Hospital-Based Trauma-Services Intervention for Gunshot Victims

Background/Purpose.  The US faces substantial firearm violence (3.55 fatal and 19.68 nonfatal gunshot injuries per 100,000 [2013]). We developed an intervention to test whether meeting the service needs of gunshot victims and their social contacts lowers the risk of subsequent violence.

Methods. GRIPS, “Gunshot Reoccurring Injury Prevention Services,” is a peer-to-peer intervention that adapts the National Network of Hospital-based Violence Intervention Programs model. It involves contact with gunshot victims in the hospital directly after a shooting and follow-up for case management and mentoring. Interventionists arrange service linkages monthly. Participants complete a baseline and 6-month interview and are tracked for repeated hospitalization and criminal justice outcomes.

Results/Outcomes: All four Level I hospital trauma centers in Allegheny County, PA have agreed to participate. In its first 8 months, the project has enrolled 33 gunshot victims, roughly a quarter of those eligible. 91% are African-American, 69% completed high school, and 76% are unemployed; 15% report gang membership, 45% selling drugs, and 33% carrying a gun. 30% meet criteria for depressed mood or PTSD. One-third has dropped out after baseline contact.  Participants sought an average of 10 services involving health, housing, education, employment, family, or legal issues. To date, one (3%) has had readmission to the hospital for assault and four (12%) have been arrested.

Conclusions. Intervention in the hospital trauma services is acceptable to a substantial proportion of gunshot victims.  Maintaining follow-up and completing service linkages is challenging.  Follow-up will determine if this model decreases firearm violence and emergency department recidivism relative to nonparticipants.