Integrating Firearm Injury Prevention into Health Care Proceedings of a Joint Workshop of the National Academies of Sciences, Engineering, and Medicine; Northwell Health; and PEACE Initiative (2022) / Chapter Skim
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4 Barriers and Facilitators to Implementing Hospital-Based Firearm Injury Prevention Strategies in Urban and Rural Communities
4 Barriers and Facilitators to Implementing Hospital-Based Firearm Injury Prevention Strategies in Urban and Rural Communities
Pages 31-44
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From page 31... ...
IMPLEMENTING FIREARM SAFETY PROMOTION PROGRAMS IN PEDIATRIC PRIMARY CARE Rinad Beidas opened the session with a position statement, noting that she identifies as an implementation scientist. That, she explained, means that she uses insights from behavioral economics and implementation science to make it easier for clinicians, leaders, and organizations to use best practices to improve the quality and equity of care and enhance health outcomes.
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From page 32... ...
If the answer is no, the next step is to do effectiveness research in the real world, and again, that by itself is not implementation science. If that study aims to understand implementation barriers or facilitators or implementation processes, that is something that implementation scientists call a hybrid effectiveness–implementation trial.
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From page 33... ...
She explained that the firearm safety promotion team is trying to understand scientifically how to implement an evidence-based firearm storage program in pediatric primary care as a universal suicide prevention strategy and promote it across health systems nationally. The problem to address, she said, is that suicides are increasing among young people in the United States (Curtin et al., 2018)
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From page 34... ...
. HOSPITAL AND COMMUNITY VIOLENCE INTERVENTION PROPAGATION IN THE SOUTH: UNIQUE NEEDS, CONSIDERATIONS, AND CHALLENGES The experience of firearm violence, specifically homicide and assault, is different in the South relative to the rest of the nation (Figure 4-2)
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. What makes Charleston and South Carolina different, said Hink, is that there are no dedicated state funds for violence intervention, no use of American
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Rescue Plan funds for community-based or hospital-based violence intervention, no Medicaid expansion, limited city or county investment in violence prevention, and some of the least stringent firearm laws in the United States. Hink said: Not only are we struggling to find ways to actually pay for this work, but almost 70 percent of our victims of violence do not have health insurance, and so we see major barriers to care and access after they are injured and need ongoing care and support.
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From page 37... ...
In doing their work, they have support from injury prevention coordinators, as well as liaisons in pediatrics, pediatric surgery, and emergency medicine. In addition, her team has part nered with many local organizations to provide a wide range of long-lasting services and wraparound support for patients ages 12 to 30 with risks for, or injuries from, community violence in the Charleston tricounty area.
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From page 38... ...
Hink noted that the City of Charleston is going through a revitalization effort that is changing the landscape of low-income housing, improving parks, creating green spaces, and renovating public housing units. Using data on violence at the neighborhood level, the Turning the Tide Violence Intervention Program focuses on areas that have the highest number of assaults involving firearms and partners with Youth Advocate Programs, Inc.
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From page 39... ...
The next year, Temple University Hospital launched the Cradle to Grave program with the goal of deglamorizing gun violence through an immersive experience that would enable young people to appreciate the real-life consequences of gun violence without them having to suffer those consequences firsthand.3 The program brings young people into the hospital for a 2-hour presentation that includes discussions about the real-life events surrounding the shooting death of a local teenager. Young participants also visit the trauma bay, where medical staff explain the procedures they undertake to try to save a shooting victim's life.
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From page 40... ...
Jacobs told him that in the decades since his release from prison, he had devoted his life to helping returning citizens reintegrate into society and trying to prevent gun violence. He was calling that day because he and others from his community were tired of watching helplessly as they waited for assistance to arrive for young people who had been shot.
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From page 41... ...
Community members, he said in closing, typically have the very insights that "we at large institutions will devote countless hours and endless amounts of money trying to gain," yet authentically integrating the commu nity voice and perspective into gun violence interventions is one of the most persistent challenges to overcome. ACCLIVUS VIOLENCE PREVENTION SERVICES Acclivus' mission, explained Sheila Regan, is to support community health and well-being for Chicago-area populations that are at risk for violence and other negative health outcomes.
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Recently, she added, the company received a grant from the state of Illinois to provide violence prevention training across the state to different service providers. The company performs its community violence prevention work at seven sites across Chicago.
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When Campbell asked how they managed to get a line item in the state budget, Regan replied that it was through the organization's commitment to advocacy and building strong relationships with state leadership. "They know us, they know we are accountable, and that we are going to do right by every dime," said Regan.
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From page 44... ...
." Campbell asked the panelists how they keep politics out of their discussions with local groups. Regan replied that "a true public health campaign is not about which [political]
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