RT Journal Article
SR Electronic
T1 Violent injury prevention does not equal to violent crime prevention: an analysis of violence intervention program efficacy using propensity score methods
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000905
DO 10.1136/tsaco-2022-000905
VO 7
IS 1
A1 Emma Holler, MPH
A1 Damaris Ortiz, MD
A1 Sanjay Mohanty, MD, MS
A1 Ashley D Meagher, MD, MPH
A1 Malaz Boustani, MD, MPH
A1 Ben L Zarzaur, MD, MPH
A1 Clark J Simons, MD
YR 2022
UL http://tsaco.bmj.com/content/7/1/e000905.abstract
AB Objective The purpose of this study was to determine if exposure to Prescription for Hope (RxH), a hospital-based violence intervention program (HVIP), is associated with reduced violent reinjury and new convictions for violent crime in the 2-year period after index hospitalization for a violent injury.Methods This was a retrospective cohort study analyzing patients from two level I trauma centers in Indianapolis, Indiana. RxH participants (n=260) enrolled between January 1, 2015 and December 31, 2018 and who had trauma registry data were included. RxH eligibility criteria: admitted for a violent injury (excluding sexual violence), at least 15 years of age, live in Marion County, Indiana, and stay in the hospital for at least 24 hours. RxH exclusion criteria: heavy active substance use, acute psychosis, dementia, severe traumatic brain injury, intentional self-harm, and incarceration. All patients admitted to IU Health Methodist Hospital, a nearby level I trauma center, for an assault, stabbing, or gunshot wound during the same period and met the RxH eligibility criteria were included as a comparison group (n=732). Doubly adjusted logistic regression with inverse probability of treatment weighting was used to estimate the average treatment effect of RxH participation on violent reinjury and new convictions for violent crime.Results Data from 992 patients were analyzed. RxH was significantly associated with reduced odds of violent reinjury (OR=0.35, 95% CI 0.20 to 0.59) and increased odds of conviction for a violent crime (OR=2.43, 95% CI 1.64 to 3.61).Conclusion RxH was associated with decreased odds of violent reinjury but increased odds of new conviction for a violent crime. Our results highlight the importance of robust, routine evaluation of HVIP efficacy and recommend inclusion of other outcomes in addition to violent reinjury when evaluating program success. High-quality randomized controlled trials are needed to further investigate the impact of HVIPs on a variety of outcomes.Level of evidence IV: retrospective study with more than one negative criterion ((1) limited control of confounding and (2) heterogeneous populations).Data are available upon reasonable request.