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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program called Bridging the Gap (BTG) to determine its effectiveness in reducing violence among young people injured in violent situations. The study aims to assess whether this hospital-based program can lower rates of violence and risky behaviors, such as firearm use, drug use, and aggression. Participants will receive either the usual hospital care or the BTG program, which includes violence prevention and support services for three months. This trial suits youth aged 10 to 17 who have been injured in violent incidents and live in specific areas around Richmond. As an unphased trial, it offers participants a unique opportunity to contribute to innovative solutions for reducing youth violence.

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 prior data suggests that the Bridging the Gap (BTG) intervention is safe for youth?

Research shows that hospital-based programs like Bridging the Gap (BTG) hold promise. Studies have found that these programs help reduce repeat injuries, improve school attendance, and decrease involvement with the justice system. These findings indicate that the programs are generally safe and well-received by participants. Although the studies emphasize results over specific safety details, the overall positive effects suggest that BTG does not pose significant risks to participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Bridging the Gap (BTG) intervention because it offers a comprehensive approach to preventing youth violence, combining hospital-based programs with community support. Unlike standard treatments, which often focus solely on immediate medical care, BTG includes a 3-month community case management component and a specialized firearm counseling program. This holistic method aims not just to address the aftermath of violence but to prevent it by equipping at-risk youth with tools and support to make safer choices. By integrating these elements, BTG seeks to reduce repeat incidents and promote long-term, positive outcomes for young individuals.

What evidence suggests that the Bridging the Gap (BTG) intervention is effective for reducing youth violence?

Research has shown that hospital-based programs like Bridging the Gap (BTG) can help reduce violence among young people. Early results indicate that these programs lead to fewer violent injuries and increased participation in school activities. Participants also tend to encounter fewer legal problems. In this trial, some youth will receive BTG services, which combine hospital care with community support and advice on gun safety. This approach helps prevent further violence by addressing the risk of retaliation. The program focuses on teaching conflict resolution and understanding the causes of violence, resulting in improved behavior and increased safety. ^{1 2 3 4 6}

Who Is on the Research Team?

Nicholas Thomson, PhD

Principal Investigator

Virginia Commonwealth University

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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 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]

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]

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 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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12340368/

Hospital-based Violence Intervention Programs May ... The early results show reductions in re-injury, improved engagement in school, lower justice system involvement, and potential healthcare cost ...

2. researchgate.net researchgate.net/publication/316632405_Bridging_the_Gap_Hospital_Community-Based_Youth_Violence_Prevention_Program-Pitfalls_and_Lessons_Learned

Hospital Community-Based Youth Violence Prevention ... A review of VCUTC data revealed that 62% of patients presenting with violent injuries were <25 years of age, and nearly 96% of assault-related ...

3. reporter.nih.gov reporter.nih.gov/project-details/10399852

Preventing Firearm Violence in Youth: A hospital-based ... BTG is a novel hybrid intervention model that capitalizes on the hospital-based intervention approach using a brief violence intervention to prevent retaliatory ...

4. phila.gov phila.gov/media/20220822090649/PDPH_HVIP_Rpt22_finWEB.pdf

Hospital-Based Violence Intervention Programs (HVIPs) in ... A Hospital-Based Violence Intervention Program (HVIP) is a collaborative of medical staff and community partners that provides trauma-informed.

5. rgvhealthconnect.org rgvhealthconnect.org/promisepractice/index/view?pid=3782

Bridging the Gap: Youth Violence Reduction Bridging the Gap is a hospital-based intervention that includes a review of the incident, a discussion of conflict resolution strategies and risk factors for ...

6. youtube.com youtube.com/watch?v=cO7mmM-ngi4

New Research on Hospital-based Violence Intervention ... Research suggests that HVIPs may effectively reduce the chances of patients experiencing violence again. During this webinar, panelists ...