SafERteens Toolkit Brings Youth Violence Prevention to Emergency Departments


This Toolkit Helped...

Generate New Research

Translate Knowledge

Disseminate the Latest Injury Prevention Science

Develop Evidence-based Interventions

Provide Technical Assistance

Train Researchers & Practitioners in Injury Prevention

The Issue

Youth violence continues to be a significant public health concern in the U.S., according to the Centers for Disease Control and Prevention (CDC). It is the leading cause of death for black males between the ages of 15 and 24, and the second leading cause of death for youth aged 15-24 generally. In 2016, over 5,300 youth ages 10 to 24 were victims of homicide, an average of 14.5 deaths per day. Additionally, the number of assault-related, nonfatal injuries bringing young people into emergency departments (ED) continues to surge. According to the CDC, in 2016 there were 531,505 youth aged 10 to 24 treated in EDs across the U.S. for assault-related, nonfatal injuries.

On a local level, Flint, MI is a city currently experiencing high levels of ED use by youth along with an extremely high violent crime rate. In 2015, Flint reported one of the highest homicide rates in the nation at a rate of 47.9 deaths per 100,000 population. Additionally, Flint reported one of the highest overall violent crime rate in the nation; a rate of 1,477 violent crimes per 100,000 population.Thus, programs and interventions directly aimed at reducing violent acts in Flint, and cities with similar hardships, are in considerable need. It is vital that public health professionals identify effective, evidenced-based programs and interventions that will help reduce youth violence in the nation. There are very few, if any, such interventions currently available to hospitals and emergency departments that can be delivered as part of clinical care.

 

How was this addressed?

One of the Center’s main research projects has focused on youth violence prevention, translating an already developed efficacious emergency-department (ED)-based “SafERteens” intervention for implementation into routine care delivery in the ED. We developed an implementation toolkit (see SafERteens ED Website) to guide training and implementation in other EDs. The toolkit contains: training materials, video demonstration of intervention sessions (with actors), and computer guided intervention screens to accelerate adoption and uptake in other EDs. This project directly led to the extension of implementation from our CDC project within routine clinical care and to develop a sustainability plan that will allow for maintenance of the intervention (project on-going). Further, we are translating the SafERteens intervention for delivery in primary care clinics/settings, creating a customized toolkit for office clinic settings; we are currently enrolling participants in an implementation study. Although our single session SafERteens intervention is scalable and sustainable with effects lasting up to one-year, some youth need more intensive interventions. Thus, an additional program developed by our Center is M-Coach, which grew from a 2015 Center exploratory pilot project into a fully-funded project in 2016. This project involves conducting a sequential, multiple assignment randomized trial (SMART) to compare the efficacy of just-in-time adaptive violence interventions (text messaging, health coaches) among emergency department youth, based on initial response/non-response to identify the most cost effective prevention strategies.

Key Results – Program Impact

This project directly led to the extension of implementation from our CDC project within routine clinical care and to develop a sustainability plan that will allow for maintenance of the intervention (project on-going). Further, we are translating the SafERteens intervention for delivery in primary care clinics/settings, creating a customized toolkit for office clinic settings; we are currently enrolling participants in an implementation study. Although our single session SafERteens intervention is scalable and sustainable with effects lasting up to one-year, some youth need more intensive interventions. Thus, an additional program developed by our Center is M-Coach, which grew from a 2015 Center exploratory pilot project into a fully-funded project in 2016. This project involves conducting a sequential, multiple assignment randomized trial (SMART) to compare the efficacy of just-in-time adaptive violence interventions (text messaging, health coaches) among emergency department youth, based on initial response/non-response to identify the most cost effective prevention strategies.