F.Y.I.: Flint Youth Injury Study
Condition: Drug Usage
Study type: Observational

Summary: 
      The provision of medical services in an inner city Emergency Department (ED) provides a
      critical opportunity to identify and characterize future timing and pattern of service use
      among youth with drug use, who may be missed in school-based samples, and who may not yet be
      in the criminal justice system. Currently, there is a paucity of data on the timing, pattern,
      barriers, and trajectory of youth with multiple risks (illicit drug use and ED visit for
      acute violence related injury) in terms of their intersection with health services (substance
      use treatment, mental health, medical) and criminal justice system, which limits the
      development of optimal timing and setting for interventions. Youth treated in the ED may have
      exacerbated rates of illicit drug use, and other risk behaviors (i.e. delinquency, HIV risk
      behaviors, weapon carriage) and different trajectories of outcomes and interactions with
      service use sectors based on presentation for intentional injury as compared to other
      complaints (medical, unintentional injuries). Understanding the outcomes and service
      utilization among inner-city youth with drug use with and without acute violent injury is
      critically important in developing prevention and treatment services to address these
      multiple risk factors. The investigators propose a prospective observational study over a
      two-year period to identify a high risk group of youth with past year illicit drug use
      (N=650) seeking care in an inner city ED. The specific aims of the study, chosen to obtain
      data necessary to determine the location and content of subsequent interventions, are: (1) To
      describe characteristics of youth (ages 14-24; n=650) who report illicit drug use presenting
      to an urban ED for an acute violent injury (n=350), compared to youth with drug use who seek
      non-violence related ED care (n=300), including demographic characteristics, problem severity
      (e.g., substance use, violence, HIV risk behaviors, etc.), enabling factors, and service
      utilization (i.e., substance use treatment, mental health, and medical); (2) To identify the
      trajectories of participants' interactions with health services during the two years
      following their ED visit and the key characteristics (i.e., predisposing, enabling, and need
      factors) associated with types of service use (substance abuse treatment, mental health, and
      medical/ ED) and barriers to these services; and, (3) To measure two-year outcomes for this
      cohort and to identify key demographic and clinical characteristics of youth with drug use,
      who have poor outcomes in the two years after ED visit for intentional injury and other
      medical care.
    


Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Patients ages 14-24 seeking treatment at the Hurley Medical Center (HMC) Emergency
        Department (ED) located in Flint, MI will be recruited for this study.