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Hale ME, Pinkman K, Quinoy AM, Schoffner KR. Identifying mental health outcomes and evidence-based psychological interventions for supporting pediatric gunshot wound patients: A systematic review and proposed conceptual model. BMC Pediatr 2024; 24:397. [PMID: 38890635 PMCID: PMC11184880 DOI: 10.1186/s12887-024-04878-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Accidental and assault gunshot wounds (GSWs) are the second leading cause of injury in the United States for youth ages 1- to 17-years-old, resulting in significant negative effects on pediatric patients' mental health functioning. Despite the critical implications of GSWs, there has yet to be a systematic review synthesizing trends in mental health outcomes for pediatric patients; a gap the present review fills. Additionally, this review identifies evidence-based psychological interventions shown to be effective in the treatment of subclinical symptoms of psychological disorders in the general population. METHODS A comprehensive search was conducted using five databases: American Psychological Association (APA) PsycInfo, APA PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resource Information Center (ERIC), and Medical Literature Analysis and Retrieval Systems Online (MEDLINE). Twenty-two articles met inclusion criteria. RESULTS Findings suggest pediatric GSW patients are at a significantly elevated risk for mental health disorders when compared to other- (e.g., motor vehicle collision) and non-injured youth. Disorders include post-traumatic stress, disruptive behavior, anxiety, depression, and substance use. Hospital-based violence intervention programs, cultivating supportive relationships with adults in one's community, and trauma-focused outpatient services were identified as effective interventions for treating subclinical psychological symptoms. CONCLUSIONS Depicted in the proposed conceptual model, the present study delineates a direct association between pediatric GSWs and subsequent onset of mental health disorders. This relation is buffered by evidence-based psychological interventions targeting subclinical symptoms. Results suggest brief psychological interventions can help treat mental health challenges, minimizing risk for significant long-term concerns. Cultural adaptations to enhance the utility and accessibility of interventions for all patients are recommended.
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Affiliation(s)
- Molly E Hale
- Department of Psychology, University of Georgia, Athens, GA, USA.
| | - Kahyah Pinkman
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Alexis M Quinoy
- Department of Neuropsychology and Rehabilitation Services, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Department of Rehabilitation Medicine, Emory School of Medicine, Atlanta, GA, USA
| | - Kindell R Schoffner
- Department of Neuropsychology and Rehabilitation Services, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Department of Rehabilitation Medicine, Emory School of Medicine, Atlanta, GA, USA
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Miller ZM, Chapman-Kramer K, Cooper BP, Coffey M, Page K, Meyers JE, Vogel M, Mancini M, Mueller K. Personal goals of young survivors of violent injury: implications for practice. Inj Prev 2024:ip-2023-045032. [PMID: 38290779 DOI: 10.1136/ip-2023-045032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/10/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Firearm injuries are the leading cause of death among young people in the USA and disproportionately impact communities of colour and those experiencing socioeconomic distress. Understanding the personal goals of violently injured patients is essential to identifying protective factors and developing interventions that promote them. However, limited research characterising these personal goals exists. OBJECTIVE The objective of this study was to use qualitative thematic analysis to analyse and describe the personal goals of young people who enrolled in a region-wide hospital-based violence intervention programme after surviving a violent injury. METHODS A qualitative coding framework was developed, evaluated, and implemented using data from Life Outside of Violence, the St. Louis Area Hospital-Based Violence Intervention Programme. Chart abstraction procedures were used to compile qualitative data on Life Outside of Violence participants' personal goals documented by clinical case managers during individual treatment planning sessions with participants (n=168). Descriptive analyses are reported and implications for practice are discussed. RESULTS Key findings reveal that (1) violent injury survivors have unmet therapeutic and resource needs, indicating the importance of having service providers with both clinical and case management skills, (2) anger management is a common clinical goal, and (3) employment opportunities are a common resource need. CONCLUSIONS Findings from this study inform the implementation of the Life Outside of Violence programme and offer a roadmap to other hospital-based violence intervention programmes operating nation-wide. Our results provide insight into participants' needs, desires, and motivations, allowing unique opportunities for improved participant engagement and service delivery.
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Affiliation(s)
- Zoe Maya Miller
- Institute for Public Health, Washington University in St Louis, St Louis, Missouri, USA
| | - Kateri Chapman-Kramer
- Institute for Public Health, Washington University in St Louis, St Louis, Missouri, USA
| | - Benjamin P Cooper
- Institute for Public Health, Washington University in St Louis, St Louis, Missouri, USA
| | - Melik Coffey
- Social Work, SSM Health Cardinal Glennon Children's Hospital, Saint Louis, Missouri, USA
| | - Keyria Page
- Social Work, St Louis Children's Hospital, St Louis, Missouri, USA
| | - Jessica E Meyers
- St. Louis Area Violence Prevention Commission, Saint Louis, Missouri, USA
| | - Matt Vogel
- Sociology, University at Albany School of Criminal Justice, Albany, New York, USA
| | - Michael Mancini
- School of Social Work, Saint Louis University, Saint Louis, Missouri, USA
| | - Kristen Mueller
- Emergency Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
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Jang A, Thomas A, Slocum J, Tesorero K, Danna G, Saklecha A, Wafford E, Regan S, Stey AM. The gap between hospital-based violence intervention services and client needs: A systematic review. Surgery 2023; 174:1008-1020. [PMID: 37586893 DOI: 10.1016/j.surg.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Survivors of intentional interpersonal violence face social challenges related to social determinants of health that led to their initial injury. Hospital-based violence intervention programs reduce reinjury. It is unclear how well they meet clients' reported needs. This systematic review aimed to quantify how well hospital-based violence intervention program services addressed clients' reported needs. METHODS Medline, The Cochrane Library, CINAHL Plus with Full Text, and PsycInfo were queried for studies addressing hospital-based violence intervention programs services and intentional injury survivors' needs in the United States. Case reports, reviews, editorials, theses, and studies focusing on pediatric patients, victims of intimate partner violence, or sexual assault were excluded. Data extracted included program structure, hospital-based violence intervention program services, and client needs assessments before and after receiving hospital-based violence intervention program services. RESULTS Of the 3,339 citations identified, 13 articles were selected for inclusion. Hospital-based violence intervention programs clients' most reported needs included mental health (10 studies), employment (7), and education (5) before receiving hospital-based violence intervention programs services. Only 4 studies conducted quantitative client needs assessments before and after receiving hospital-based violence intervention program services. All 4 studies were able to meet at least 50% of each of the clients' reported needs. The success rate depended on the need and program location: success in meeting mental health needs ranged from 65% to 90% of clients. Conversely, time-intensive long-term needs were least met, including employment 60% to 86% of clients, education 47% to 73%, and housing 50% to 71%. CONCLUSION Few hospital-based violence intervention programs studies considered clients' reported needs. Employment, education, and housing must be a stronger focus of hospital-based violence intervention programs.
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Affiliation(s)
- Angie Jang
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Arielle Thomas
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI. https://twitter.com/ac_thomas7
| | - John Slocum
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Giovanna Danna
- Chicago Medical School, Rosalind Franklin University, North Chicago, IL
| | - Anjay Saklecha
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Eileen Wafford
- Galter Health Sciences Librarian and Learning Center, Feinberg School of Medicine, Northwestern University
| | | | - Anne M Stey
- Feinberg School of Medicine, Northwestern University, Chicago, IL.
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Mancini MA, Mueller KL, Moran V, Anwuri V, Foraker RE, Chapman-Kramer K. Implementing a hospital-based violence intervention program for assault-injured youth: implications for social work practice. SOCIAL WORK IN HEALTH CARE 2023; 62:280-301. [PMID: 37463018 DOI: 10.1080/00981389.2023.2238025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/05/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
Youth in the U.S. experience a high rate of assault-related injuries resulting in physical, psychological and social sequelae that require a wide range of services after discharge from the hospital. Hospital-based violence intervention programs (HVIP's) have been developed to engage youth in services designed to reduce the incidence of violent injury in young people. HVIP's combine the efforts of medical staff with community-based partners to provide trauma-informed care to violently-injured people and have been found to be a cost-effective means to reduce re-injury rates and improve social and behavioral health outcomes. Few studies have explored the organizational and community level factors that impact implementation of these important and complex interventions. The objective of this study was to develop an in-depth understanding of the factors that impact HVIP implementation from the perspectives of 41 stakeholders through qualitative interviews. Thematic analysis generated three themes that included the importance of integrated, collaborative care, the need for providers who can perform multiple service roles and deploy a range of skills, and the importance of engaging clients through extended contact. In this article we explore these themes and their implications for healthcare social work.
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Affiliation(s)
| | | | - Vicki Moran
- Trudy Busch Valentine School of Nursing, St. Louis University, Saint Louis, USA
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Mueller KL, Chapman-Kramer K, Cooper BP, Kaser T, Mancini M, Moran V, Vogel M, Foraker RE, Anwuri V. A Regional Approach to Hospital-Based Violence Intervention Programs Through LOV. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:306-316. [PMID: 36961541 DOI: 10.1097/phh.0000000000001716] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
CONTEXT Community violence is an underaddressed public health threat. Hospital-based violence intervention programs (HVIPs) have been used to address the root causes of violence and prevent reinjury. OBJECTIVE In this article, we describe the methodology of the St Louis Region-wide HVIP, Life Outside Violence (LOV) program, and provide preliminary process outcomes. DESIGN Life Outside Violence mentors intervene following a violent injury to decrease risk of subsequent victimization and achieve goals unique to each participant by providing therapeutic counseling and case management services to patients and their families. PARTICIPANTS AND SETTING Eligible patients are victims of violent injury between the ages of 8 and 24 years, who are residents of St Louis, Missouri, and present for care at a LOV partner adult or pediatric level I trauma hospital. INTERVENTION Enrolled participants receive program services for 6 to 12 months and complete an individual treatment plan. MAIN OUTCOME MEASURES In this article, we report LOV operational methodology, as well as process metrics, including program enrollment, graduation, and qualitative data on program implementation. RESULTS From August 15, 2018, through April 30, 2022, 1750 LOV-eligible violently injured patients presented to a partner hospital, 349 were approached for program enrollment, and 206 consented to enroll in the program. During this pilot phase, 91 participants graduated from the LOV program and have process output data available for analysis. CONCLUSIONS Life Outside Violence has been implemented into clinical practice as the first HVIP to influence across an entire region through partnership with multiple university and hospital systems. It is our hope that methods shared in this article will serve as a primer for organizations hoping to implement and expand HVIPs to interrupt community violence at the regional level.
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Affiliation(s)
- Kristen L Mueller
- Department of Emergency Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri (Dr Mueller); Institute for Public Health, Washington University in St Louis School of Medicine, St Louis, Missouri (Mss Chapman-Kramer, Kaser, and Anwuri, Mr Cooper, and Dr Foraker); Saint Louis University School of Social Work, St Louis, Missouri (Dr Mancini); Trudy Busch Valentine School of Nursing, Saint Louis University, St Louis, Missouri (Dr Moran); and School of Criminal Justice, University at Albany, Albany, New York (Dr Vogel)
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