Clinical trial NCT02573480: Optimization Study of the Wraparound Care for Youth Injured by Violence Program
Official title: Optimization Study of the Wraparound Care for Youth Injured by Violence Program
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Violence
Violence, Non-accidental
Physical Violence
Keywords: youth violence, intervention, emergency medicine
Lead sponsor: University of Manitoba
Sponsor class: OTHER
First posted: 2015-10-09
Enrollment: 11
Sex: ALL
Minimum age (years): 14
Maximum age (years): 24
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This study is an optimization study to evaluate how a wraparound program for youth who have been injured by violence helps to change violence related attitudes and beliefs, change individual risk factors for violence and reduce the risk of future injury due to violence. Wraparound care involves linking the youth with a support worker who will work with the youth to develop positive support networks and help them link with services that address risk factors towards future violence.

Detailed description: In Canada, violence is the most common reason for youth (aged 12- 24) to visit an emergency department (ED) and the leading cause of hospitalization among males aged 20 to 24. Injury is a chronic, recurring disease. In Winnipeg, Canada, 20% of youth injured by violence visited the same ED in the next year with a repeat injury due to violence. Currently the standard of care for this vulnerable population is to discharge them from our EDs with no effort to prevent the next injury.

There are 5 components key to implementing wraparound care for youth who are at risk of violence. The 1st component is the establishment of a relationship between support worker and youth at the time of injury - i.e. during a teachable moment. The 2nd component is that the support worker has extensive "lived experience". Many youth affected by violence have been marginalized by society and have significant trust issues with figures of traditional power (i.e. doctors, social workers etc.). It is imperative that the support worker establish trust quickly and act as a role model. The 3rd component is that the care program is individualized for and by each youth. The support worker helps the youth to define their own goals and the steps required to achieve them. The 4th component is to provide trauma-informed care. Trauma-informed care is an approach used by caregivers that acknowledges the current and past traumas a person may have experienced and helps the person heal and build a sense of control over their lives. The final component is the opportunity to access community supports within their own culture.

Eligibility criteria: Inclusion Criteria:

1) Age 14 - 24, and 2) Presentation with an injury due to violence (defined as an injury inflicted by someone else and one caused by a gunshot wound, stab wound, blunt object, or bodily force).

Exclusion Criteria:

1) Unable to consent due to language or brain injury, 2) Sexual assault, 3) Child Abuse, 4) Self-Inflicted Injury, or 5) Transfer from hospital \> 1 hr from Winnipeg, Canada

Primary outcomes:
measure: Violence risk scores
timeFrame: 1 year post injury
Secondary outcomes:
measure: Report risk/protective factors of youth injured by violence
timeFrame: Within 1 month post injury
measure: Prevalence of post-traumatic stress disorder (PTSD) among participants
timeFrame: Within 1 month post injury
measure: Prevalence of depression/mental health conditions among participants
timeFrame: Within 1 month post injury
measure: Prevalence of adverse childhood events (ACE) among participants
timeFrame: Within 1 month post injury
measure: Prevalence of alcohol use disorder among participants
timeFrame: Within 1 month post injury
measure: Prevalence of (non-alcohol) substance use among participants
timeFrame: Within 1 month post injury
measure: Intensity-of-care measurements
timeFrame: 1 year post-injury
measure: Rate of past year and post year visits to hospital for injury/substance use/mental health
timeFrame: 1 year pre and post injury
measure: Effect of EDVIP on resilience and post traumatic growth
timeFrame: 6 months and 1 year post injury
Other outcomes:
Locations:
city: Winnipeg
country: Canada
facility: Winnipeg Health Sciences Centre
state: Manitoba
Study officials:
affiliation: University of Manitoba
name: Carolyn Snider, MD
role: PRINCIPAL_INVESTIGATOR
References: