BTG Intervention for Preventing Youth Violence

Overseen By Nicholas Thomson

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Virginia Commonwealth University

Disqualifiers: Under 10, Over 18, Prisoners

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 3 months

300 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of the study is to understand if hospital-based violence interventions are effective for reducing youth violence among violently injured youth. This study will allow researchers to learn more about the intervention's effectiveness. The researchers also want to understand if the violence intervention impacts other behaviors, such as firearm use, drug use, aggression, risky behaviors, and rates of violent re-injury.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Bridging the Gap (BTG) for preventing youth violence?

Hospital-based violence intervention programs (HVIPs) like Bridging the Gap (BTG) have shown promise in reducing repeat violence and criminal justice involvement among youth. Studies indicate that these programs help connect injured youth to essential services, potentially breaking the cycle of violence. ^{1 2 3 4 5}

Is the Hospital-Based Violence Intervention Program (HVIP) safe for participants?

The research does not provide specific safety data for the Hospital-Based Violence Intervention Program (HVIP) or related programs like Bridging the Gap (BTG). ^{1 6 7 8 9}

How is the BTG treatment different from other treatments for preventing youth violence?

The BTG treatment is unique because it is a hospital-based violence intervention program that connects injured youth with medical, mental health, and social services to prevent future violence. Unlike other treatments, it focuses on immediate intervention after a violent injury and involves peer support to reduce the risk of further violence and criminal justice involvement. ^{1 4 10 11 12}

Research Team

Nicholas Thomson, PhD

Principal Investigator

Virginia Commonwealth University

Eligibility Criteria

This trial is for English-speaking youth aged 10-17 who are being treated in the hospital for a violence-related injury, like a gunshot wound, and live within certain areas near Richmond City. Their adult caregivers must be over 18. It's not open to those under 10 or over 18, or prisoners.

Inclusion Criteria

I am between 10-17 years old, or I am an adult caregiver aged 18+.

I am in the hospital for an injury caused by violence or have been referred for violence prevention services.

Eligible for BTG services (which includes living within the BTG catchment area for the hospital; Richmond City and neighboring counties)

Exclusion Criteria

Prisoners

I am over 18 years old.

I am under 10 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the Bridging the Gap intervention or Treatment as Usual. Bridging the Gap includes a hospital-based violence prevention program and 3-months of community case management.

3 months

In-hospital intervention and community visits

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessments of firearm-related behaviors and violence.

3 months

Treatment Details

Interventions

• Bridging the Gap (BTG)

Trial Overview The study tests 'Bridging the Gap' (BTG), a hospital-based program aimed at reducing youth violence. Researchers want to see if BTG lowers violent behaviors, firearm and drug use, aggression, risky actions, and repeat injuries from violence among young people.

Participant Groups

Group I: Bridging the Gap (BTG) Experimental Treatment 1 Intervention

Youth randomized to Bridging the Gap (BTG) services will receive a hospital-based violence prevention program with 3-months of community case management and a firearm counseling program.

Group II: Treatment as Usual Active Control 1 Intervention

Youth who will not receive BTG services and will receive treatment as usual (TAU) in the hospital.

Bridging the Gap (BTG) is already approved in United States for the following indications:

Approved in United States as Bridging the Gap for:

• Prevention of firearm violence in youth
• Reduction of violent re-injury
• Reduction of risky behaviors

Who Is Running the Clinical Trial?

Virginia Commonwealth University

Lead Sponsor

Trials

732

Recruited

22,900,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Findings from Research

A quality improvement project at a pediatric emergency department successfully increased the referral rate to the Hospital-based Violence Intervention Program (HVIP) from 32.5% to 61.1% for eligible patients aged 7-18 with violent injuries, representing an 88% increase.

Key interventions included educating healthcare providers about eligibility, encouraging timely referrals by nurses, and improving communication about the program, which collectively enhanced the connection of youth to essential medical and social services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing improvements in emergency department referrals to a hospital-based violence intervention program. Watkins, J., Scoggins, N., Cheaton, BM., et al.[2021]

Out of 2,243 violently injured patients, 839 (37.4%) engaged with the Boston Violence Intervention Advocacy Program (VIAP), with younger age, Black race, and more severe injuries being significant predictors of engagement.

Clients who engaged with VIAP faced challenges in achieving goals related to education, employment, and housing, indicating that while the program is effective in reaching its target population, there is a need for tailored strategies to address these complex needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Boston Violence Intervention Advocacy Program: Challenges and Opportunities for Client Engagement and Goal Achievement. Pino, EC., Fontin, F., James, TL., et al.[2021]

The Violence Intervention Program (VIP) provided intensive psychosocial support to repeat victims of violence, resulting in significantly lower rates of violent crime arrests and convictions compared to a control group that received standard treatment.

Participants in the control group were three times more likely to be arrested for violent crimes and faced longer projected incarceration times, highlighting the effectiveness of the VIP intervention in reducing repeat violent behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hospital-based violence intervention programs work. Cooper, C., Eslinger, DM., Stolley, PD.[2022]

The 'Caught in the Crossfire' hospital-based peer intervention program significantly reduced the risk of criminal justice involvement among participants, with a relative risk of 0.67, indicating a 33% lower risk compared to the control group.

The program is also cost-effective, potentially saving between $750,000 to $1.5 million annually compared to juvenile detention center costs, although it did not show a significant impact on reducing reinjury or death rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefits of a hospital-based peer intervention program for violently injured youth. Shibru, D., Zahnd, E., Becker, M., et al.[2022]

Hospital Based Violence Intervention programs (HVIPs) serve a variety of populations affected by community violence, intimate partner violence, and trafficking, but face challenges related to funding and resource availability.

Programs with stable funding of $300,000 or more per year tend to be more successful, highlighting the importance of financial support and adequate staffing for the sustainability of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding the makeup of a growing field: A committee on trauma survey of the national network of hospital-based violence intervention programs. Bonne, S., Hink, A., Violano, P., et al.[2022]

The study assessed the implementation of the Global Trigger Tool (GTT) in three German university hospitals, identifying nine feasibility criteria as low-level challenges, while highlighting significant obstacles such as lack of time and staff resources.

Key facilitators for successful GTT implementation included the involvement of local coordinators and external experts, suggesting that early planning and support can help overcome challenges in integrating GTT into clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using the Global Trigger Tool in surgical and neurosurgical patients: A feasibility study. Brösterhaus, M., Hammer, A., Gruber, R., et al.[2023]

The Global Assessment of Pediatric Patient Safety (GAPPS) identified a 12.5% prevalence of adverse events (AEs) in a study of 240 hospitalized pediatric patients, indicating its effectiveness in detecting patient safety incidents.

The study found that 68.2% of the AEs were preventable, and the presence of triggers in medical charts significantly increased the likelihood of AEs, highlighting the importance of monitoring and prevention strategies in pediatric care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Global Assessment of Pediatric Patient Safety Tool for identifying safety incidents in pediatric patients. Brandão, MB., Hermann, AP., Lima, MN.[2023]

A significant prevalence of patient safety events was found among hospitalized children, particularly affecting very young patients and those on Medicaid, indicating a need for targeted safety measures for these vulnerable groups.

Patient safety events were linked to substantial increases in hospital length of stay, medical charges, and in-hospital mortality, with estimated excess costs exceeding 1 billion dollars for pediatric care in 2000, highlighting the financial and health impacts of these safety issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pediatric patient safety in hospitals: a national picture in 2000. Miller, MR., Zhan, C.[2021]

The implementation of an interdisciplinary quality improvement team led to a significant increase in the reporting of safety events related to aggressive pediatric patients, rising from less than 1.0 to 3.0 events per 1000 patient days over 12 months.

Compliance with the pediatric aggression risk screening tool improved to nearly 90%, indicating that structured interventions can enhance staff awareness and response to workplace violence, ultimately promoting a safer healthcare environment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mitigating Pediatric Inpatient Aggression: A Quality Improvement Initiative. Keller, AR., Kanaley, RL., Starr, T., et al.[2022]

The Cradle to Grave (C2G) program significantly reduced violent attitudes in public school students, as evidenced by a decrease in total scores on the Attitudes Towards Guns and Violence Questionnaire (AGVQ) after participation.

The most notable change was in the 'Aggressive Response to Shame' subscale, indicating that the program effectively influences attitudes towards violence, particularly in adolescents with higher initial tendencies towards aggression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An analysis of inner-city students' attitudes towards violence before and after participation in the "Cradle to Grave" programme. Goldberg, AJ., Toto, JM., Kulp, HR., et al.[2021]

Maryland's first hospital-based trauma prevention program was developed through collaboration with various community agencies to address the needs of high-risk teens.

The program has successfully expanded to offer a range of prevention education initiatives that benefit individuals of all ages, demonstrating its effectiveness and adaptability in promoting safety and health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-risk adolescent injury prevention: the first program of its kind. Dearing, B., Yohn, D.[2019]

The CDC's Division of Violence Prevention has been actively funding National Centers of Excellence in Youth Violence Prevention (YVPCs) since 2000, focusing on university-community partnerships to effectively address and reduce youth violence.

Current YVPCs emphasize identifying community needs, implementing evidence-based programs, and rigorously evaluating their impact on youth violence rates, aiming for a comprehensive approach to prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing and Evaluating Comprehensive Evidence-Based Approaches to Prevent Youth Violence: Partnering to Create Communities Where Youth Are Safe From Violence. Matjasko, JL., Massetti, GM., Bacon, S.[2018]

References

1. England pubmed.ncbi.nlm.nih.gov

Assessing improvements in emergency department referrals to a hospital-based violence intervention program. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Boston Violence Intervention Advocacy Program: Challenges and Opportunities for Client Engagement and Goal Achievement. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Hospital-based violence intervention programs work. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Benefits of a hospital-based peer intervention program for violently injured youth. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Understanding the makeup of a growing field: A committee on trauma survey of the national network of hospital-based violence intervention programs. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Using the Global Trigger Tool in surgical and neurosurgical patients: A feasibility study. [2023]

7. Brazil pubmed.ncbi.nlm.nih.gov

Global Assessment of Pediatric Patient Safety Tool for identifying safety incidents in pediatric patients. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Pediatric patient safety in hospitals: a national picture in 2000. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Mitigating Pediatric Inpatient Aggression: A Quality Improvement Initiative. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

An analysis of inner-city students' attitudes towards violence before and after participation in the "Cradle to Grave" programme. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

High-risk adolescent injury prevention: the first program of its kind. [2019]

12. Netherlands pubmed.ncbi.nlm.nih.gov

Implementing and Evaluating Comprehensive Evidence-Based Approaches to Prevent Youth Violence: Partnering to Create Communities Where Youth Are Safe From Violence. [2018]