Hospital-Based Violence Intervention Programs to Reduce Firearm Injuries in Children: A Scoping Review

Colleen P Nofi; Bailey K Roberts; Emma Cornell; Montserrat Tijerina; Olivia Tussing; Marion C Henry; Chethan Sathya

doi:10.1016/j.jpedsurg.2023.04.020

Hospital-Based Violence Intervention Programs to Reduce Firearm Injuries in Children: A Scoping Review

J Pediatr Surg. 2023 Nov;58(11):2212-2221. doi: 10.1016/j.jpedsurg.2023.04.020. Epub 2023 Apr 29.

Authors

Colleen P Nofi¹, Bailey K Roberts², Emma Cornell³, Montserrat Tijerina⁴, Olivia Tussing⁵, Marion C Henry⁶, Chethan Sathya⁷

Affiliations

¹ Cohen Children's Medical Center at Northwell Health, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA. Electronic address: cnofi@northwell.edu.
² Cohen Children's Medical Center at Northwell Health, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA.
³ Center for Gun Violence Prevention, Northwell Health, New Hyde Park, NY, USA.
⁴ Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
⁵ University of Michigan, Ann Arbor, MI, USA.
⁶ Department of Surgery, University of Chicago, Chicago, IL, USA.
⁷ Cohen Children's Medical Center at Northwell Health, New Hyde Park, NY, USA; Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA; Center for Gun Violence Prevention, Northwell Health, New Hyde Park, NY, USA.

PMID: 37217364
DOI: 10.1016/j.jpedsurg.2023.04.020

Abstract

Introduction: Hospital-based violence intervention programs (HVIPs) have shown promise in preventing reinjury and enhancing recovery from violent injuries, including those related to firearms. Historically, HVIPs have primarily focused on at-risk adolescents and young adults. The aim of this study is to perform a scoping review of HVIPs targeting children under the age of 18, describe the evidence supporting these programs, and deduce the potential impact of expanding HVIPs to younger children.

Methods: A scoping review was performed utilizing PubMed database with search terms "violence intervention program" and pediatric, or children, or youth. Articles were screened for youth-inclusive violence programs, and the literature was analyzed for program descriptions, evidence supporting interventions, and barriers to evaluation.

Results: 36 studies (covering 23 programs) were identified that met criteria (including patients ≤18 years old), with only 4 programs including children under 10. Many HVIPs utilize brief hospital interventions with longitudinal wraparound outpatient services. Despite heterogeneity in programs and studied outcomes, many HVIPs demonstrated positive outcomes, such as reduction of risk factors, decreased reinjury, decreased violent behaviors, decreased criminal justice involvement, and positive attitude or behavioral changes. Only a few studies reported increased odds of enrollment and positive impact in younger patients specifically.

Conclusions: Children are an impressionable population in which HVIPs may have significant impact; however, there remains a gap in targeted programs. Given that firearm injuries are the leading cause of death in children and adolescents, priority should be given to piloting, implementing, and evaluating HVIPs among younger age groups.

Level of evidence: Level IV.

Keywords: Firearm injury; Hospital-based violence intervention programs; Pediatric.

Publication types

Review