Translating Violence Prevention Programs from Research to Practice: SafERteens Implementation In an Urban Emergency Department

Details

• Alternative Title:
  J Emerg Med
• Personal Author:
  Carter, Patrick M. ; Cunningham, Rebecca M. ; Eisman, Andria B. ; Resnicow, Ken ; Roche, Jessica S. ; Cole, Jennifer Tang ; Goldstick, Jason ; Kilbourne, Amy M. ; Walton, Maureen A.
• Description:
  Background:
  
  Youth violence is a leading cause of adolescent mortality, underscoring the need to integrate evidence-based violence prevention programs into routine Emergency Department (ED) care.
  
  Objectives:
  
  To examine the translation of the SafERteens program into clinical care.
  
  Methods:
  
  Hospital staff provided input on implementation facilitators/barriers to inform toolkit development. Implementation was piloted in a 4-arm effectiveness-implementation trial, with youth (age: 14-18) screening positive for past 3-month aggression randomized to either SafERteens (delivered remotely or in-person) or enhanced usual care (EUC; remote or in-person), with follow-up at post-test and 3-months. During maintenance, ED staff continued in-person SafERteens delivery and external facilitation was provided. Outcomes were measured using the RE-AIM implementation framework.
  
  Results:
  
  SafERteens completion rates were 77.6% (52/67) for remote and 49.1% (27/55) for in-person delivery. In addition to high acceptability ratings (e.g., helpfulness), post-test data demonstrated increased self-efficacy to avoid fighting among patients receiving remote (IRR=1.22; 95%CI=1.09-1.36) and in-person (IRR=1.23; 95%CI=1.12-1.36) SafERteens, as well as decreased pro-violence attitudes among patients receiving remote (IRR=0.83; 95%CI=0.75-0.91) and in-person (IRR=0.87; 95%CI=0.77-0.99) SafERteens when compared to their respective EUC groups. At 3-months, youth receiving remote SafERteens reported less non-partner aggression (IRR=0.52; 95% CI=0.31-0.87; Cohen’s d=−0.39) and violence consequences (IRR=0.47; 95%CI=0.22-1.00; Cohen’s d=−0.49) compared to remote-EUC; no differences were noted for in-person SafERteens delivery. Barriers to implementation maintenance included limited staff availability and a lack of reimbursement codes.
  
  Conclusions:
  
  Implementing behavioral interventions such as SafERteens into routine ED care is feasible using remote delivery. Policymakers should consider reimbursement for violence prevention services to sustain long-term implementation.
  
  
• Subjects:
  Adolescent Aggression Article Behavior Therapy Emergency Departments Emergency Medical Services Emergency Service, Hospital Humans Implementation Translation Violence Youth Violence

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• Source:
  J Emerg Med. 62(1):109-124
• Pubmed ID:
  34688506
• Pubmed Central ID:
  PMC8810595
• Document Type:
  Journal Article
• Funding:
  K23 DA039341/DA/NIDA NIH HHSUnited States/ ; R49 CE002099/CE/NCIPC CDC HHSUnited States/ ; R49 CE003085/CE/NCIPC CDC HHSUnited States/ ; R49CE002099/ACL/ACL HHSUnited States/
• Volume:
  62
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:816fdaecf74824fbc64f4167671d3d41203bee7260697a36a9144ed2a65ce01f
• Download URL:
  https://stacks.cdc.gov/view/cdc/114113/cdc_114113_DS1.pdf
• File Type:
  [PDF - 732.92 KB ]