Gun violence and violent injury are major concerns in our society today, especially in urban settings. Research has demonstrated that there are specific risk factors for violent gun injury among men, but literature in this area has historically disregarded women. Previous research on men found that participation in criminal activities significantly increases risk of violent injury, but it is unknown whether criminal behaviour increases the risk of violent victimization in women. This study aims to determine whether criminal arrests differ significantly between violently injured women and women in the general population. To pursue this aim, rates of gun, drug, property, violent, and prostitution crime arrests were compared between women treated for violent injuries at a Level I Trauma Centre and women in the community at large. Chi-square analyses found that violently injured women are significantly more likely to have criminal arrests than women in the comparison population, indicating that criminal behaviour may be an important risk factor for violent injury in women. Supplementary analyses found that violent crimes contribute uniquely to the risk of violent injury in comparison to other crimes. Implications for female victims of violence are discussed. / 1 / Samia Lalani

Background: From 2002-2011, there were over 17,000 shootings in Philadelphia. "Turning Point", Temple University Hospital's violence intervention program, takes advantage of the teachable moment that occurs after violent injury. In addition to receiving social work services, Turning Point patients watch their trauma bay resuscitation video and a movie about violence, meet with a gunshot wound survivor and an outpatient case manager, and undergo psychiatric assessment. The purpose of this study was to determine the efficacy of Turning Point in changing attitudes toward guns and violence among victims of penetrating trauma. Methods: This prospective randomized study was conducted from January-June 2012. Patients who sustained a gunshot or stab wound were randomized to Standard of Care, which involved social work services only, or Turning Point. The Attitudes Toward Guns and Violence Questionnaire was administered to assess attitude change. Analysis was performed with the Wilcoxon signed-rank test. A p < 0.05 was significant. Results: A total of 40 out of 159 patients with gunshot or stab wounds were enrolled and completed the study in its entirety. The most common reason for exclusion was anticipated length of stay being less than 48 hours. The two groups were similar with respect to most demographics. Unlike the Standard of Care group, the Turning Point group demonstrated a 44% reduction in its Aggressive Response to Shame, a 33% reduction in its Comfort with Aggression, and a 20% reduction in its overall proclivity toward violence. Conclusion: Turning Point is effective in changing attitudes toward guns and violence among victims of penetrating trauma. Continued enrollment and longer follow-up are necessary to determine if this program can have a long-lasting impact and truly be a turning point in patients' lives. / Public Health

This study will describe Boston Medical Center's (BMC) Community Violence Response Team (CVRT) a program that provides mental health services to victims of interpersonal violence. Though these services are offered to all traumatic injury patients regardless of specific injury type, CVRT patients are almost exclusively victims of gunshot and stab wounds. This study focuses specifically on this patient population. CVRT counselors work in close collaboration with members of BMC's Violence Intervention Advocacy Program, as well as physicians and staff of the Emergency and Trauma departments. While many hospitals have violence intervention programs (VIPs), BMC is one of the first hospitals in the country to integrate mental health services into the hospital-based model of violence intervention and violent injury prevention. It is planned to conduct anonymous recorded interviews of people who have been through the violence intervention programs and received mental health services. A professionally licensed member of CVRT will screen the patient database for potential interview subjects. Subjects will be chosen based on when and for how long they were involved with our programs, as well as other factors such as injury type and language spoken. The subjects' anonymity will be protected and risks minimized as much as possible throughout the screening and interview process. Interview data will be examined for trends among the clients served. This will be a first look at evaluating CVRT, which was launched in 2011. The purpose of this study is to provide feedback on BMC's novel model for an integrated hospital-based violence intervention program and mental health services program for victims of interpersonal violence. The patient's perspective on these programs will provide valuable insight on this approach to violence intervention. The benefits of this model will be explored to identify any ways in which violence intervention services at BMC might be improved. Outcomes of the assessment of study data will be used to generalize the model for adaptation in other trauma centers. In addition, it is anticipated that this study will demonstrate the importance of seamless, integrated collaboration between community advocates of hospital-based intervention programs and trained professionals dedicated to providing mental health care to this vulnerable patient population and their families. It is hypothesized that BMC's integrated model for violence programming makes it easier for patients to take advantage of mental health services. This ease of access and comfortable transition from advocacy interventions to mental healthcare may translate into better long-term outcomes for patients. More patients may also use mental health services with this model than with a model that requires patients to access mental health services at another facility. A detailed explanation of BMC's programs complete with patients' experience will inform other institutions which may choose to adapt this integrated model to their practices. Finally, this pilot study will inform future research on violent injury patients and their treatment. This research has the potential to improve recovery and quality of life for future violent injury patients at BMC and other trauma centers.