Center for Injury Research and Prevention

After Violent Injury, Recovery Goes Beyond Avoiding Future Violence

December 11, 2018

The post-injury needs of someone who has been violently assaulted are varied and complex. To reduce future re-injuries, hospital-based violence intervention programs (HVIPs), including CHOP’s Violence Intervention Program (VIP), provide violently injured individuals with support and case management following discharge from the hospital. But what types of outcomes can and should these programs look to achieve for their clients to create safety in the aftermath of violent injury? This is a question my co-authors and I looked to address in a study recently published in the Journal of Interpersonal Violence.

Prioritizing Positive Outcomes

Using a two-stage Delphi method—an iterative process designed to explore a group’s judgements or questions on a given topic—79 front-line staff members from 22 member programs of the National Network of Hospital-based Violence Intervention Program (NNHVIP) were asked to identify and prioritize individual-level outcomes they believe are achieved among their clients by participating in a HVIP.

The identified outcomes highlight a clear focus on resiliency-based assets that support healing. To date, much of what we know about HVIP outcomes is focused on criminal justice involvement or preventing re-injury. Our study found that mental health and coping, social support, and well-being were important indicators of HVIP success. In fact, 17 of the top 25 most highly prioritized outcomes related to psychosocial health. This finding is in line with past research led by our team, which found that the majority of young men of color enrolled in CHOP’s VIP program wanted support to access mental health care services following violent injury.

CHOP's Violence Intervention Program
Through CHOP's Violence Intervention Program, peer mentors faciliate group support sessions through the Building Resilience After A Violent Event (BRAVE) program.

These results are useful in changing the way we think about healing after a violent injury. While avoiding future re-injury and exposure to violence remain key, our approach must center on serving the whole person in multiple domains and facets of their life. For instance, outcomes such as “better coping strategies” and “establishing a connection with a positive adult role model” were among the top prioritized outcomes. These results highlight the valuable role HVIPs play in helping clients’ achieve successful recovery to promote safety and overall wellness.

What’s Next

Importantly, this work underscores the need to expand our measurement of salient HVIP outcomes. Now that common outcomes have been identified by program staff, we are working to develop recommended assessment tools that will allow HVIPs to consistently collect and measure outcomes. Such instruments could be used across multiple HVIP sites to collect common outcomes, enhancing our ability to understand areas of programmatic success and the impact of HVIPs on clients’ lives.  In the interim, tools such as PROMIS (Patient-Reported Outcomes Measurement Information System) and a compendium of resources from the Centers for Disease Control and Prevention are available. Further, we also must continue to gain understanding of important outcomes from other key stakeholders in this work, such as funders and, most critically, clients and their families.

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