PT - JOURNAL ARTICLE AU - Katelyn K Jetelina AU - Jennifer M Reingle Gonzalez AU - Stephen A Bishopp TI - Gradual escalation of use-of-force reduces police officer injury AID - 10.1136/injuryprev-2016-042198 DP - 2017 Mar 16 TA - Injury Prevention PG - injuryprev-2016-042198 4099 - http://injuryprevention.bmj.com/content/early/2017/03/16/injuryprev-2016-042198.short 4100 - http://injuryprevention.bmj.com/content/early/2017/03/16/injuryprev-2016-042198.full AB - Objective To examine how escalation through the force continuum predicts officer injury in the presence of citizen aggression, while controlling for extraneous factors, like citizen and officer characteristics.Methods Cross-sectional data were extracted from 2244 use-of-force reports from the Dallas Police Department in 2015. Multilevel, mixed logistic regression models were used to evaluate the relationship between use of force and officer injury. Multilevel path analysis tested indirect and direct relationships between citizen aggression and officer injury.Results Results suggest that gradual escalation through the force continuum significantly decreases officer injury when a citizen is actively aggressive (β=−1.06, p value <0.001). Further, non-Hispanic black officers (β=−0.22, p value <0.001) and Hispanic officers (β=−0.08, p value <0.05) are less likely to gradually escalate through the force continuum, due to lower odds of verbal commands (black: OR=0.51, 95% CI 0.39 to 0.68; Hispanic: OR=0.77, 95% CI 0.60 to 0.99) and hard-empty hand control (black: OR=0.58, 95% CI 0.43 to 0.77) compared with white officers. Finally, officers with higher tenure (β=−0.01, p value <0.001) are less likely to gradually escalate through the force continuum.Conclusions Escalation through the force continuum significantly reduces police officer injury. Future research should assess whether further environmental or situational factors contribute to the strong relationship between use of force and officer injury. Also, reliability and validity testing of use-of-force reports is an imperative direction for future research.