Cheng Tina L, Haynie Denise, Brenner Ruth, Wright Joseph L, Chung Shang-en, Simons-Morton Bruce
Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Pediatrics. 2008 Nov;122(5):938-46. doi: 10.1542/peds.2007-2096.
The goal was to assess the impact of a mentor-implemented, violence prevention intervention in reducing aggression, fighting, and reinjury among assault-injured youths.
In a randomized, controlled trial performed in the emergency departments of 2 large urban hospitals, 10- to 15-year-old youths who presented with peer assault injuries were recruited and randomly assigned to intervention and comparison groups. In the intervention group, youths received a mentor, who implemented a 6-session problem-solving curriculum, and parents received 3 home visits with a health educator, to discuss family needs and to facilitate service use and parental monitoring. The comparison group received a list of community resources, with 2 follow-up telephone calls to facilitate service use. Youths and parents were interviewed at baseline and at 6 months, for assessment of attitudes about violence, risk factors, fighting, and repeat injury.
A total of 227 families were recruited, with 23% refusing participation and 4% providing partial interview completion. A total of 166 families were enrolled, with 87 assigned to the intervention group and 79 to the comparison group; 118 (71%) completed both youth and parent follow-up interviews, and 113 had usable data. The intervention and comparison groups were not significantly different at baseline with respect to demographic features or risk factors, except for increased knife-carrying and fewer deviant peers in the intervention group. After adjustment for baseline differences, there was a trend toward significant program effects, including reduced misdemeanor activity and youth-reported aggression scores and increased youth self-efficacy. Program impact was associated with the number of intervention sessions received.
A community-based, mentor-implemented program with assault-injured youths who presented to the emergency department trended in the direction of decreased violence, with reduced misdemeanors and increased self-efficacy.
评估由导师实施的预防暴力干预措施对减少受攻击受伤青少年的攻击行为、打架行为和再次受伤情况的影响。
在两家大型城市医院的急诊科进行了一项随机对照试验，招募了10至15岁因同伴攻击而受伤的青少年，并将他们随机分为干预组和对照组。干预组的青少年接受一名导师指导，该导师实施一个为期6节的解决问题课程，家长接受健康教育家的3次家访，以讨论家庭需求并促进服务利用和家长监督。对照组收到一份社区资源清单，并接到2次跟进电话以促进服务利用。在基线和6个月时对青少年和家长进行访谈，以评估他们对暴力的态度、风险因素、打架行为和再次受伤情况。
共招募了227个家庭，其中23%拒绝参与，4%部分完成访谈。共纳入166个家庭，87个被分配到干预组，79个被分配到对照组；118个（71%）完成了青少年和家长的跟进访谈，113个有可用数据。干预组和对照组在基线时的人口统计学特征或风险因素方面无显著差异，但干预组携带刀具的情况增加，异常同伴较少。在对基线差异进行调整后，有显著项目效果的趋势，包括轻罪活动减少、青少年报告的攻击得分降低以及青少年自我效能感提高。项目影响与接受的干预课程数量有关。
一项针对到急诊科就诊的受攻击受伤青少年的社区导师实施项目呈现出暴力减少的趋势，轻罪减少，自我效能感增强。
