Preventing Retaliatory Gun Violence in Violently Injured Adults: A RCT of a Hospital-Based Intervention

防止遭受暴力伤害的成年人遭受报复性枪支暴力：医院干预的随机对照试验

• 批准号: 10268934
• 负责人: Nicholas David Thomson
• 金额: $ 64.9万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2023-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10268934
• 关键词: Preventing; Retaliatory; Gun; Violence; Violently

Abstract In the United States, firearm-related violence has reached epidemic proportions and has become a major public health problem. To help prevent the high rates of firearm-related deaths, most violence intervention programs have targeted youth (<18 years old) in the hope to slow the rapid increase of violence seen in early adulthood. However, most victims of firearm-related violence are adults (>18 years old), and national statistics show young adults (18-35 years) in particular are the most likely to die from firearm-related violence. It is important to recognize that this risk is not evenly shared among subpopulations of adults, and it is young African American men who come from economically disadvantaged communities with high rates of exposure to violence that are the most vulnerable to firearm-related violence. Unfortunately, they are difficult to engage in community-based intervention efforts. More recently, however, hospital-based violence intervention programs have become increasingly popular because of their success at engaging individuals who have suffered a violent injury. Violently injured adults are not only victims in the present, but 40% will be violently re-injured and 20% will be killed within 5 years; these patients are also 88 times more likely to commit retaliatory violence (Cunningham et al., 2009). It is clear that these adults are in dire need of effective violence intervention. At Virginia Commonwealth University (VCU) Health, we have developed Bridging the Gap (BTG), a promising violence intervention strategy that includes a hospital-based violence intervention, a firearm counseling program, and 6-months of community case management to victims of violence. BTG was originally developed for violently injured youth and results indicate it is effective for reducing youth violence. However, it is yet to be established if it is effective for reducing firearm- related violence in adults. It is also yet to be established if BTG is a cost effective strategy for reducing firearm- related violence and injury. The present study addresses Objective Two of this funding announcement; to rigorously evaluate the effectiveness of innovative and promising strategies to keep individuals safe from firearm- related injuries, deaths, and crime. This research proposal falls under Funding Option B; which supports research projects that collect new data. The goal of the present study is to assess the efficacy of BTG using a randomized control trial design in a large sample of 616 adult victims of violence over a 1-year follow-up period. Efficacy will be assessed using multiple sources of data for firearm-related violence (e.g., criminal arrest records, self-report, semi-structured clinical assessment of non-convicted firearm-related violence) and firearm-related re-injury and mortality (e.g., hospital records). To improve our understanding of the impact BTG has on firearm-related violence, we will test for psychosocial mediators linking BTG to reductions in firearm-related violence. We also aim to understand what psychosocial vulnerabilities may weaken the impact of BTG on firearm-related violence. Lastly, a cost-benefit analysis will determine the economic benefits of implementing BTG. Collectively, results from this study may support the use of BTG as a firearm-related violence intervention for adult victims of violence.

抽象的 在美国，与枪支相关的暴力已达到流行程度，并已成为主要公共问题 健康问题。为了帮助防止与枪支相关的高死亡率，大多数暴力干预计划 以青少年（<18 岁）为目标，希望减缓成年早期暴力行为的迅速增加。 然而，大多数枪支相关暴力的受害者是成年人（>18 岁），国家统计数据显示年轻人 尤其是成年人（18-35 岁）最有可能死于与枪支相关的暴力。重要的是 认识到这种风险并没有在成年人亚群中平均分担，而是年轻的非裔美国人 来自经济贫困社区的男性，遭受暴力的几率很高， 最容易遭受与枪支有关的暴力行为。不幸的是，他们很难参与基于社区的活动 干预努力。然而，最近，以医院为基础的暴力干预计划已成为 由于它们成功地吸引了遭受暴力伤害的人，因此越来越受欢迎。猛烈地 受伤的成年人不仅是当下的受害者，40%的人会在短时间内再次遭受暴力伤害，20%的人会被杀害 5年；这些患者实施报复性暴力的可能性也高出 88 倍（Cunningham 等人，2009 年）。它 显然，这些成年人迫切需要有效的暴力干预。在弗吉尼亚联邦大学 (VCU) 健康方面，我们制定了弥合差距 (BTG)，这是一项很有前途的暴力干预战略， 包括基于医院的暴力干预、枪支咨询计划和为期 6 个月的社区案例 对暴力受害者的管理。 BTG 最初是为遭受暴力伤害的青少年开发的，结果表明 它对于减少青少年暴力是有效的。然而，它是否能有效减少枪支使用仍有待确定。 与成人相关的暴力行为。 BTG 是否是减少枪支的具有成本效益的策略也尚未确定。 相关的暴力和伤害。本研究涉及本资助公告的目标二；到 严格评估创新和有前途的策略的有效性，以确保个人免受枪支伤害 相关的伤害、死亡和犯罪。本研究提案属于资助选项 B；支持研究 收集新数据的项目。本研究的目的是使用随机试验评估 BTG 的功效 在 1 年的随访期内对 616 名成年暴力受害者的大样本进行对照试验设计。功效会 使用多种数据源对枪支相关暴力进行评估（例如刑事逮捕记录、自我报告、 对未定罪的枪支相关暴力的半结构化临床评估）和枪支相关的再伤害和 死亡率（例如医院记录）。提高我们对 BTG 对枪支相关影响的了解 暴力，我们将测试将 BTG 与减少枪支相关暴力联系起来的社会心理中介。我们也 旨在了解哪些社会心理脆弱性可能会削弱 BTG 对枪支相关暴力的影响。 最后，成本效益分析将确定实施 BTG 的经济效益。综合来看，结果 这项研究可能支持使用 BTG 作为成年暴力受害者的枪支相关暴力干预措施。