CE25-021 - Disrupting the Cycle: Expansion of a Novel Hospital-Based Violence Intervention in New Orleans.

About This Grant

Abstract The proposed project aims to test the short- and long-term effects of a hospital-initiated, community-integrated intervention and examine how social contexts influence its adoption and sustained effects. This study will be conducted in collaboration with the Spirit of Charity Trauma Center to implement a hospital-initiated motivational interviewing (MI) approach augmented by firearm safety training (FST) and monthly case management. We will employ a randomized control trial, to test the efficacy of the prevention approach (MI/FST) compared to treatment as usual (TAU) control condition. The scientific premise is that the intervention will be more effective in changing firearm-related behaviors and beliefs than the control at 6-months while meeting the needs of victims of violent injury. Firearm violence disproportionately occurs in black communities and hospitalized victims of firearm injury are at increased risk for violent injury reoccurrence. This calls for community-integrated, evidence-based approaches that identify critical barriers to prevention, including the need to test the effectiveness of hospital- initiated violent injury prevent program (HVIP) and examine how social contexts influence HVIP adoption and sustained effects. This proposal is quite feasible to complete because it leverages our ongoing community- integrated youth HVIP through our Violence Prevention Institute, including a CDC-supported Youth Violence Prevention Research Center (U01CE003384), currently being conducted in youth aged 18-24 in New Orleans. Our aims are to 1) establish the effects (at 6 months) of an expanded hospital-initiated, community-integrated intervention on firearm related behaviors and beliefs amongst adults ages 16-34, 2) to establish the effects (at 6-months) of the MI/FST intervention on meeting the needs of traumatically injured victims of violence that allow them to avoid violent injury recurrence, and 3) to understand and analyze stakeholders’ perspectives and experiences with the MI/FST intervention components and its implementation. Results will continue and expand a novel HVIP aimed at mitigating recurrent firearm injuries in New Orleans—particularly in largely black communities—and inform future studies on the root issues underlying firearm violence recurrence nationwide. This research is significant because it will expand our understanding of the efficacy of community-based HVIPs in New Orleans that decrease the risk of recurrent violent injury in a growing and underappreciated, high-risk population that has already been hospitalized with a firearm injury. This proposal addresses the RFA’s first primary objective by testing the effectiveness of an innovative approach with the potential for immediate and near immediate benefits to reduce community violence and racial/ethnic inequities in risk for community violence.