Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
Center on Trauma and Adversity, Cleveland, Ohio, USA.
Health Soc Care Community. 2022 Nov;30(6):e4873-e4884. doi: 10.1111/hsc.13900. Epub 2022 Jul 8.
Black and Latinx youth are disproportionately affected by violence in the United States. Hospital-based violence intervention programs (HVIPs) have emerged as an effective response to this epidemic; however, participation rates remain low. This study aimed to identify facilitators and barriers to recruitment and engagement amongst black and Latinx youth from the perspective of HVIP staff. Employing a phenomenological approach, a purposive sample of key informants was recruited. Focus groups and semi-structured interviews lasting approximately 90 min were conducted with representatives (N = 12) from five HVIPs in U.S. cities across the Midwest and Northeast, making up 15% of all HVIPs in the United States. Each interview was recorded and transcribed verbatim. The research team employed rigorous content analysis of the data. Three themes and subsequent categories resulted from the analysis: (1) Interpersonal/Relational Facilitators (building rapport; connecting with youth; enhancing the teachable moment; building relational health); (2) Structural/Systemic Barriers (lack of reinforcement; difficulties connecting after discharge from the hospital; hospital workflow; institutional challenges); (3) Structural/Systemic Facilitators (embedding the HVIP; trauma-informed practices and policies). Given the limited research on black and Latinx youth and the disproportionate rate of violent injuries amongst these groups, an evidence-based systematic approach to engage youth is essential to promote health equity. The findings from this study suggest that there are several steps that HVIPs and hospitals can take to enhance their recruitment and engagement of youth and their families.
美国的黑人和拉丁裔青年不成比例地受到暴力的影响。医院为基础的暴力干预计划(HVIPs)已经成为应对这一流行病的有效措施;然而,参与率仍然很低。本研究旨在从 HVIP 工作人员的角度确定招募和参与黑人和拉丁裔青年的促进因素和障碍。采用现象学方法,从美国中西部和东北部城市的五家 HVIP 中招募了有代表性的关键信息提供者进行了焦点小组和半结构化访谈,共持续约 90 分钟,参与者(N=12)来自五家 HVIP,占美国所有 HVIP 的 15%。每次访谈都进行了录音和逐字记录。研究小组对数据进行了严格的内容分析。分析产生了三个主题和随后的类别:(1)人际/关系促进因素(建立融洽关系;与青年联系;增强可教时刻;建立关系健康);(2)结构/系统障碍(缺乏强化;出院后联系困难;医院工作流程;机构挑战);(3)结构/系统促进因素(嵌入 HVIP;创伤知情实践和政策)。鉴于针对黑人和拉丁裔青年的研究有限,以及这些群体中暴力伤害的比例过高,采用循证系统方法吸引青年对于促进健康公平至关重要。本研究的结果表明,HVIP 和医院可以采取一些措施来增强他们对青年及其家庭的招募和参与。