District of Columbia — Targeted Issue

Author(s)/Presenter(s)

Cheng TL, Haynie D, Brenner R, Wright JL, Chung SE, Simons-Morton B

Abstract/Description

Objective: The goal was to assess the impact of a mentor-implemented, violence prevention intervention in reducing aggression, fighting, and reinjury among assault-injured youths.

Methods: In a randomized, controlled trial performed in the emergency departments of 2 large urban hospitals, 10- to 15-year-old youths who presented with peer assault injuries were recruited and randomly assigned to intervention and comparison groups. In the intervention group, youths received a mentor, who implemented a 6-session problem-solving curriculum, and parents received 3 home visits with a health educator, to discuss family needs and to facilitate service use and parental monitoring. The comparison group received a list of community resources, with 2 follow-up telephone calls to facilitate service use. Youths and parents were interviewed at baseline and at 6 months, for assessment of attitudes about violence, risk factors, fighting, and repeat injury.

Results: A total of 227 families were recruited, with 23% refusing participation and 4% providing partial interview completion. A total of 166 families were enrolled, with 87 assigned to the intervention group and 79 to the comparison group; 118 (71%) completed both youth and parent follow-up interviews, and 113 had usable data. The intervention and comparison groups were not significantly different at baseline with respect to demographic features or risk factors, except for increased knife-carrying and fewer deviant peers in the intervention group. After adjustment for baseline differences, there was a trend toward significant program effects, including reduced misdemeanor activity and youth-reported aggression scores and increased youth self-efficacy. Program impact was associated with the number of intervention sessions received.

Conclusions: A community-based, mentor-implemented program with assault-injured youths who presented to the emergency department trended in the direction of decreased violence, with reduced misdemeanors and increased self-efficacy.

Author(s)/Presenter(s)

Cheng TL, Wright JL, Markakis D, Copeland-Linder N, Menvielle E

Abstract/Description

Objectives: The purposes of this study were to (1) assess receptiveness of families to violence prevention interventions initiated after an assault injury and (2) assess the effectiveness of a case management program on increasing service utilization and reducing risk factors for reinjury among assault-injured youth presenting to the emergency department.

Design/methods: A randomized controlled trial of youth, aged 12 to 17 years, presenting to a large urban hospital with peer assault injury was conducted. Youth and parents were interviewed at baseline and 6 months to measure service utilization, risk behavior, attitudes about violence, mental health, and injury history.

Intervention: Intervention families received case management services by telephone or in person during 4 months by a counselor who discussed sequelae of assault injury and assessed family needs and facilitated service use. Controls received a list of community resources.

Results: Eighty-eight families were enrolled; 50 (57%) completed both youth and parent follow-up interviews. Intervention and control groups were not significantly different at baseline on demographics, service utilization, and risk factors. Fighting was common in both groups. Most parents and youth identified service needs at baseline, with recreational programs, educational services, mentoring, and counseling as most frequently desired. There was no significant program effect on service utilization or risk factors for injury. Although intervention families were satisfied with case management services, there was no significant increase in service utilization compared with controls.

Conclusions: Youth and parents were receptive to this violence prevention intervention initiated after an emergency department visit. This pilot case management program, however, did not increase service utilization or significantly reduce risk factors for injury. More intensive violence prevention strategies are needed to address the needs of assault-injured youths and their families.

Author(s)/Presenter(s)

Solomon BS, Bradshaw CP, Wright J, Cheng TL

Abstract/Description

Certain parenting behaviors have been linked with youth aggression and violence, but less is known about whether parents' attitudes toward fighting are a risk factor for children's aggressive behavior problems and future injury risk. Social cognitive theory suggests that parents' beliefs about fighting and retaliation may influence their children's attitudes toward fighting and aggression. The authors examined the associations among parental and youth attitudes toward fighting, parent-child relationships, and youth aggressive behavior in adolescents at great risk for future interpersonal violence. Data came from 72 parents and their adolescents (aged 12 to 17 years, 89% African American), who presented to an emergency department for youth's assault-related injuries. Analyses revealed an association between parents' and youth's attitudes toward fighting. Youth's and parents' attitudes were positively correlated with aggressive behavior, fighting, and school suspension. Parents' attitudes predicted youth's aggressive behavior, even after controlling for youth's attitudes. The findings suggest that interventions for high-risk youth should target the fighting-related attitudes of both parents and youth.