Helping Individuals With Firearm Injuries

Summary

The investigators will conduct a cluster randomized trial of an intervention program that combines a hospital-based intervention, structured outreach program, and multi-agency attention. The goal of the study is to test the effect of this multi-component intervention on criminal activity, injury, substance abuse, mental health, quality of life, violent behavior, and death.

Investigators aim to enroll a total of 300 patients admitted to the Harborview Medical Center (HMC) for firearm-related injuries. Patients will be randomized to receive a multi-component intervention or treatment as usual. All participants will complete surveys at the time of study consent (baseline) and then at designated time points for 12 months post-consent. Study staff will routinely collect participant records from Washington State Patrol records, HMC medical records, Washington State trauma registry, Washington State Emergency Department Information Exchange, Administrative Office of the Courts, and vital records. The investigators will test the impact of the intervention against standard care. The hypothesis is that participants in the intervention group will see greater improvements in aforementioned outcomes than those in the control group.

Conditions

• Wounds, Gunshot

Interventions

BEHAVIORAL

Critical Time Intervention

The Critical Time Intervention approach strengthens an individual's long-term ties to services, family and friends as well as provides emotional and practical support to individuals during the critical time of transition back to the community. CTI contains three phases: Phase 1 - The Support Specialist gets to know the individual, assesses the individual's need and implements a transition plan intended to link the individual to services and supports in the community. Phase 2 -- The Support Specialist monitors and adjusts the systems of support that were developed in Phase 1. Phase 3 -- The Support Specialist helps the individual develop and implement a plan to achieve long-term goals and finalizes the transfer of responsibilities to caregivers and community providers.

OTHER

Treatment as Usual

Services provided by HMC physicians and staff that are part of standard care for patients with firearm-related injuries. This care could include: 1. All necessary medical care and scheduled follow-ups with subspecialty services 2. Evaluation by social work with referral to appropriate community services 3. Screening for alcohol use 4. Discharge planning services 5. Financial counseling

BEHAVIORAL

Motivational Interviewing

A brief intervention to elicit the goals and needs of participants. As needed, this will included referrals to community resources.

OTHER

Multi-Agency Attention

Intervention cases will receive attention from a multidisciplinary team of professionals. This team will help the study Support Specialist identify service recommendations and provide case management guidance.

Sponsors & Collaborators

• U.S. Department of Justice

  collaborator FED

• City of Seattle

  collaborator UNKNOWN

• Arnold Ventures

  collaborator UNKNOWN

• University of Washington

  lead OTHER

Principal Investigators

• Ali Rowhani-Rahbar, MD, MPH · University of Washignton

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-03-23

Primary Completion

2019-06-30

Completion

2019-12-31

Countries

• United States

Study Locations