Stanford University School of Medicine, Stanford, CA, USA.
Washington University School of Medicine in St. Louis, MO, USA.
J Interpers Violence. 2020 Nov;35(21-22):4262-4275. doi: 10.1177/0886260517705662. Epub 2017 Jun 16.
Pediatric interpersonal violence is a public health crisis resulting in morbidity and mortality and recidivism. St. Louis City and surrounding areas have the highest rates of youth interpersonal violence nationally. St. Louis Children's Hospital (SLCH) Social Work in conjunction with Pediatric Emergency Medicine established a novel emergency department (ED)-initiated program to determine whether co-location of services followed by outpatient mentoring reduced the rate of morbidity, mortality, and recidivism in youths experiencing interpersonal violence. SLCH developed the "Empowering Youth Through Interpersonal Violence Prevention Program," co-locating initial social work services and emergency medical services in the pediatric ED. Youths, ages 8 to 17 years, presenting for interpersonal violence were approached for immediate social work counseling and subsequent individualized outpatient mentoring, developed from national best practices and model programs. A prospective 2:1 randomized, controlled pilot study assessing for youth morbidity, mortality, and recidivism was conducted for program service feasibility from 2012 to 2014. The study was followed by a 1-year retrospective analysis of program service integration as a hospital standard-of-care evaluating the same outcome measures. Of the 24 youths who participated in the pilot study and received the intervention, there was a 4% rate of morbidity and recidivism. Conversely, there was a 3.4% rate of mortality, 6.7% rate of morbidity, and 11.8% recidivism rate in those who refused to participate in services. EYIPP was offered as a service from 2014 to 2015 and 57 youths participated with a 3.5% rate of both morbidity and recidivism. During this time, 78 eligible youths declined services with a 1.1% rate of morbidity, and 2.3% recidivism rate. This novelprogram reduces recidivism, morbidity, and mortality in youths presenting to SLCH for interpersonal violence-related injuries suggesting that co-location of social services in the ED, followed by individualized mentoring may be important for engagement.
儿科人际暴力是一种公共健康危机，导致发病率、死亡率和复发性。圣路易斯市及其周边地区的青少年人际暴力发生率全国最高。圣路易斯儿童医院（SLCH）社会工作与儿科急诊医学合作，建立了一个新的急诊部（ED）启动项目，以确定服务的共同定位，然后进行门诊指导，是否可以降低经历人际暴力的青少年的发病率、死亡率和复发性。SLCH 开发了“通过人际暴力预防计划赋予青年力量”，在儿科 ED 中共同定位最初的社会工作服务和紧急医疗服务。年龄在 8 至 17 岁之间，因人际暴力就诊的青少年立即接受社会工作咨询，随后根据国家最佳实践和示范方案进行个性化的门诊指导。从 2012 年到 2014 年，对该项目的可行性进行了一项前瞻性 2:1 随机对照试点研究，以评估青年发病率、死亡率和复发性。随后对该项目作为医院标准护理的服务整合进行了为期 1 年的回顾性分析，评估了相同的结果指标。在参与试点研究并接受干预的 24 名青少年中，发病率和复发性为 4%。相反，拒绝接受服务的患者的死亡率、发病率和复发性分别为 3.4%、6.7%和 11.8%。EYIPP 于 2014 年至 2015 年提供服务，有 57 名青少年参加，发病率和复发性均为 3.5%。在此期间，78 名符合条件的青少年拒绝服务，发病率为 1.1%，复发性为 2.3%。这个新的项目降低了因人际暴力相关伤害到 SLCH 就诊的青少年的复发性、发病率和死亡率，这表明在 ED 中共同定位社会服务，然后进行个性化指导，对于参与可能很重要。
