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.

项目概要 枪支暴力是美国的一个主要原因，并且对少数群体产生了不成比例的影响 种族群体，因为它高度集中在经历了数十年种族主义的有色人种社区 枪支暴力的受害者往往陷入暴力循环，其比例是其他人的两倍。 与没有暴力史的人相比，有可能因暴力事件而死亡或住院 因此，以医院为基础的干预计划（HVIP）对于提供全面的治疗至关重要。 支持枪支暴力受害者的关键社区暴力干预措施的服务和联系 制定影响枪支暴力的干预措施需要跨学科的研究。 目前大休斯顿地区缺乏 HVIP—— 美国第四大城市——强调了制定和实施该计划的必要性 因此，本研究旨在建立基于社区的干预措施，以减少枪支暴力。 德克萨斯医学中心赫尔曼纪念医院休斯顿医院暴力干预计划 德克萨斯州休斯顿中心，作为目标 1 中枪支暴力的社区级响应。 我们将建立一个由内部和外部利益相关者组成的联盟，就其组建提供建议并监督 实施休斯敦-HVIP。 一个 期间 效力 将通过发展来创造接待HVIP的文化底蕴 具有健康公平视角的跨专业、创伤知情护理教育平台。 在UG3阶段，我们将实施和评估Houston-HVIP计划，以确定 减少计划参与者重复发生的暴力事件。 整群随机对照试验，采用完全沉浸式医院暴力干预计划和 针对枪支受害者需求定制的增强型案件管理计划 该计划以关键原则为指导。 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 领导者以及伤害预防、健康科学分析和混合方法方面的多学科专家团队 将对这种干预措施进行严格评估，以了解计划的有效性和可接受性， 再伤对参与该计划各部分的人员的影响以及健康问题社会决定因素的作用 此外，我们还将研究该计划对种族和社区的影响。 受枪支暴力影响的人的种族差异。