevention; interdisciplinary approach; intervention program; medical schools; metropolitan; mortality; multidisciplinary; neighborhood safety; novel; programs; racial disparity; racial minority population; racism; recidivism; recruit; response; revictimization; service programs; social health determinants; success

PROJECT SUMMARY Firearm violence is a leading cause of death in the United States and disproportionately impacts minoritized racial groups, given its high concentration in communities of color that have experienced decades of racism and health inequity. Victims of firearm violence are often stuck in a cycle of violence, as they are twice as likely to die or be hospitalized from a violent event compared to those without a history of violent victimization. Therefore, hospital-based intervention programs (HVIPs) can be crucial to provide holistic services and connections to critical community-based violence interventions that support firearm violence victims and reduce reinjury risk. Developing interventions to impact firearm violence requires a transdisciplinary approach with community–city–hospital interventions. The lack of a current HVIP in the greater Houston area– the fourth largest city in the United States–highlights the need to develop and implement this program as a critical community-based intervention to reduce firearm violence. Therefore, the current study aims to create the Houston-Hospital-Based Violence Intervention program at Memorial Hermann Hospital in the Texas Medical Center in Houston, Texas, as a community-level response to firearm violence. In Aim 1, during the UG3 phase, we will develop a coalition of internal and external stakeholders to advise on the formation and oversee the implementation of the Houston-HVIP. We an during effectiveness will create the culture prime for the reception of the HVIP by developing inter-professional, trauma-informed care educational platform with a health equity lens. In our second aim, the UG3 phase, we will implement and evaluate the Houston-HVIP program to determine the of reducing repeat violent events by a program participant. The Houston-HVIP will feature a clustered randomized controlled trial, with a fully immersive hospital violence intervention program and an enhanced case manager program tailored to the firearm victim's needs. The program is guided by critical stakeholders, including hospital leadership, public health advocates, law enforcement, community and city leaders, and a multidisciplinary team of experts in injury prevention, health science analysis, and mixed methods evaluations. This intervention will be rigorously evaluated to understand program effectiveness and acceptability, the impact of reinjury on those enrolled in each arm of the program, and the role of social determinants of health on firearm injury to the participant and the community. Also, we will examine the program's impact on racial and ethnic disparities in those impacted by firearm violence.

项目摘要 枪支暴力是美国死亡的主要原因，不成比例地影响少数 种族群体，鉴于其在经历了数十年种族主义和 健康不平等。枪支暴力的受害者经常被困在暴力周期中，因为它们是两倍的 与没有暴力病史的人相比，可能死于暴力事件或住院 因此，基于医院的干预计划（HVIP）对于提供整体至关重要 服务和与关键的基于社区的暴力干预措施的联系，以支持违反枪支暴力滥用 并降低重伤风险。制定影响枪支暴力的干预措施需要跨学科 与社区 - 城市 - 医院干预措施的接近。大休斯顿地区缺乏目前的HVIP - 美国第四大城市 - 高光是开发和实施该计划的必要性 基于社区的干预措施，以减少枪支暴力。因此，当前的研究旨在创建 在德克萨斯医疗的纪念赫尔曼医院举行的基于休斯顿医院的暴力干预计划 德克萨斯州休斯敦的中心是对枪支暴力的社区级反应。在AIM 1中，在UG3阶段， 我们将建立一个内部和外部利益相关者的联盟，以建议形成并监督 实施休斯顿-HVIP。我们 一个 期间 效力 将通过开发来建立接受HVIP的文化素材 具有健康平等镜头的专业间，创伤信息的护理教育平台。在我们的第二个目标中 UG3阶段，我们将实施和评估休斯顿-HVIP计划，以确定 减少计划参与者的重复暴力事件。休斯顿-HVIP将有一个 聚集的随机对照试验，具有完全身临其境的医院暴力干预计划和 增强了针对枪支受害者需求量的案件经理计划。该计划以关键为指导 利益相关者，包括医院领导，公共卫生倡导者，执法部门，社区和城市 领导者和跨学科预防，健康科学分析和混合方法的多学科专家团队 评估。该干预措施将经过严格评估，以了解计划有效性和可接受性， 重枪对计划中每个部门的人的影响以及卫生的社会决定者的作用 关于参与者和社区的枪支伤害。此外，我们将研究该计划对种族和 受枪支暴力影响的种族差异。