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

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.

Implementing a hospital-based violence intervention program for assault-injured youth: implications for social work practice.

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.

A Regional Approach to Hospital-Based Violence Intervention Programs Through LOV.

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.