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Udoh K, Wessel C, Branch R, Mahler J, Holland J, Coleman B, Alluri S, Jordan S, Ahmed A, Polzin B, Dye C, Smith K, Brown A, Gully Z, Sawning S, Ziegler C, Ruther M, Jones C, Miller K. Evaluating the Feasibility of a Novel Firearm Injury Prevention Program for Pre-adolescent Children Through Health Care and Community-Based Partnerships: The Future Healers Program Pilot Study. Am Surg 2024; 90:1050-1058. [PMID: 38093402 DOI: 10.1177/00031348231220595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
BACKGROUND Firearm violence is an American public health crisis that negatively impacts children and disproportionately affects Black youth. Few firearm injury prevention programs have been described in pre-adolescent children. The Future Healers Program is a novel collaboration constructed via partnership between the medical school, trauma center, academic surgery department, and local non-profit community organization. Our study sought to evaluate if (1) partnering with community organizations facilitated recruitment of children with prior exposure to firearm violence and (2) the health care community was a potential trusted partner appropriate for program delivery. METHODS Children aged 4-13 were recruited to join the program via news outlets and social media and in partnership with a local non-profit organization. Of the children and parents participating in the program, 48% (44/92) and 59% (38/64), respectively, completed an IRB-approved survey study. Pearson's chi-square, percentages, and 95% confidence intervals evaluated differences between children and caregivers on sociodemographic characteristics, firearm exposure (FE), firearm violence exposure (FVE), and perception of health care. Participant's residence was geocoded in relationship to incidents of firearm injury (2008-2021) in the same region. RESULTS Caregivers (95%) and children (84%) reported substantial exposure to firearm violence and resided in areas with frequent firearm injury incidents. Notably, 82% of caregivers and 66% of children reported having a family member injured by gunfire. A high percentage of caregivers (79%) and children (91%) self-reported trust in the health care system. CONCLUSION Partnerships between community organizations and health care systems can develop prevention programs that effectively recruit and engage pre-adolescent children impacted by firearm violence.
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Affiliation(s)
- Karen Udoh
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Caitlin Wessel
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Rheyana Branch
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Jessica Mahler
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Joseph Holland
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Briana Coleman
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Satya Alluri
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Symone Jordan
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Anam Ahmed
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Baylee Polzin
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Crystal Dye
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Kiara Smith
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Alyssa Brown
- Department of Surgery, Northwestern University, Chicago, IL, USA
| | - Zahara Gully
- Jefferson Community and Technical College, Louisville, KY, USA
| | - Susan Sawning
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Craig Ziegler
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Matthew Ruther
- University of Louisville School of Urban and Public Affairs, Louisville, KY, USA
| | - Christopher Jones
- University of Louisville School of Medicine, Louisville, KY, USA
- Department of Surgery, Division of Transplant, University of Louisville School of Medicine, Louisville, KY, USA
| | - Keith Miller
- University of Louisville School of Medicine, Louisville, KY, USA
- Department of Surgery, Division of Trauma and Surgery Critical Care, University of Louisville School of Medicine, Louisville, KY, USA
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Abstract
OBJECTIVE To survey the status of current tamoxifen pharmacovigilance documentation reflecting tamoxifen use in an academic outpatient multispecialty practice in older adults. This data will help provide information to develop improved pharmacovigilance for a growing cohort of older adult users. The data will be utilized by an interdisciplinary team developing new methods of identifying factors for individualized pharmacovigilance in older adults. DESIGN Retrospective chart review to gather descriptive and quantitative data on tamoxifen pharmacovigilance. SETTING Multi-specialty clinic. PATIENTS Ninety-three patients 60 years of age and older. MAIN OUTCOME MEASURES Quantitative report of tamoxifen monitoring as well as descriptive analysis of individual cases. RESULTS We found 19 cases of serious adverse events possibly related to tamoxifen (thrombi, uterine malignancies). There were 15 cases with no documentation of pharmacovigilance. All cases had incomplete pharmacovigilance documented. There were two cases of hypercalcemia. There was one case of tamoxifen discontinuation resulting from muscle pain and with chronic muscle pain complaints while receiving tamoxifen. We observed a correlation in older age or high comorbidity burden patients and adverse events patients. CONCLUSION Some studies direct the important pharmacovigilance toward prevention of thrombi, uterine malignancies, and hypercalcemia; however, it is not easy to identify recommendations for frequency or focus of monitoring to prevent adverse events for individual older adults based on existing recommendations. The data collected and presented in this study serve to heighten awareness of tamoxifen pharmacovigilance and as a starting point for the application of machine learning techniques and modeling to identify high-risk patients and individualized pharmacovigilance recommendations.
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