Hospital-based violence intervention programs targeting adult populations: an Eastern Association for the Surgery of Trauma evidence-based review.

Abstract

BackgroundViolent 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.ObjectivesTo 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 sourcesPubMed, 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, interventionsEligible studies examined adult patients treated for intentional injury in a hospital-based violence prevention program compared to a control group.Study appraisal and synthesis methodsWe used the Grading of Recommendations Assessment, Development, and Evaluation methodology to assess the breadth and quality of the evidence.Results71 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.LimitationsThere was a relative paucity of data, and available studies were limited by self-selection bias and small sample sizes.ConclusionsWe make no recommendation with respect to adult-focused HVIP interventions.