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Are ED-based violence intervention programmes effective in reducing revictimisation and perpetration in victims of violence? A systematic review
  1. James Matthew Brice1,
  2. Adrian A Boyle2
  1. 1 University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge, UK
  2. 2 Emergency Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Adrian A Boyle, Emergency Department, Addenbrooke’s Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 2QQ, UK; adrian.boyle{at}addenbrookes.nhs.uk

Abstract

Objectives Community violence bears significant human and economic costs. Furthermore, victims requiring ED treatment are at a greater risk of violent reinjury, arrest due to perpetration and violent death. We aimed to evaluate the effectiveness of ED-based violence intervention programmes (EVIPs), which aim to reduce future violence involvement in these individuals.

Methods We performed a systematic literature review searching MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, The Cochrane Library and Web of Science, in addition to hand-searching. Randomised controlled trials (RCTs) were included if they enrolled victims of community violence requiring ED treatment, evaluated interventions taking place in the ED and used violent revictimisation, arrests or intermediate outcome measures as endpoints. We included trials that had a Jadad score of 2 or above.

Results 297 records were identified, and 13 articles were included in our final qualitative analysis, representing 10 RCTs and 9 different EVIPs. The risk of selection bias was low; the risk of performance, detection and attrition bias was moderate. 9 out of 13 papers reported statistically significant improvements in one or more outcome measures related to violence, including violent reinjury and arrests due to violence perpetration.

Conclusion The results of this literature review show that EVIPs may be capable of reducing violent reinjury and arrests due to violence perpetration. Larger RCTs, taking place in different regions, in different age groups and using different techniques, are justified to determine which conditions may be required for success and whether EVIPs are generalisable.

  • violence
  • emergency department
  • trauma
  • non accidental injury
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Footnotes

  • Handling editor Ellen Weber

  • Twitter @dradrianboyle

  • Collaborators James Matthew Brice; Adrian Boyle.

  • Contributors AAB outlined the aim of the literature review, provided guidance on how to conduct the review and he also proofread the completed manuscript. I, JMB, performed the literature review, compiled all figures and tables and wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Press release Yes.

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