Linking hospital-based violence intervention program implementation with patient-reported outcomes

BACKGROUND: Understanding patient perspectives on the short-term impact of hospital-based violence intervention programs (HVIPs) is crucial to providing patient-centered care. However, HVIP evaluations often fail to integrate patient-reported outcomes (PROs), relying predominately on distal outcomes (e.g., reinjury, fatality) captured by administrative data sources to determine impact. We aimed to examine how observable program implementation metrics may be related to PROs, including satisfaction with and short-term impacts of a pediatric HVIP. 

METHODS: We conducted a retrospective cohort study of 357 patients (ages 8-18 years) who participated in our HVIP located within an urban pediatric trauma center. We linked HVIP implementation metrics from case management records and PROs to proxy caregiver-reported satisfaction and outcome data from the HVIP-Client Satisfaction Questionnaire (HVIP-CSQ). We summarized patient demographic and injury characteristics, as well as program implementation metrics and HVIP-CSQ responses. We conducted multivariate linear regression analyses to examine associations between implementation metrics and caregiver-reported satisfaction and outcomes. 

RESULTS: Patients with (n = 199) and without PROs data (n = 158) had similar demographic, clinical, and HVIP implementation characteristics, though those with PROs were more likely to have been retained in HVIP vs. being lost to follow-up (59% vs. 47%, p = 0.039). Overall, caregivers indicated high satisfaction with program services, improved well-being, increased knowledge of community resources, and self-efficacy to apply new skills and tools. Nearly all PROs were positively associated with HVIP retention and need resolution (p < 0.050). 

CONCLUSIONS: We observed high levels of caregiver-reported satisfaction with program experiences and short-term outcomes following HVIP participation. Families' positive PROs were associated with measurable aspects of HVIP implementation, including retention and need resolution. This work expands our understanding of short-term impacts of HVIPs from the perspectives of patient families and helps to establish key metrics of program implementation that may influence these outcomes.