Only 7.6% of violently injured youth enrolled in a regional hospital-based intervention program were reinjured within 1 year—virtually the same as their matched peers who did not participate, according to a recent study.
Researchers evaluated the implementation and early outcomes of a region-wide, hospital-based violence intervention program (HVIP) known as Life Outside of Violence (LOV). The pilot cohort study, led by Kristen L. Mueller of the Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, and colleagues, examined whether participation in LOV was associated with reduced risk of violent reinjury among youth following an initial assault-related hospitalization.
The study was a retrospective observational cohort analysis that included patients aged 8 to 24 years who sustained a nonfatal violent injury—firearm, stabbing, or blunt assault—and presented to one of four level 1 trauma hospitals participating in the LOV program between August 15, 2018, and December 31, 2022.
Of 3,744 patients eligible for LOV, 233 enrolled and 198 had complete data for inclusion. A total of 388 matched control participants were selected from the nonenrolled eligible pool (n = 3,260) using nearest neighbor propensity score matching. Matching variables included age, sex, race and ethnicity, insurance status, injury type, injury year, hospital type, hospital admission status, and neighborhood socioeconomic status.
The primary outcome was the probability of violent reinjury within 1 year of the index injury, assessed using Kaplan–Meier survival estimates. The one-year reinjury probability was 7.6% (95% CI, 3.8% to 11.2%) among LOV participants and 7.4% (95% CI, 4.8% to 10.0%) among matched controls. The absolute difference in reinjury probability was 0.2% (95% CI, –4.3% to 4.7%), indicating no statistically significant effect of LOV participation on reinjury risk during the pilot period.
Program engagement among LOV participants was high. Case managers recorded a median of 22 progress notes per patient, and 89% of participants had a documented individualized treatment plan.
The researchers concluded that while LOV demonstrated successful implementation across multiple health systems, its individual-level scale was insufficient to significantly impact reinjury rates in a high-risk population. They highlighted the need for broader, multi-level strategies to address the structural determinants contributing to community violence.
Full disclosures can be found in the published study.
Source: Annals of Internal Medicine