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

Abstract

Background: Nationally, firearm homicide is the leading cause of mortality for adolescents 1 to 19 years of age. Though rates of violence have decreased over the years, violent injury among adolescents remains an important public health issue, particularly in areas impacted by disproportionate rates of poverty and violence (Purtle et al., 2016). Objectives: 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 was used to assess knowledge, usage, importance, and efficacy while free responses captured data on “existing resources, resource barriers, and TRVP areas of improvement”. 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 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 TRVP into standard youth medical care. Over 88% of participants identified resources as minimally effective at preventing reinjury. Conclusion: Providers agree that TRVP use should be standard care of 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 train providers on TRVP resources to improve provider utilization. (Figure Presented).