Clinical SciencePassing the torch: evaluating exportability of a violence intervention program
Section snippets
The violence intervention programs
The Wraparound Project, a hospital-based VIP, was developed at our level 1 trauma center (ie, SFGH) in 2005. In January 2010, our VIP was exported to UCD Medical Center, another level I trauma center that treats a significant number of victims of violent injury. Eligibility criteria for the program include individuals injured from interpersonal violence between the ages of 10 to 30 years. Victims of child abuse and domestic violence are excluded and referred to appropriate services. At SFGH,
Results
Annually, approximately 900 patients are treated for injury at both SFGH (the initial VIP host institution) and UCD Medical Center (the exported VIP host institution). Nearly a quarter of these victims are admitted to the hospital for observation, intervention, and/or long-term care. Of those admitted, individuals determined by case managers to be at high risk for reinjury are recruited for enrollment in the VIP. On average, the VIPs serve 30 to 50 clients per year at UCD and SFGH, respectively.
Comments
To achieve widespread violence prevention and lessen the resource and energy expenditure required for “reinventing the wheel,” we must figure out how to replicate and export intervention programs that have proven effective at reducing injury.8 Successful program exportation hinges on a balance between 2 main concepts: (1) implementation fidelity; and (2) adaptability. According to Carroll et al,9 implementation fidelity can be described as “the degree to which programs are implemented as
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Cited by (15)
Hospital-Based Violence Intervention Programs to Reduce Firearm Injuries in Children: A Scoping Review
2023, Journal of Pediatric SurgeryUnderstanding the makeup of a growing field: A committee on trauma survey of the national network of hospital-based violence intervention programs
2022, American Journal of SurgeryCitation Excerpt :The membership is primarily urban trauma centers serving patients with a high level of interpersonal violence. HVIPs have developed locally within motivated trauma centers and communities, but there is no standardized model.11 Furthermore, the variety of services provided, practice patterns, funding sources, or populations served by these programs is not widely known.
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention
2018, American Journal of Emergency MedicineCitation Excerpt :This shifted a significant amount of the bill for violent injury from patients and hospitals to taxpayers. Policy measures and programs that prevent violent injury would provide considerable financial relief to patients, hospitals, and taxpayers [13,15,17,25-29]. Violence intervention programs such as the Wrap-around Program (WAP) based out of San-Francisco General Hospital have been shown to be cost-effective in reducing violence [30].
Structural Violence and Trauma Outcomes: An Ethical Framework for Practical Solutions
2018, Journal of the American College of SurgeonsCitation Excerpt :These interventions were either comprehensive case management programs, in which case managers worked with patients on multiple aspects of the recovery process, or brief interventions encompassing motivational interviewing techniques. Of the 10 studies identified, 9 were effective by at least 1 outcome measure.49-58 Case management programs were especially found to be associated with lower rates of violence recurrence.
Violent reinjury risk assessment instrument (VRRAI) for hospital-based violence intervention programs
2017, Journal of Surgical ResearchCitation Excerpt :The National Network of HVIPs has spurred collaboration for sharing best practices and enhancing research efforts. This has been immensely useful to new and emerging programs, as a greater understanding of the key points of success for established programs is crucial to their ongoing funding and success.12,13 An important gap in knowledge exists surrounding the process of client risk evaluation in HVIPs.
Cost-benefit analysis simulation of a hospital-based violence intervention program
2015, American Journal of Preventive MedicineCitation Excerpt :HVIPs have shown effectiveness in preventing violent reinjury and perpetration; in improving employment, education, and healthcare utilization; and in reducing aggressive behaviors.14,27–32 More than 20 HVIPs operate across the U.S. under the National Network of Hospital-Based Violence Intervention Programs (NNHVIP)33 and well-established HVIPs have begun to be replicated.34 The U.S. Department of Justice (DOJ) has acknowledged the value of HVIPs, recommending that “Hospital-based counseling and prevention programs should be established in all hospital emergency departments (EDs)—especially those that provide services to victims of violence” (p. 13).35
The authors declare no conflicts of interest.