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Implementing the Cardiff Model for violence prevention: using the diffusion of innovation theory to understand facilitators and barriers to implementation
  1. Sara Kohlbeck1,
  2. Michael Levas2,
  3. Jennifer Hernandez-Meier3,
  4. Stephen Hargarten3
  1. 1 Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  2. 2 Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  3. 3 Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  1. Correspondence to Sara Kohlbeck, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; skohlbeck{at}


Objective Interpersonal violence is an ongoing, vexing public health issue. Communities require comprehensive timely data on violence to plan and implement effective violence prevention strategies. Emergency departments (EDs) can play an important role in violence prevention. EDs treat injuries associated with violent crime, and they are well-positioned to systematically collect information about these injuries, including the location where the injury occurred. The Cardiff Model for Violence Prevention (The Cardiff Model) provides a framework for interdisciplinary data collection and sharing.

Methods This paper uses the Diffusion of Innovation Theory as a framework to present our experiences of implementing the Cardiff Model in several EDs that serve the Milwaukee area, and to detail the processes of data collection, linking and presentation across four different hospital systems.

Results Implementing a city-wide data collection effort that involves multiple hospital systems is challenging. Viewing our findings through the lens of the Diffusion of Innovations theory provides a way to anticipate facilitators and challenges to Cardiff Model implementation in a hospital setting.

Conclusions Facilitators and barriers to Cardiff Model adoption in the ED setting can be understood using the Diffusion of Innovation theory, and barriers can be interrupted through careful planning and continuous communication between partners.

  • screening
  • cross sectional study
  • program evaluation

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors SK drafted the initial manuscript and conducted data analysis. All authors contributed to the conception of the study and study implementation. ML served as a physician champion in our paediatric trauma centre. JH-M and SH serve as principal investigators on this study. All authors contributed to revisions and edits to this manuscript.

  • Funding This work is funded by the Bureau of Justice Assistance award number 2018-AR-BX-K106.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.