Document Type
Article
Publication Date
4-11-2024
Abstract
Background: Stemming from poverty and systemic racism, Black youth are disproportionately represented in hospital-based violence intervention programs (HVIPs) due to greater violence exposure. HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth. Methods: Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between-group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi-square and logistic regression. ACEs were approximated using a novel approach with administrative data. Results: Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups. Conclusions: This study highlights a novel approach to understanding ACEs among a hard-to-reach population and illuminates the significant level of ACEs faced by violence-exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma-informed and healing-centered interactions during recruitment and later stages of engagement.
Language
English
Publication Title
Academic Emergency Medicine
Grant
R03HD102452‐02
Rights
© The Author(s)2024. This is an open access work distributed under the terms of the Creative Commons Attribution-Non-Commercial (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Voith LA, Salas Atwell M, D’AlessioAS, Evans KE, Korsch-Williams A. Examining adversechildhood experiences and Black youth's engagement in ahospital-based violence intervention program usingadministrative data. Acad Emerg Med. 2024;31:870-882.doi:10.1111/acem.14920
Manuscript Version
Final Publisher Version