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Hospital-based violence intervention programs targeting adult populations: an Eastern Association for the Surgery of Trauma evidence-based review
  1. Steven Affinati1,
  2. Desmond Patton2,
  3. Luke Hansen3,
  4. Megan Ranney4,
  5. A Britton Christmas5,
  6. Pina Violano6,
  7. Aparna Sodhi7,
  8. Bryce Robinson8,
  9. Marie Crandall9,
  10. from the Eastern Association for the Surgery of Trauma Injury Control and Violence Prevention Section and Guidelines Section
  1. 1The Family Institute at Northwestern University, Evanston, Illinois, USA
  2. 2School of Social Work and School of Information, University of Michigan, Ann Arbor, Michigan, USA
  3. 3Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  4. 4Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  5. 5Department of Surgery, The F. H. ‘Sammy’ Ross, Jr Trauma Center, Carolinas Medical Center, Charlotte, North Carolina, USA
  6. 6Department of Injury Prevention, Community Outreach & Research, Yale-New Haven Hospital, New Haven, Connecticut, USA
  7. 7Northwestern University, Evanston, Illinois, USA
  8. 8Department of Surgery, University of Washington Harborview Medical Center, Seattle, Washington, USA
  9. 9Department of Surgery, University of Florida College of Medicine, Jacksonville, Florida, USA
  1. Correspondence to Dr Marie Crandall; Marie.crandall{at}


Background Violent injury and reinjury take a devastating toll on distressed communities. Many trauma centers have created hospital-based violent injury prevention programs (HVIP) to address psychosocial, educational, and mental health needs of injured patients that may contribute to reinjury.

Objectives To evaluate the overall effectiveness of HVIPs for violent injury prevention. We performed an evidence-based review to answer the following population, intervention, comparator, outcomes (PICO) question: Are HVIPs attending to adult patients (age 18+) treated for intentional injury more effective than the usual care at preventing: intentional violent reinjury and/or death; arrest and/or incarceration; substance abuse and/or mental issues; job and/or school attainment?

Data sources PubMed, Web of Science, Google Scholar, and the Cochrane Library were queried for salient articles by a professional librarian on two separate occasions, and related articles were identified from references.

Study eligibility criteria, participants, interventions Eligible studies examined adult patients treated for intentional injury in a hospital-based violence prevention program compared to a control group.

Study appraisal and synthesis methods We used the Grading of Recommendations Assessment, Development, and Evaluation methodology to assess the breadth and quality of the evidence.

Results 71 articles were identified. After discarding duplicates, reviews, and those articles that did not address our PICO questions, we ultimately reviewed 10 articles. We found insufficient evidence to recommend adult-focused HVIP interventions.

Limitations There was a relative paucity of data, and available studies were limited by self-selection bias and small sample sizes.

Conclusions We make no recommendation with respect to adult-focused HVIP interventions.

  • violence
  • injury prevention

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