Translating Violence Prevention Programs from Research to Practice: SafERteens Implementation in an Urban Emergency Department
Carter PM, Cunningham RM, Eisman AB, Resnicow K, Roche JS, Cole JT, Goldstick J, Kilbourne AM, & Walton MA. (2022). Translating Violence Prevention Programs from Research to Practice: SafERteens Implementation in an Urban Emergency Department. The Journal of Emergency Medicine, 62(1), 109–124. https://doi.org/10.1016/j.jemermed.2021.09.003
This study examined the translation of SafERteens, an evidence-based violence prevention program, into clinical care. Implementation of the program was piloted in an emergency department (ED) hospital setting with youth (14-18 years old) who screened positive for recent aggression during an ED visit. Youth participants were randomized to SafERteens (delivered remotely by study therapists or in-person by hospital staff) or enhanced usual care. The SafERteens intervention is a 30–45-minute brief behavioral intervention that integrates motivational interviewing for cognitive behavioral strategies. Participants also received an optional 2-month tailored text messaging program on self-efficacy, reminders on their goals, and tools to avoid violence. Data was collected from hospital staff on implementation facilitators and barriers using the RE-AIM framework. SafERteens completion rate was found to be 77.6% for remote delivery and 49.1% for in-person delivery. The SafERteens and tailored text messaging demonstrated high acceptability among youth; 84.9% of participants found it helpful. After the intervention, participants reported increased self-efficacy to avoid fighting and decreased pro-violence attitudes compared to baseline. Hospital staff reported a number of barriers to implementation such as limited staff availability and lack of reimbursement for staff time to conduct intervention delivery. Remote delivery of SafERteens can be a promising strategy to overcome resource limitations. Results demonstrate that policymakers should continue to expand reimbursement mechanisms in hospitals for violence screening and interventions.