Violence Intervention Programs Research Articles

"I am a survivor!": Violently Injured Black Men's Perceptions of Labeling After a Violent Firearm Injury.

Self-appraisal after a life-altering event is a critical process for individuals, often comprised by assigned labels that may not align with an individuals' perceptions of themselves or of their situation. Existing research within this victim-survivor dichotomy largely rests in the interpersonal violence space, with a victim assuming legal recourse and wrongdoing, and a survivor associating with positive personal characteristics like grit and resilience. Much existing literature on self-appraisal after interpersonal injury is heavily concentrated within the sexual violence literature, and this study applies these concepts to a sample of Black men injured by firearms. Ten Black men enrolled in a hospital-based violence intervention program (HVIP) were interviewed to understand how they label their experience of firearm injury, and if their perceptions aligned with common labels seen among other populations and/or in other areas of study (e.g., cancer, domestic violence). Each participant assigned themselves their own label, with three labels emerging: survivor, victim and survivor, and neither victim nor survivor. The results illustrate the nuance of experiences beyond the victim-survivor dichotomy, and how labels and personal identities may shift following injury into new terms and considerations of resilience and trauma processing. More research is warranted to understand the factors that shape self-labeling within this population, including influences of masculine norms, racialized stereotypes, community context, and availability of services. Findings support public awareness campaigns to reframe surviving violence as a strength, and for community partners and practitioners to increase access to culturally competent and trauma-informed mental healthcare.

Regionalization of Hospital-based Violence Intervention Programs: One Trauma Center Cannot Do It Alone

Regionalization of Hospital-based Violence Intervention Programs: One Trauma Center Cannot Do It Alone

Assessing primary health care provider and organization readiness to address family violence in Alberta, Canada: development of a Delphi consensus readiness tool

BackgroundFamily violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta’s PHC settings by exploring readiness factors.MethodsAn integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators.ResultsPhase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta.ConclusionThe current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.

Examining adverse childhood experiences and Black youth's engagement in a hospital-based violence intervention program using administrative data.

Stemming from poverty and systemic racism, Black youth are disproportionately represented in hospital-based violence intervention programs (HVIPs) due to greater violence exposure. HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth. Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between-group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi-square and logistic regression. ACEs were approximated using a novel approach with administrative data. Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups. This study highlights a novel approach to understanding ACEs among a hard-to-reach population and illuminates the significant level of ACEs faced by violence-exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma-informed and healing-centered interactions during recruitment and later stages of engagement.

The Uptake and Measurement of Alternative Approaches to Domestic Violence Intervention Programs: A Scoping Review.

This scoping review explores the breadth and depth to which Domestic Violence Intervention Programs (DVIPs) in the United States and globally: (a) incorporate components that address the relationship between intimate partner violence (IPV) and social injustice, racism, economic inequality, and adverse childhood experiences (ACEs); (b) use restorative (RJ)/transformative justice (TJ) practices, individualized case management, partnerships with social justice actors, and strengths-based parenting training in current programming; and (c) measure effectiveness. In 2021, we searched 12 academic databases using a combination of search terms and Medical Subject Headings. In all, 27 articles that discussed at least one key concept relative to DVIP curricula were included in the final review. Findings suggest that very few DVIPs address ACEs and/or the relationship between structural violence, social inequality, and IPV perpetration. Even fewer programs use restorative practices including RJ or TJ. Furthermore, DVIPs use inconsistent methods and measures to evaluate effectiveness. To respond to IPV perpetration more effectively and create lasting change, DVIPs must adopt evidence-informed approaches that prioritize social and structural determinants of violence, trauma-informed care, and restoration.

Qualitative study of factors affecting engagement with a hospital-based violence intervention programme in Indianapolis, Indiana

BackgroundThere are few qualitative studies of firearm injury survivors and hospital-based violence intervention programme (HVIP) participants. The original study aimed to identify facilitators and barriers to survivors’ utilisation of mental...

Co-Developing Theories of Change for Improved Community-Based Violence Intervention Evaluation.

Community-based violence intervention (CVI) programs are considered important strategies for preventing community violence and promoting health and safety. Mixed and inconclusive results from some prior CVI evaluations-and our general lack of understanding about the reasons for such varied findings-may be explained in part by misalignment of program theories of change and evaluation measures. Further, most prior evaluations have focused solely on deficit-based outcomes; this narrow focus is inconsistent with the premise of CVI and may fail to capture improvements in health and wellbeing that are on the hypothesized pathway from intervention to violence reduction. This paper describes the process and results of co-developing a theory of change for community-based youth firearm violence intervention and prevention programs in Washington state through a community-researcher partnership. We followed a multi-step iterative process, involving 1) CVI program documentation review, 2) individual meetings, and 3) a day-long workshop. The theory of change included 6 key domains: 1) root causes, 2) promotive factors, 3) activities, 4) inter-mediate outcomes, 5) longer-term outcomes, and 6) multi-level context (youth/family, staff/organizational, community, and societal). Root causes were social and structural drivers of community violence. Promotive factors were assets and resources among the community, youth/their families, and community organizations that promote health and safety. Activities were supports and services the program provided to youth and their families, staff, and potentially the broader community. Inter-mediate and longer-term outcomes were the changes among youth, their families, staff, and the community that resulted from program activities. Inter-mediate outcomes may be felt within 6 months to 1 year and longer-term outcomes may be felt after 1-2 years and beyond. The theory of change we co-developed provides a common lens to conceptualize, compare, and evaluate CVI programs in Washington state and may support more rigorous and equity-centered evaluations.Study type: original investigation. N/A.

Integration of Medical Legal Services into a Hospital-Based Violence Intervention Program: A Survey and Interview-Based Provider Needs Assessment.

Violent injury among trauma surgery patients is strongly associated with exposure to harmful social determinants of health and negative long-term health outcomes. Medical-legal partnerships in other settings successfully provide patients with legal services to address similar health-harming legal needs and may offer a promising model for the care of violently-injured patients. An electronic survey tool was distributed to clinicians and staff affiliated with the hospital-based violence intervention program at a single urban level one trauma center. Semi-structured follow up interviews were conducted with participants, and interviews were coded using thematic analysis and grounded theory. Participants reported many health-harming legal needs among their violently injured patients. The most commonly-identified needs were: health insurance denials (62.5%); difficulty accessing crime victims compensation funds (56.3%); trouble accessing official documents (50%); and problems with non-SSDI public benefits (50%). Participants reported inconsistent methods for learning about and responding to patients' health-harming legal needs. The most common barriers to addressing these needs included: lack of awareness that a lawyer could help with the issue (68.8%); prioritization of other needs (68.8%); previous negative legal experiences (62.5%); and cost (62.5%). Identified needs encompass issues traditionally-addressed by MLPs as well as more novel challenges faced by violent injury survivors. This survey and interview-based study identifies complex health-harming legal needs present among violently-injured trauma surgery patients. Medical-legal partnerships specially-designed for the setting of violent injury appear well-suited to meet these needs, potentially reducing risk of violent re-injury, long-term negative health outcomes, and healthcare system costs. Level IV / Prognostic and Epidemiological.

When Equality Is Not Equity: The Ethics of Access to Trauma Care A Surgical Perspective.

The purpose of this surgical perspective is to describe the trauma care needs of the South Side of Chicago and the creation of an adult trauma center at the University of Chicago Medicine and associated hospital-based violence intervention program. Traumatic injury is a leading cause of death and disability in the US. Disparities across the continuum of trauma care exist, which are often rooted in the social determinants of health. Trauma center distribution is critical to timely treatment and should be based on the trauma needs of the area. The previous trauma ecosystem of Chicago was incongruent with the concentration of violent injuries on the south and west sides of the city leading to a fallacy of distributive justice. A descriptive analysis of community partners, trauma program leadership, trauma surgeons and the violence intervention program director was performed. The UCM trauma center opened in May 2018 and has since been one of the busiest trauma centers in the country with a 40% penetrating trauma rate. There have been significant reductions in patient transport time on the South Side up to 8.9 minutes (P<0.001). The violence intervention program employs credible messengers with lived experience representing the community and has engaged over 8000 patients since 2018 developing both community-based and medical legal partnerships. The persistent efforts of the community and key stakeholders led to a system change improving trauma care for the South Side of Chicago.

Stuck Behind the Times: How Current Controversies Related to Domestic Violence Intervention Programs are Addressed in U.S. State-Specific Documents

ABSTRACT This research assesses the extent to which current treatment-related controversies are addressed in state documents related to Domestic Violence Intervention Programs (DVIP). Specifically, we consider state-specific guidance on conducting treatment with female-identifying perpetrators, perpetrators in LGBTQ+ relationships, perpetrators located within relationships with bi-directional violence and perpetrators with a trauma history. Relevant DVIP governing documents were obtained from all U.S. states, as available (n = 47, 94%). Documents were coded with good interrater reliability (IRR = 82.4%). Although most states have gender-neutral or gender-non-specified DVIP guidelines (n = 31, 66%), 16 states (24%) have documents that specify they can only be applied to male perpetrators. Only two states (4%) provide detailed guidance for work with LGBTQ+ perpetrators. Of note, 44% of states (n = 22) exclude addressing bidirectional violence within their programs, despite its prevalence among violent couples. Only one state currently advises its DVIPs to assess for bidirectional violence at intake. While a substantial minority of states (n = 20, 40%) advise DVIPs to assess for perpetrator trauma, only a few state documents specifically endorse a trauma-informed approach (n = 6, 12%) even fewer require DVIP facilitators to include trauma information in their curriculum (n = 2, 4%). Problematically, many states’ DVIP guidelines have not been updated recently, with only 17 states having guidelines updated in the last five years. State policies must address the needs, motivations, and experiences of all DVIP perpetrators by acknowledging violence-related dynamics, incorporating a strength-based perspective, providing trauma-informed care, and enacting gender and LGBTQ±specific treatment recommendations.

Social support in relation to posttraumatic stress disorder symptoms among patients with violent versus nonviolent injury.

Violent injuries have become increasingly more common in the United States. Individuals experiencing violent injury are at increased risk for the development of posttraumatic stress disorder (PTSD) as compared to those experiencing nonviolent injury. Social support is touted as a protective factor against various psychiatric symptoms (i.e., PTSD), though little is known about the relation between PTSD symptoms and social support in traumatic injury populations. The aims of the present paper were twofold: (1) examine the prevalence of PTSD as a function of injury type (2) explore differences in levels of social support as a function of injury type and (3) explore the association between injury type and later PTSD symptoms as moderated by baseline social support. Participants were 553 adults from a level-one trauma center in the Southeast United States who experienced a violent injury or nonviolent injury and completed measures of social support at baseline as well as PTSD symptoms at the 30-day follow-up timepoint. The study utilized data from both the baseline timepoint (i.e., upon admission to the trauma surgery unit), as well as a 30-day follow-up timepoint. Results demonstrated that those endorsing nonviolent injury reported lower levels of social support and PTSD symptoms. Social support predicted later PTSD symptoms until injury type was included as a covariate in the model. Social support did not moderate the relationship between injury type and later PTSD symptoms. Findings highlight the interrelatedness of key risk variables (i.e., injury type) with protective factors in influencing the trajectory of psychopathology postinjury. Violence intervention and interruption programs may have the capacity to fill patient needs when social support networks are insufficient. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pathways to Resistance: Theorizing Trauma and Women's Use of Force in Intimate Relationships.

Using a feminist pathways general strain perspective, we explore the victim-offender continuum for women who perpetrated intimate partner violence/abuse (IPV/A). We use data from 86 women court-mandated to "female offender" domestic violence treatment programs, located in an American East Coast state, who were surveyed about their adverse childhood experiences and mental health/well-being as adults. Findings from bivariate linear regressions indicate childhood trauma negatively affects adult mental health/well-being, exacerbated for Black Indigenous People of Color women, suggesting a victim rather than an offender categorization for women using force against their abusive partner. Results imply the need to consider women's traumatic histories and IPV/A victimization, given an incident-driven system that criminalizes victimization over the life course.

Health system barriers to access to quality sexual and reproductive health and rights in relation to family planning and contraception

Background: Access to reproductive health information and services is critical to health, well-being, and the ability to achieve personal and corporate life and work goals. Within the context of sexual and reproductive health rights (SRHR), the health system should adopt a life course approach to achieve a continuum of care. This spectrum needs to span from conception to the care of the aging woman across all contexts and must encompass humanitarian crises, climate change, and environmental exposures while embracing the ongoing digital transformation narrative. Current challenges relating to family planning and contraception (FPC) within the Kenyan context typically arise from highly prevalent unfavorable sociocultural norms and traditions.&#x0D; Selected SRHR intervention programs: Programs that promote girls’ education and enhance community engagement to effect sociobehavioral change programing have high transformative potential. Some of these programs include the provision of contraception, adolescent, and youth-friendly programs (AYFS), intimate partner violence intervention programs, HIV prevention, use of multipurpose product technologies (MPT), prevention of abortion-related mortality, provision of access to maternity care, and continuous improvement of quality of care.&#x0D; Conclusion: Obstetricians and gynecologists must commit to governance leadership that focuses on SMART advocacy, the establishment of health system resilience to provide access, effective coverage, and rights-based approaches. These are vital to the provision of optimal FPC care in Kenya.

“We’re Not Miracle Workers”: An Examination of the Relationship Between Community Violence Intervention Workers and Their Participants

Community violence intervention (CVI) programs are civilian-led, locally oriented efforts that center around street intervention work, which involves proactive community engagement of individuals at high risk of violent victimization or perpetration. CVI professionals are peer support workers who use their experiential wisdom to mediate violent conflict and prevent victimization through engaging high-risk individuals in social services. The study comprehensively examines the relationship between CVI workers, their clients, and challenges associated with their outreach and engagement via qualitative interviews conducted among 35 CVI workers and their supervisors in Chicago. Thematic analyses identified the challenges experienced by the workforce as “work as mission,” “tethered healing,” “tethered harm,” and “falling back.” The results also lend support to firearm violence reduction potential of this professional field.

Hospital Based Violence Intervention Programs Using Peer Support Specialists: A Concise Review.

Interpersonal violence remains a significant public health problem in the United States. The toll of violence has spurred the development of hospital-based violence intervention programs that use peer support specialists or navigators. Yet, their effectiveness remains uncertain. This study aims to concisely review the recent literature on the effectiveness of hospital-based violence intervention programs using the peer support specialist role. A systematic search of articles from PubMed, OVID, and Google Scholar was performed for this review. Peer reviewed studies addressing hospital-based violence intervention programs using peer support specialists between 2017 and 2022 were selected. Key data points were extracted and analyzed by consensus of the authors. Eight of the 232 studies reviewed met eligibility requirements. Across these studies, the recidivism rate was reduced between 43% and 95% in victims participating in hospital-based violence intervention programs with peer support specialists. The peer support specialist (navigator) role is central to the success of the violence intervention programs. This role guides and coordinates health services for victims of violence, extending after discharge into the community. Programs showed the most success with helping victims reach short-term goals focused on immediate basic needs but are more challenged meeting longer-term goals, such as education or relocation. This review reveals that hospital-based violence intervention programs using peer support specialists (navigators) lead to the achievement of meeting victim goals and reduce recidivism rates.

Improved follow-up care for gun violence survivors in the Trauma Quality of Life Clinic

BackgroundOutpatient follow-up represents a crucial opportunity to re-engage with gun violence survivors (GVS) and to facilitate positive health outcomes. Current outpatient models for firearm-related injuries and trauma care are inconsistent...

Personal goals of young survivors of violent injury: implications for practice

IntroductionFirearm 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...

Sexual violence in nightlife and positive bystander intervention in an English city

BackgroundNightlife environments are high risk settings for sexual violence and bystander intervention programmes are being developed in response. However, more research is needed to understand nightlife-related sexual violence, and factors that influence bystander interventions. This study examined nightlife patron’s experiences of sexual violence and associated factors; and relationships between attitudes towards, awareness and experience of sexual violence, and confidence to intervene.MethodsCross-sectional on-street survey of nightlife patrons (N = 307, aged 18+) on a night out in an English city. Surveys (7.30pm-1.30am; Wednesday-Saturday) established sexual violence awareness, myth acceptance, and experience, and confidence to intervene. Participant’s socio-demographics, nightlife alcohol consumption, and frequency of nightlife usage were collected.Results58.0% had ever experienced sexual violence whilst on a night out. In adjusted analyses, sexual violence was higher amongst females (adjusted odds ratio [AOR] 4.0; p < 0.001), and regular nightlife patrons (AOR 2.1; p < 0.05). The majority agreed that they would feel confident asking someone who has experienced sexual violence if they are okay/would like support (92.2%). In adjusted analyses, confidence to intervene was higher amongst those who agreed that sexual violence was an issue in nightlife (AOR 3.6; p < 0.05), however it reduced as sexual violence myth acceptance increased (AOR 0.5; p < 0.05).ConclusionSexual violence is a pertinent issue in nightlife. Programmes aiming to address nightlife-related sexual violence must address the wider social norms that promote sexual violence, and ensure patrons understand the extent and significance of the issue, to increase confidence to positively intervene.

Protect and Provide: Perceptions of Manhood and Masculinities Among Disabled Violently Injured Black Men in a Hospital-Based Violence Intervention Program.

Exploring the post-injury lives of those who have survived gunshot wounds is essential to understanding the entire scope of firearm violence. The lives of Black male firearm violence survivors are transformed in various ways due to their injuries both visible and invisible. This study explored how Black men who suffer from disabilities via a firearm negotiated their masculine identities. Semi-structured, qualitative interviews were conducted with 10 violently injured Black men participating in a hospital-based violence intervention program. Survivors expressed their thoughts on how their injuries impacted their manhood and masculinities. Three themes emerged: (1) perceptions of manhood, (2) loss of independence and burden on others, and (3) and mobility. These themes highlighted and described how their lives were impacted post-injury and characterized their psychological and physical experience of recovery. The research findings suggest the need for more qualitative studies to further explore the relationship between firearm injury, Black masculinity, and perceptions of manhood. While Black men are understudied in health research and invisible in disability research, they continue to be hyper-invisible when discussing violently acquired disabilities.

Assessing Risk Factors for Victims of Violence in a Hospital-Based Violence Intervention Program

Assessing Risk Factors for Victims of Violence in a Hospital-Based Violence Intervention Program