PC2136: Provider Perspectives on Trauma Recovery & Violence Prevention Resource Allocation for Assault Injured Adolescents in an Urban Level 1 Trauma Center

Background: Nationally, youth violence is a major contributor to adolescent mortality and morbidity. For youths aged 15-25, homicide and violent injury is the second leading cause of death and is the leading cause of death for Black males ages 15 to 24 (Cunningham et al, 2009). Between 2013-2017, there were 509 victims of firearm homicide, aged 15-19 in Chicago (Chadha et al., 2020). Data shows that assault-injured adolescents in urban environments face up to a 37% reinjury rate (Cunningham et al., 2015). The expanding body of literature on evidence-based approaches to violence prevention and the alarming rate of adolescent violence- induced mortality indicates a need for providers (physicians, nurses, social workers, technicians) to implement youth focused trauma and violence prevention interventions. This study sought to assess provider reported knowledge and usage of trauma recovery and violence prevention (TRVP) interventions at an urban Level 1 Pediatric Trauma Center and Emergency Department.

Methods: We surveyed 70 health providers working in a Level 1 pediatric emergency department over a 6-month period. All participants completed a 12-item survey to assess knowledge, usage, importance, and efficacy of TRVP resources (N=70). A psychometric 5-point scale (Likert scale) was used to assess knowledge, usage, importance, and efficacy while free responses captured data on “existing resources, resource barriers, and TRVP areas of improvement”. Qualitative data was sorted into broad categories based on common response themes. The survey was approved by The University of Chicago Institutional Review Board.

Results: The 70 participants consisted of 53 physicians, 12 nurses, 2 ED technicians, and 3 other staff. Of physicians, 74% were residents with 47% in EM residency and 47% in pediatrics. Participant awareness of existing TRVP resources was low, 80% scored a ≤3 (of 5). Overall 67% of participants indicated a moderate to frequent use of trauma recovery and violence prevention (TRVP) resources. However, nearly 41% of participants reported feeling slightly to not at all confident in activating existing resources. Most participants (90%) agreed that providers should incorporate violence prevention into standard youth medical care. Over 88% of participants identified existing resources as moderately to not at all effective at preventing reinjury. Broadly, participants’ comments on barriers to TRVP resources could be sorted into the categories “Resource insufficiency, Patient interest, Communication barriers, Systemic issues, Lack of provider knowledge”. These categories aligned closely with reported areas of TRVP resource improvement previously mentioned.

Conclusion: Level 1 Pediatric Trauma Center providers agree that trauma recovery and violence prevention should be incorporated into standard care for assault injured youth. However, they have limited awareness of resources, low confidence in utilizing resources, and low efficacy rating for existing resources. Further work is needed to develop educational interventions to train providers on TRVP resources to improve provider utilization and patient outcomes.