RT Journal Article SR Electronic T1 Gradual escalation of use-of-force reduces police officer injury JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP 35 OP 40 DO 10.1136/injuryprev-2016-042198 VO 24 IS 1 A1 Katelyn K Jetelina A1 Jennifer M Reingle Gonzalez A1 Stephen A Bishopp YR 2018 UL http://injuryprevention.bmj.com/content/24/1/35.abstract 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.