Dataset Information

Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments.

ABSTRACT: Strengths-based strategies to reduce youth violence in low-resource urban communities are urgently needed. Supportive adolescent-adult relationships may confer protection, but studies have been limited by self-reported composite outcomes. We conducted a population-based case-control study among 10- to 24-year-old males in low-resource neighborhoods to examine associations between supportive adult connection and severe assault injury. Cases were victims of gunshot assault injury (n?=?143) and non-gun assault injury (n?=?206) from two level I trauma centers. Age- and race-matched controls (n?=?283) were recruited using random digit dial from the same catchment. Adolescent-adult connections were defined by: (1) brief survey questions and (2) detailed family genograms. Analysis used conditional logistic regression. There were no significant associations between positive adult connection, as defined by brief survey questions, and either gunshot or non-gun assault injury among adolescents with high prior violence involvement (GSW OR?=?2.46, 95% CI 0.81-7.49; non-gun OR?=?1.59, 95% CI 0.54-4.67) or low prior violence involvement (GSW OR?=?0.92, 95% CI 0.34-2.44; non-gun OR?=?1.96, 95% CI 0.73-5.28). In contrast, among adolescents with high levels of prior violence involvement, reporting at least one supportive adult family member in the family genogram was associated with higher odds of gunshot assault injury (OR?=?4.01, 95% CI 1.36-11.80) and non-gun assault injury (OR?=?4.22, 95% CI 1.48-12.04). We were thus unable to demonstrate that positive adult connections protected adolescent males from severe assault injury in this highly under-resourced environment. However, at the time of injury, assault-injured adolescents, particularly those with high prior violence involvement, reported high levels of family support. The post-injury period may provide opportunities to intervene to enhance and leverage family connections to explore how to better safeguard adolescents.

SUBMITTER: Culyba AJ

PROVIDER: S-EPMC5993693 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments.

Culyba Alison J AJ Miller Elizabeth E Ginsburg Kenneth R KR Branas Charles C CC Guo Wensheng W Fein Joel A JA Richmond Therese S TS Halpern-Felsher Bonnie L BL Wiebe Douglas J DJ

Journal of urban health : bulletin of the New York Academy of Medicine 20180601 3

Strengths-based strategies to reduce youth violence in low-resource urban communities are urgently needed. Supportive adolescent-adult relationships may confer protection, but studies have been limited by self-reported composite outcomes. We conducted a population-based case-control study among 10- to 24-year-old males in low-resource neighborhoods to examine associations between supportive adult connection and severe assault injury. Cases were victims of gunshot assault injury (n = 143) and non ...[more]

PMID: 29700679

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Project description:INTRODUCTION:Violence is a leading cause of morbidity and mortality for youth, with more than 600,000 emergency department visits annually for assault-related injuries. Risk for criminal justice involvement among this population is poorly understood. The objective of this study was to characterize arrests among high-risk, assault-injured, drug-using youth following emergency department treatment. METHODS:Youth (aged 18-24 years) with past 6-month drug use who were seeking emergency department treatment for either an assault or for non-violence reasons were enrolled (December 2009-September 2011) in a 2-year longitudinal study. Arrests in the 24 months following the emergency department visit were analyzed in 2016-2017 using survival analysis of objective Law Enforcement Information Network data. Hazard ratios quantifying the association between risk factors for arrest were estimated using Cox regression. RESULTS:In the longitudinal cohort, 511 youth seeking emergency department care (assault injury group n=299, comparison group n=212) were aged ?18 years and were included for analysis. Youth in the assault injury group cohort had a 47% higher risk of arrest than the comparison group (38.1% vs 25.9%, RR=1.47, p<0.05). In unadjusted analyses, male sex, assault injury, binge drinking, drug use disorder, and community violence exposure were all associated with increased risk of arrest during the follow-up period. Cox regression identified that male sex (hazard ratio=2.57), drug use disorder diagnosis (hazard ratio=1.42), assault injury at baseline (hazard ratio=1.63), and community violence exposure (hazard ratio=1.35) increased risk for arrest. CONCLUSIONS:Drug-using assault-injured youth have high rates of arrest. Emergency department and community interventions addressing substance use and violence involvement may aid in decreasing negative violence and criminal justice outcomes among high-risk youth. TRIAL REGISTRATION:This study is registered at www.clinicaltrials.gov NCT01152970.

Project description:ImportanceMale youth in lower-resource neighborhoods bear a disproportionate burden of violence involvement, but little is known about clusters of specific violence-related behaviors to inform cross-cutting interventions that address multiple forms of violence.ObjectiveTo examine associations between adult support and patterns of violence and risk or protective behavior co-occurrence among male youths in urban neighborhoods.Design, setting, and participantsCross-sectional analysis of baseline and end-of-program data from a recently completed cluster-randomized sexual violence prevention trial across 20 lower-resource neighborhoods. Participants were male youths, aged 13 to 19 years, enrolled at youth-serving community agencies in Pittsburgh, Pennsylvania, from July 27, 2015, to June 5, 2017. Data were analyzed from July 1, 2018, to February 28, 2019.ExposuresSocial support and natural mentoring, as defined by validated survey measures.Main outcomes and measuresValidated survey measures (youth violence, bullying, sexual and dating violence, history of exposure to violence and related adversities, substance use, school engagement, and future orientation) were assessed for detailed co-occurrence patterns using hierarchical clustering, dendrograms, and heatmaps across prespecified domains. Wilcoxon rank sum tests and logistic regression models examined associations between adult support and violence involvement.ResultsAmong 866 participants, the mean (SD) age was 15.5 (1.6) years and 632 participants (77.5%) identified as African American. All 866 participants completed baseline surveys and 577 completed end-of-program surveys. Seven clusters of risk and protective behaviors emerged: (1) school engagement; (2) career and future aspirations; (3) substance use and bullying exposure; (4) exposure to violence and related adversities, sexual violence exposure, peer delinquency, and gang involvement; (5) sexual violence, youth violence, and bullying perpetration; (6) dating abuse perpetration; and (7) physical or sexual partner violence perpetration. The strongest association cluster occurred among sexual violence perpetration behaviors. Youth with high social support engaged in significantly fewer of the 40 prespecified risk behaviors (high social support median [interquartile range], 8 [5-12] behaviors vs low social support median [interquartile range], 10 [6-14] behaviors; mean difference, 1.64 behaviors; 95% CI, 0.63-2.64 behaviors; P = .004). High social support and natural mentoring were both inversely associated with gang involvement (social support: odds ratio [OR], 0.39; 95% CI, 0.22-0.71; and natural mentoring: OR, 0.44; 95% CI, 0.25-0.76) and sexual violence exposure (social support: OR, 0.39; 95% CI, 0.24-0.64; and natural mentoring: OR, 0.61; 95% CI, 0.39-0.98).Conclusions and relevanceThese findings suggest that co-occurrence of risk and protective behaviors differ significantly among youth with vs without adult support. Violence prevention interventions designed to leverage adult support should address broader co-occurrence patterns.

Dataset Information

Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments.

Publications

Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments.

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