Relief of Symptoms of Post-traumatic Stress for Victims of Gun Violence

Study Overview
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Brief Summary
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To test the hypothesis that adult individuals who are victims of gun violence will have decreased symptoms of post-traumatic stress after an individual-level intervention with the Screening and Tool for Awareness and Relief of Trauma (START).

Detailed Description
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In response to the lack of targeted mental health intervention for gunshot wound survivors, the Screening and Tool for Awareness and Relief of Trauma (START) was developed for patients that come from communities with sustained and persistent trauma. It consists of six screening questions adapted from the validated Primary Care PTSD Screen,[30] with input from focus groups, surveys and in-depth interviews with victims of violence and in particular, boys and young men of color. START has been shown to be effective at decreasing symptoms of PTSD in a one-month follow-up, but it has not been piloted on recently injured victims of gun violence specifically nor has it been tested in a randomized control trial design. A better understanding of the utility of this tool and others like it in victims of violent crime for relief of symptoms of post-traumatic stress and prevention of PTSD would contribute to the larger body of literature on PTSD prevention for victims of gun violence while simultaneously addressing a major need in this community.

Official Title
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Relief of Symptoms of Post-traumatic Stress for Victims of Gun Violence:

Conditions
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PTSD, Stress, Psychological, Gunshot Wound

Intervention / Treatment
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* Behavioral: Screening Tool for Relief of Trauma (START)
* Behavioral: standard of care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Survivors of gunshot wound presenting to the Emergency room and/or admitted as inpatient that are eligible for the Violence Prevention and Outreach Program (VPOP). Exclusion Criteria: Patients with severe traumatic brain injury Children under the age of 18 Patients otherwise unable to give consent Non-English speaking patients Victims of sexual assault Patients with history of a severe mental illness and/or those already undergoing treatment for a mental illness by a licensed professional.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: START treatment<br>Participants randomized into the treatment arm will receive the START intervention as described above alongside usual care from the VPOP staff | Behavioral: Screening Tool for Relief of Trauma (START)<br>* The Screening and Tool for Awareness and Relief of Trauma (START) was developed for patients that come from communities with sustained and persistent trauma. It consists of six screening questions adapted from the validated Primary Care PTSD Screen,[30] with input from focus groups, surveys and in-depth interviews with victims of violence. The full START intervention requires 30-45 minutes of structured conversation at the end of which the participant leaves with a better understanding of trauma symptoms as well as on-the-spot instruction on a set of techniques designed to alleviate the symptoms of PTSD. Based on the results of their screening, the participant will be offered up to four techniques to alleviate their symptoms<br>|
| Active Comparator: standard of care<br>Those randomized to the control arm will receive the usual screening for PTSD and referral for outpatient services if warranted as well as usual care from VPOP staff. | Behavioral: standard of care<br>* Screening for PTSD and referral for outpatient services if warranted as well as usual care from Violence Prevention and Outreach Program (VPOP) staff.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PTSD evaluation | Post Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) | baseline | 
| Change in PTSD evaluation test scores | Post Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) A decrease in PCL-C score greater than or equal to 5 points relative to controls. | 12 weeks | 
| Change PTSD evaluation test scores | Post Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) A decrease in PCL-C score greater than or equal to 5 points relative to controls. | 6 months |