The effectiveness of an ED-based violence prevention program

Background: Youth violence continues to be a problem in the United States, most prominent in the inner-city minority youth population. The recurrence rate for repeat violence has been reported from 6% to 44% with a 5-year mortality of 20%. This study describes the results of a program to reduce violence recurrence based in the ED. Methods: Patients aged 10 to 24 years who were victims of interpersonal violence (excluding child abuse, sexual assault, and intimate partner violence) were randomly enrolled in the study in level 1 trauma center. The control group was given a written list of services, and the treatment group received an assessment and case management for 6 months. Both groups were evaluated 6 and 12 months after enrollment in the study. The primary indicators of the success of the intervention were reduction of self-reported revictimization or arrest and state-reported incarceration and reinjury. The study was approved by the institutional review board. The results compared the change in treatment and control groups over the time using a combination of X-2 and analysis of covariance. Results: One hundred eighty-eight victims of interpersonal violence met the criteria and had the initial evaluation completed. By X-2 analysis, the treatment group (96 subjects) and the control group (92 subjects) were similar in age, sex, and racial composition. The average age was 18.6 years (range, 11-24), and 82.5% were boys. Most youth were African Americans (65.4%), followed by Hispanic (31.4%), whites (1.6%), or others (1.5%). A reduction in the self-reported reinjury rate was significantly reduced over time in the treatment group (X-2 3.87, P =.05). There were no differences between the groups in the number of self-reported arrests, state-reported reinjuries via the trauma registry, or state-reported incarcerations (P <.05). Conclusions: The results of this study demonstrated a reduction in self-reported reinjury rate in the intervention group. Further research is needed to confirm if ED-based violence prevention programs are effective in reducing other determinants for revictirnization. (c) 2006 Elsevier Inc. All rights reserved.