Published online October 31, 2008
PEDIATRICS Vol. 122 No. 5 November 2008, pp. 938-946 (doi:10.1542/peds.2007-2096)
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ARTICLE

Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial

Tina L. Cheng, MD, MPHa, Denise Haynie, PhD, MPHb, Ruth Brenner, MD, MPHc, Joseph L. Wright, MD, MPHd, Shang-en Chung, ScMa and Bruce Simons-Morton, EdD, MPHb

a Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
b Departments of Prevention Research
c National Children's Study Program Office, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
d Child Health Advocacy Institute, Children's National Medical Center, Washington, DC

OBJECTIVE. The goal was to assess the impact of a mentor-implemented, violence prevention intervention in reducing aggression, fighting, and reinjury among assault-injured youths.

METHODS. In a randomized, controlled trial performed in the emergency departments of 2 large urban hospitals, 10- to 15-year-old youths who presented with peer assault injuries were recruited and randomly assigned to intervention and comparison groups. In the intervention group, youths received a mentor, who implemented a 6-session problem-solving curriculum, and parents received 3 home visits with a health educator, to discuss family needs and to facilitate service use and parental monitoring. The comparison group received a list of community resources, with 2 follow-up telephone calls to facilitate service use. Youths and parents were interviewed at baseline and at 6 months, for assessment of attitudes about violence, risk factors, fighting, and repeat injury.

RESULTS. A total of 227 families were recruited, with 23% refusing participation and 4% providing partial interview completion. A total of 166 families were enrolled, with 87 assigned to the intervention group and 79 to the comparison group; 118 (71%) completed both youth and parent follow-up interviews, and 113 had usable data. The intervention and comparison groups were not significantly different at baseline with respect to demographic features or risk factors, except for increased knife-carrying and fewer deviant peers in the intervention group. After adjustment for baseline differences, there was a trend toward significant program effects, including reduced misdemeanor activity and youth-reported aggression scores and increased youth self-efficacy. Program impact was associated with the number of intervention sessions received.

CONCLUSIONS. A community-based, mentor-implemented program with assault-injured youths who presented to the emergency department trended in the direction of decreased violence, with reduced misdemeanors and increased self-efficacy.

Key Words: adolescent health • emergency department • fighting • injury prevention and control • youth violence

Abbreviations: ED—emergency department • CI—confidence interval • CDC—Centers for Disease Control and Prevention

Accepted Jan 30, 2008.


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