Hospital-Based Interventions

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An emergency department (ED) visit can be an opportunity to intervene and address youth violence outcomes and risky behaviors such as violence and substance use. Each year, more than 200,000 adolescents visit the emergency room due to youth violence.

Theory

SafERteens is a brief, motivational counseling intervention for teens aged 14-20 who have been admitted to the ED and have recently been in a fight. The intervention consists of a single counseling session that combines Motivational Interviewing and Cognitive Behavioral Therapy (CBT). Through this session, the teen learns to recognize violent behaviors and develop skills in conflict resolution, violence avoidance, and safety behaviors. To reinforce these concepts, SafERteens sends text messages to youth 2 months after the intervention.

Key Findings

  • Youth experiencing violent injuries are at an increased risk for repeat violent injuries, substance use, and mental health issues 
  • SafERteens has been shown to reduce aggressive behavior for up to 12 months after intervention 
  • SafERteens has been shown to reduce severe victimization, depressive symptoms, violence consequences, and alcohol consequences 
  • Implementation of SafERteens in a single trauma center is estimated to reduce 4,200 violent events in a single year 
  • Teens who have participated in SafERteens are less likely to report aggression, victimization, and violence-related consequences than teens who did not participate in the intervention (saferteens.org)

Related Resources

Key Publications

Pelletier, K. R., Schmidt, C. J., Seewald, L., Cunningham, R. M., Zimmerman, M. A., Walton, M. A., Resnicow, K., & Carter, P. M. (2022). Understanding factors associated with firearm possession: Examining differences between male and female adolescents and emerging adults seeking emergency department care. Preventive Medicine, 107286. https://doi.org/10.1016/j.ypmed.2022.107286
Roche, J. S., Clery, M. J., Carter, P. M., Dora-Laskey, A., Walton, M. A., Ngo, Q. M., & Cunningham, R. M. (2018). Tracking Assault-injured, Drug-using Youth in Longitudinal Research: Follow-up Methods. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine. https://doi.org/10.1111/acem.13495
Ngo, Q. M., Eisman, A. B., Walton, M. A., Kusunoki, Y., Chermack, S. T., Singh, V., & Cunningham, R. (2018). Emergency Department Alcohol Intervention: Effects on Dating Violence and Depression. Pediatrics, 142(1). https://doi.org/10.1542/peds.2017-3525
Goldstick, J. E., Carter, P. M., Walton, M. A., Dahlberg, L. L., Sumner, S. A., Zimmerman, M. A., & Cunningham, R. M. (2017). Development of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence Risk. Annals of Internal Medicine, 166(10), 707–714. https://doi.org/10.7326/M16-1927
Ranney, M. L., Goldstick, J., Eisman, A., Carter, P. M., Walton, M., & Cunningham, R. M. (2017). Effects of a brief ED-based alcohol and violence intervention on depressive symptoms. General Hospital Psychiatry, 46, 44–48. https://doi.org/10.1016/j.genhosppsych.2017.01.008
Carter, P. M., Walton, M. A., Zimmerman, M. A., Chermack, S. T., Roche, J. S., & Cunningham, R. M. (2016). Efficacy of a Universal Brief Intervention for Violence Among Urban Emergency Department Youth. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 23(9), 1061–1070. https://doi.org/10.1111/acem.13021
Cunningham, R. M., Whiteside, L. K., Chermack, S. T., Zimmerman, M. A., Shope, J. T., Bingham, C. R., Blow, F. C., & Walton, M. A. (2013). Dating violence: outcomes following a brief motivational interviewing intervention among at-risk adolescents in an urban emergency department. Acad Emerg Med, 20(6), 562–569. https://doi.org/10.1111/acem.12151
Cunningham, R. M., Chermack, S. T., Zimmerman, M. A., Shope, J. T., Bingham, C. R., Blow, F. C., & Walton, M. A. (2012). Brief motivational interviewing intervention for peer violence and alcohol use in teens: one-year follow-up. Pediatrics, 129(6), 1083–1090. https://doi.org/10.1542/peds.2011-3419
Walton, M. A., Chermack, S. T., Shope, J. T., Bingham, C. R., Zimmerman, M. A., Blow, F. C., & Cunningham, R. M. (2010). Effects of a Brief Intervention for Reducing Violence and Alcohol Misuse Among Adolescents: A Randomized Controlled Trial. JAMA, 304(5), 527–535. https://doi.org/10.1001/jama.2010.1066