Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T07:22:48.689Z Has data issue: false hasContentIssue false
  • English
  • Français

Youth violence secondary prevention initiatives in emergency departments: a systematic review

Published online by Cambridge University Press:  21 May 2015

Carolyn Snider  and
Jacques Lee
Carolyn Snider*
Affiliation:
Division of Emergency Medicine, University of Toronto, Toronto, Ont. Emergency Department, St. Michael's Hospital, Toronto, Ont.
Jacques Lee
Affiliation:
Division of Emergency Medicine, University of Toronto, Toronto, Ont. Sunnybrook Research Institute, University of Toronto, Toronto, Ont.
*
Emergency Department, St. Michael’s Hospital, 30 Bond St., Toronto ON M5B 1W8; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Youth violence continues to trouble Canadians. Emergency department (ED) visits by youth after a violent injury may represent a “teachable moment,” and thus secondary violence prevention interventions may be effective. We conducted a systematic review to identify the success rates of any interventions, the populations likely to benefit and the outcome measures used.

Data source:

We searched 8 databases (i.e., MEDLINE, EMBASE, PubMed, CINAHL, the Cochrane Database of Systematic Reviews, the ACP Journal Club, DARE and CENTRAL).

Study selection:

Studies were included if they described and evaluated an intervention, were health care–based and targeted youth who were injured by violence. Two blinded investigators selected 15 articles from 181 abstracts. After full-text review, 8 articles were excluded, leaving 7 articles from 4 intervention programs.

Data extraction:

All interventions used ED case management of the violently injured patient. One randomized control trial (RCT) demonstrated a significant reduction in reinjury rates (treatment group 8.1% v. control group 20.3%, p = 0.05). Another small RCT found no statistically significant reductions in repeat violence or service use. One retrospective cohort study demonstrated a lower relative risk (RR) in future criminal justice involvement (RR = 0.67, 95% confidence interval 0.45–0.99). A retrospective study of pediatric patients with violent injuries found only 1% of these youth returned with injuries as a result of repeat violence.

Data synthesis:

Although all 4 case management interventions that we reviewed showed promise in the United States, small sample sizes and incomplete follow-up limited their ability to demonstrate significant decreases in reinjury.

Conclusion:

Future research is necessary to help EDs capitalize on the opportunity to effectively reduce youth violence.

Keywords

systematic reviewemergency departmentyouthviolenceprevention
Type
State of the Art • À la fine pointe
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 2 , March 2009 , pp. 161 - 168
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

1.Crime statistics in Canada, 2006. Ottawa (ON): Statistics Canada; 2007. Cat no 85-002-XIE. Available: http://www.statcan.ca/english/freepub/85-002-XIE/85-002-XIE2007005.pdf (accessed 2009 Jan 30).Google Scholar
2.Mortality, summary list of causes 2004. Ottawa (ON): Statistics Canada; 2007. Cat no 84F0209XIE. Available: http://www.statcan.ca/bsolc/english/bsolc?catno=84F0209XWE (accessed 2009 Jan 30).Google Scholar
3.Youth self-reported delinquency, Toronto, 2006. Ottawa (ON): Statistics Canada; 2007. Cat no 85-002-XPE.27. Available: http://www.statcan.ca/english/freepub/85-002-XIE/85-002-XIE2007006.pdf (accessed 2009 Jan 30).Google Scholar
4.Chang, DC, Cornwell, EE III, Sutton, ERH, et al. A multidisciplinary youth violence-prevention initiative: impact on attitudes. J Am Coll Surg 2005;201:721–3.CrossRefGoogle ScholarPubMed
5.Rivara, FP, Shepherd, JP, Farrington, DP, et al. Victim as offender in youth violence. Ann Emerg Med 1995;26:609–14.Google Scholar
6.Dowd, MD, Langley, J, Koepsell, T, et al. Hospitalizations for injury in New Zealand: prior injury as a risk factor for assaultive injury. Am J Public Health 1996;86:929–34.Google Scholar
7.Morrissey, TB, Byrd, CR, Deitch, EA. The incidence of recurrent penetrating trauma in an urban trauma center. J Trauma 1991;31:1536–8.CrossRefGoogle Scholar
8.Sims, DW, Bivins, BA, Obeid, FN, et al. Urban trauma: a chronic recurrent disease. J Trauma 1989;29:940–6.Google Scholar
9.Smith, RS, Fry, WR, Morabito, DJ, et al. Recidivism in an urban trauma center. Arch Surg 1992;127:668–70.1CrossRefGoogle Scholar
10.McBride, CM, Emmons, KM, Lipkus, IM. Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res 2003;18:156–70.CrossRefGoogle ScholarPubMed
11.Johnson, SB, Bradshaw, C, Wright, J, et al. Characterizing the teachable moment: is an emergency department visit a teachable moment for intervention among assault-injured youth and their parents? Pediatr Emerg Care 2007;23:553–9.Google Scholar
12.Snider, CE, Lee, JS. Emergency department dispositions among 4100 youth injured by violence: a population-based study. CJEM 2007;9:164–9.Google Scholar
13.Berlin, JA, Miles, CG, Crigliano, MD. Does blinding of readers affect the results of meta-analyses? Results of a randomized trial. Online J Curr Clin Trials 1997.Google Scholar
14.Becker, MG, Hall, JS, Ursic, CM, et al. Caught in the Crossfire: the effects of a peer-based intervention program for violently injured youth. J Adolesc Health 2004;34:177–83.CrossRefGoogle ScholarPubMed
15.Borowsky, IW, Mozayeny, S, Stuenkel, K, et al. Effects of a primary care-based intervention on violent behavior and injury in children. Pediatrics 2004;114:e392–9.Google Scholar
16.Cheng, TL, Wright, JL, Markakis, D, et al. Randomized trial of a case management program for assault-injured youth: impact on service utilization and risk for reinjury. Pediatr Emerg Care 2008;24:130–6.CrossRefGoogle ScholarPubMed
17.Cooper, C, Eslinger, DM, Stolley, PD. Hospital-based violence intervention programs work. J Trauma 2006;61:534–7.Google Scholar
18.De Vos, E, Stone, DA, Goetz, MA, et al. Evaluation of a hospital-based youth violence intervention. Am J Prev Med 1996;12(Suppl5):101–8.Google Scholar
19.Hausman, AJ, Prothrow-Stith, D, Spivak, H. Implementation of violence prevention education in clinical settings. Patient Educ Couns 1995;25:205–10.CrossRefGoogle ScholarPubMed
20.Lane-Reticker, A, Weiner, AL, Morgan, AS, et al. Violence prevention program targeting Connecticut adolescents: description and preliminary results. Conn Med 1996;60:15–9.Google ScholarPubMed
21.Marcelle, DR, Melzer-Lange, MD. Project UJIMA: working together to make things right. WMJ 2001;100:22–5.Google ScholarPubMed
22.May, JP, Martin, KL. A role for the primary care physician in counseling young African-American men about homicide prevention. J Gen Intern Med 1993;8:380–2.CrossRefGoogle ScholarPubMed
23.Shibru, D, Zahnd, E, Becker, M, et al. Benefits of a hospital-based peer intervention program for violently injured youth. J Am Coll Surg 2007;205:684–9.CrossRefGoogle ScholarPubMed
24.Tucker, JB, Barone, JE, Stewart, J, et al. Violence prevention: reaching adolescents with the message. Pediatr Emerg Care 1999;15:436–9.Google Scholar
25.Zun, LS, Downey, L, Rosen, J.An emergency department-based program to change attitudes of youth toward violence. J Emerg Med 2004;26:247–51.Google Scholar
26.Zun, LS, Downey, L, Rosen, J. The effectiveness of an ED-based violence prevention program. Am J Emerg Med 2006;24:8–13.Google Scholar
27.Zun, LS, Downey, LV, Rosen, J. Violence prevention in the ED: linkage of the ED to a social service agency. Am J Emerg Med 2003;21:454–7.Google Scholar
28.Baker, SP. Childhood injuries: the community approach to prevention. J Public Health Policy 1981;2:235–46.CrossRefGoogle ScholarPubMed
29.Karlson, T. Injury control and public policy: a review. Crit Rev Environ Control. 1992;22:195–241.CrossRefGoogle Scholar
30.Mello, MJ, Nirenberg, TD, Longabaugh, R, et al. Emergency department brief motivational interventions for alcohol with motor vehicle crash patients. Ann Emerg Med 2005;45:620–5.Google Scholar
31.Morrison, LJ, Allan, R, Grunfeld, A. Improving the emergency department detection rate of domestic violence using direct questioning. J Emerg Med 2000;19:117–24.CrossRefGoogle ScholarPubMed
32.Rhodes, KV, Gordon, JA, Lowe, RA.; Society for Academic Emergency Medicine Public Health and Education Task Force Preventive Services Work Group. Preventive care in the emergency department, Part I: Clinical preventive services — Are they relevant to emergency medicine? Acad Emerg Med 2000;7:1036–41.CrossRefGoogle ScholarPubMed