Statement of Purpose Individuals who experience assaultive firearm injury are at elevated risk of violent reinjury. Hospital-based violence intervention programs (HVIPs) may reduce violent reinjury though intensive, community-based case management. We conducted a mixed-methods evaluation of the first 18 months of an HVIP in New Haven, Connecticut utilizing the RE-AIM framework.
Methods/Approach Recruitment yield was calculated, and logistic regression was used to evaluate for associations between baseline characteristics and HVIP enrollment. We conducted semi-structured, qualitative interviews with ten HVIP participants and two program administrators. Codes were generated using the constant-comparative method, and themes were organized using the RE-AIM framework. We conducted an online survey of hospital clinicians to assess knowledge about HVIP services.
Results During the 18-month study period, 245 individuals experienced non-fatal assaultive firearm injury. 34 individuals (14%) were enrolled in the HVIP. Inpatient admission was associated with greater odds of enrollment (OR 2.8, 95% CI 1.3–6.1). Participants described a personal connection with program staff as an important facilitator of enrollment. Effectiveness: Violent reinjury occurred among 1 enrolled individual (3%) and 10 individuals not enrolled (5%). Participants identified needs related to housing, employment, mental health services and financial assistance, and areas to improve HVIP services. Adoption: Of 63 clinicians who completed an online survey about HVIP services, only 24 (38%) were aware of HVIP services. Implementation: Participants described the sense of being supported by HVIP staff as important. Participants identified a need for greater intensity of program outreach. Maintenance: Participants, program administrators and clinicians endorsed a need for HVIP services.
Conclusion Personal connection with HVIP staff was an important facilitator of enrollment, and inpatient admission may provide an opportunity to connect with eligible individuals at the bedside. HVIPs may benefit from increased intensity of outreach.
Significance Mixed-methods evaluations may help identify optimal implementation strategies for HVIPs.
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