Defense Date

6-10-2024

Graduation Date

Summer 7-2024

Availability

One-year Embargo

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Dr. Alison Colbert

Committee Member

Dr. Kathleen Sekula

Committee Member

Dr. James Schreiber

Committee Member

Dr. Steven Albert

Keywords

Hospital Based Violence Prevention, Gun Violence, Enrollment, Engagement, Retention

Abstract

BACKGROUND: Violence is a significant healthcare issue that affects the health and well-being of individuals, families, and communities. Violence prevention and intervention programs are a powerful way to stop the revolving door of violent injury in our hospitals and communities. The Health Alliance for Violence Intervention (HAVI), develops and connects violence intervention programs, promotes equity for victims of violence globally, and is dedicated to engaging patients during the window of opportunity when they are recovering in the hospital after a violent injury to reduce the chance of retaliation (related to the injury) and recurrence. A small body of research shows that such programs can improve outcomes, but that research is limited by the challenges of enrollment, engagement, retention, and service delivery. The goal is to understand who is being served while identifying the factors that may lead to greater engagement in the intervention.

METHODS: The study was conducted as a retrospective secondary data analysis of the parent intervention study (without control group) and was guided by the Socio-Ecological Framework of the Public Health Model, specifically focusing on the first (individual) and second (relationship) level. The study investigated the engagement and participation of HVIP. Analyzing engagement and long-term/follow-up data regarding utilization of hospital-based programs and resources can help to establish effective ways to study and assess these programs and the population affected by violence.

RESULTS: A total of one hundred thirty-one participants were included in the secondary review and data analysis. The 131 participants accounted for 29% of the 445 hospital admissions for gunshot wounds during the 2-year enrollment period. Bivariate analysis of the demographic data with engagement and retention was performed revealing only 26.7% of the participants completed the entire six-month study. Logistic regression was performed to ascertain the effects and relationship of age, gender, social support, use of illegal drugs, length of inpatient hospital stay (LOS), mental health, and attitudes towards violence and gangs with engagement and retention of the HVIP.

CONCLUSION: Engagement and retention are known issues with this vulnerable population. While this study may have provided limited insight about the predictors of engagement, gun violence remains a critical public health issue. Hospital-based prevention programs can be utilized as a vital integration of providing services to at-risk patients, but with potential revisions necessary. Although there are different organizational structures for each program, one format may be helpful so that data can be collected similarly.

LEVEL OF EVIDENCE: Level IV – Therapeutic/Care Management, Prognostic & Epidemiological

KEY WORDS: Hospital Based Violence Prevention, Gun Violence, Enrollment, Engagement, Retention

Language

English

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