Implementation of a youth violence prevention programme in primary care

Details

• Alternative Title:
  Inj Prev
• Personal Author:
  Roche, Jessica S. ; Philyaw-Kotov, Meredith L. ; Sigel, Eric ; Eisman, Andria B. ; Wernette, Golfo Tzilos ; Resnicow, Kenneth ; Carter, Patrick M. ; Cunningham, Rebecca M. ; Walton, Maureen A.
• Description:
  Background and objectives
  
  Youth violence is an alarming public health problem, yet, violence screening and interventions are not systematically offered in primary care (PC). This paper describes data from a pilot effectiveness-implementation trial of an efficacious youth violence prevention programme (SafERteens).
  
  Methods
  
  The study was conducted in two PC clinics: a university-affiliated satellite clinic and a community health centre. in phase 1, we obtained stakeholder feedback to customise the SafERteens package and enrolled a comparison group of adolescents (age 14–18) seeking care in two clinics. in phase 2, clinical staff delivered the SafERteens-PC intervention with adolescents, which is a single, behavioural health therapy session delivered one-on-one from clinic providers to youth patients, followed by text message (TM) reminders. In phase 3, we assessed planned maintenance. All participants reported past-year violent behaviour at intake and completed a 3-month follow-up assessment.
  
  Results
  
  Based on stakeholder interviews (n=13), we created a web-based SafERteens-PC programme package, including a three-item past-year violence screen, 30 min motivational interviewing-based brief intervention delivery tool, training videos and 2 months of TM boosters. We enrolled a comparison group (n=49) first, then an intervention group (n=61). Intervention delivery characteristics varied by clinic, including completion of intervention (75.9%; 62.5%), modality (100% delivered via telehealth; 60% via telehealth/40% in-person) and enrolment in TMs (81.8%; 55.0%); 91.8% completed the follow-up. Using an intention-to-treat approach, the intervention group showed significantly greater reductions in severe peer aggression (p<0.05), anxiety (p<0.05) and substance use consequences (p<0.05) relative to the comparison group. Participant and staff feedback were positive and identified challenges to long-term implementation, such as lack of availability of reimbursement for youth violence prevention.
  
  Conclusions
  
  If these challenges could be addressed, routine provision of behavioural health services for violence prevention in PC could have high impact on health outcomes for adolescents.
  
  
• Subjects:
  Adolescent Adolescent Behavior Aggression Article Clinical Trials As Topic Humans Motivational Interviewing Multicenter Studies As Topic Pilot Projects Primary Health Care Violence

  More +
• Source:
  Inj Prev. 28(3):231-237
• Pubmed ID:
  34716179
• Pubmed Central ID:
  PMC9063683
• Document Type:
  Journal Article
• Funding:
  R49 CE002099/CE/NCIPC CDC HHSUnited States/ ; R49 CE003085/CE/NCIPC CDC HHSUnited States/ ; R49CE002099/ACL/ACL HHSUnited States/ ; R49CE003085/ACL/ACL HHSUnited States/
• Volume:
  28
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7ef106f31e6f6c806a45f8381da63a395f749d02fc384b7712f171aa661412b1
• Download URL:
  https://stacks.cdc.gov/view/cdc/116947/cdc_116947_DS1.pdf
• File Type:
  [PDF - 643.63 KB ]