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参与青少年暴力干预项目与暴力伤害后再次就诊率降低相关:英国重大创伤网络观察性研究。

Engagement with a youth violence intervention programme is associated with lower re-attendance after violent injury: A UK major trauma network observational study.

机构信息

East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.

Academic Department of Military, Surgery and Trauma, Royal Centre for Defence Medicine, University Hospitals Birmingham NHS, Foundation Trust, Birmingham, United Kingdom.

出版信息

PLoS One. 2023 Oct 18;18(10):e0292836. doi: 10.1371/journal.pone.0292836. eCollection 2023.

Abstract

The hospital based Redthread Youth Violence Intervention Programme (YVIP) utilises experienced youth workers to support 11-24 year olds following an episode of violent injury, assault or exploitation who present to the Emergency Department (ED) at the East Midlands Major Trauma Centre (MTC), Nottingham, UK. The YVIP aims to promote personal change with the aim of reducing the incidence of further similar events. We conducted a retrospective, observational, cohort study to examine the association between engagement with the YVIP and re-attendance rates to the ED following a referral to Redthread. We also examined factors associated with engagement with the full YVIP. We found that 573 eligible individuals were referred to the YVIP over two years. Assault with body parts 34.9% (n = 200) or a bladed object 29.8% (n = 171) were the commonest reason for referral. A prior event rate ratio (PERR) analysis was used to compare rates of attendance between those who did and did not engage with the full YVIP. Engagement was associated with a reduction in re-attendances of 51% compared to those who did not engage (PERR 0.49 [95% 0.28-0.64]). A previous attendance to the ED by an individual positively predicted engagement. (OR 2.82 [95% CI 1.07-7.42], P = 0.035). A weekend attendance (OR 0.26 [0.15-0.44], P<0.001) and a phone call approach (OR 0.25 [0.14-0.47], P = 0.001), rather than a face-to-face approach by a Redthread worker, negatively impacted engagement. In conclusion, assaults with or without a weapon contributed to a significant proportion of attendances among this age group. The Redthread YVIP was associated with reduced rates of re-attendance to the East Midlands MTC among young persons who engaged with the full programme.

摘要

基于医院的 Redthread 青年暴力干预计划(YVIP)利用经验丰富的青年工作者,为在英国诺丁汉东米德兰兹重大创伤中心(MTC)的急诊部(ED)就诊的 11-24 岁暴力受伤、袭击或剥削的青少年提供支持。YVIP 的目的是促进个人改变,减少进一步类似事件的发生。我们进行了一项回顾性、观察性队列研究,以检查与向 Redthread 转介后 ED 再次就诊率相关的与 YVIP 的参与程度之间的关联。我们还研究了与全面参与 YVIP 相关的因素。我们发现,在两年内,有 573 名符合条件的个人被转介到 YVIP。转介的最常见原因是身体部位攻击 34.9%(n = 200)或刀片状物体攻击 29.8%(n = 171)。使用事件前比率(PERR)分析比较了与完全参与 YVIP 的人相比,就诊率。与不参与的人相比,参与率与就诊率降低 51%相关(PERR 0.49 [95% 0.28-0.64])。个体以前到 ED 的就诊次数正预测着参与度。(OR 2.82 [95%CI 1.07-7.42],P = 0.035)。周末就诊(OR 0.26 [0.15-0.44],P<0.001)和电话咨询(OR 0.25 [0.14-0.47],P = 0.001),而不是 Redthread 工作人员的面对面咨询,会对参与产生负面影响。总之,有或没有武器的袭击导致了这个年龄段的很大一部分就诊。Redthread YVIP 与在该计划中全面参与的年轻人中,减少了到东米德兰兹 MTC 的再就诊率。

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