Abstract
Domestic violence risk prediction and management: A public-private partnership approach
Ya-Yun Chen1, Yu-Hsiu Wang2, Sue-Chuan Chen3, Ying-Yi Chang4, Hui-Chuan Lin5, Chien-Sheh Chou4 and T. C. Hsieh6
(1)National Yang-Ming University, Institute of brain science, Kaohsiung City, Taiwan, (2)Institute for Information Industry, Taipei, Taiwan, (3)Taipei City Center for Prevention of Domestic Violence and Sexual Assault, Taipei, Taiwan, (4)Taipei City Center for Prevention of Domestic Violence and Sexual Assault, Taipei City, Taiwan, (5)Taipei City Center for Prevention of Domestic Violence and Sexual Assault, Taipei CIty, Taiwan, (6)DSP, Inc., Taipei City, Taiwan
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background. The issue of domestic violence (DV) prevention has aroused wide concern in Taiwan because the scarce supply of social workers did not meet the demand of the reported DV cases that doubled over the past decade. Objectives. We organized a team of interdisciplinary volunteer experts and formed a public-private partnership with Taipei City Government to improve DV prevention strategies on the community-based level with a DV risk map and the individual level with a repeat victimization prediction model. Methods. Data used in this study were from the 2015 Taipei City’s DV database. We performed a spatial pattern analysis to visualize the reported DV cases and their demographic features on the DV risk map, and extracted the intimate partner violence (IPV) cases to build our prediction model using random forest algorithm. Results. The DV risk map showed that children/adolescent cases had the greatest proportion of victims from low- and middle-income families while elderly protection and inter-sibling and others cases had larger proportion of victims with disabilities or mental illness. For our prediction model, the average accuracy and recall rate were 96.3% and 88.9%, indicating a high performance accuracy and sensitivity of the model. Conclusion. Through the joint efforts between public and private sector, this study can significantly reduce the overload of social work by visualizing the distribution of different DV case types on the risk map to generate corresponding prevention strategies as well as assisting front-line social workers in identifying the risk level of new cases to prevent future victimization.
Administration, management, leadership Communication and informatics Other professions or practice related to public health Social and behavioral sciences
Abstract
Avoiding Fist Fights: Assessing the Relationship Between Fighting and Self-Efficacy Among Assault-Injured Youth Who Visit the Emergency Department
Merissa Yellman, MPH1, Vanya Jones, PhD, MPH2, Tina L. Cheng, MD, MPH3, Sarah Lindstrom Johnson, PhD4, Leticia Ryan, MD, MPH5 and Joel Fein, MD, MPH6
(1)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (2)Johns Hopkins University, Baltimore, MD, (3)Johns Hopkins University School of Medicine, Baltimore, MD, (4)Arizona State University, Tempe, AZ, (5)The Johns Hopkins Hospital, Baltimore, MD, (6)The Children's Hospital of Philadelphia, Philadelphia, PA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
The purpose was to determine the role that self-efficacy may play regarding the number of physical fights in a 30-day period among assault-injured youth under a variety of demographic and contextual factors.
Baseline survey assessments were administered to 186 youth (ages 10-15) treated in two mid-Atlantic Emergency Departments for assault injuries experienced in a physical fight with other adolescents. Youth were asked about demographic characteristics, their self-efficacy in avoiding fights, parental attitudes regarding fighting, and exposure to neighborhood violence. A Poisson regression was utilized to understand the relationship between self-efficacy and number of fights in the past month. Interactions were included to model possible moderation by contextual characteristics (i.e., parental attitudes and exposure to violence).
The mean number of reported monthly fights was 0.87 (SD=2.52). In the final model, age was significantly associated with 16% fewer monthly fights (adjusted incidence rate ratio [AIRR], 0.84; CI 0.75 to 0.94; p=0.002). The association between positive self-efficacy and 26% fewer monthly fights trended significant (AIRR, 0.74; CI, 0.52 to 1.06; p=0.100). Parental attitudes discouraging fighting were significantly associated with 30% fewer monthly fights (AIRR, 0.70; CI, 0.5 to 0.84; p<0.001). There was a significant positive interaction between self-efficacy and parental attitudes about violence (p=0.03).
Self-efficacy appears to be an important determinant in youth involvement in fighting. It also seems to be supported by parental attitudes. This suggests that interventions focused on helping parents encourage their high-risk youth to avoid fights could bring about positive self-efficacy among youth and further reduce violent fighting behaviors.
Public health or related research Social and behavioral sciences
Abstract
Opioid overdose deaths among former inmates in North Carolina: 2000-2015
Shabbar Ranapurwala, PhD, MPH1, Meghan Shanahan, PhD2, David Edwards, MRP3 and Scott Proescholdbell, MPH4
(1)University of North Carolina, Chapel Hill, Chapel Hill, NC, (2)University of North Carolina at Chapel Hill, Chapel Hill, NC, (3)North Carolina Department of Public Safety, (4)NC Division of Public Health, Injury and Violence Prevention Branch, Raleigh, NC
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
The ongoing opioid epidemic is adversely affecting all Americans. Most vulnerable among us, and likely the most overlooked, are the former inmates. Prior studies suggest that opioid overdose mortality is ten times higher among former inmates than the general population. In this study, we examine the rates of opioid overdose death (ODD) among former North Carolina (NC) inmates from 2000 to 2015, compare them to the general population, and identify predictors of post-release overdose death. We linked 2000-2015 prisoner release data from the NC Department of Public Safety to 2000-2015 NC death records using soundex codes for names, birth date, and sex. Opioid overdoses were identified using ICD-10CM codes. We calculated 1-year post-release ODD rates among former inmates to compare with annual NC rates, and calculated weekly and monthly rates to identify predictors of overdose death among former inmates. From 2000-2015, 237,455 prisoners were released and 12,237 died post-release, of whom 1,104 died of an opioid overdose-related death. The opioid overdose mortality rate among former inmates increased from 53 per 100,000 person-years in 2000 to 216 per 100,000 person-years in 2014, compared to 3.3 to 9.2 per 100,000 person-years, respectively, in the general NC population. Opioid overdose mortality rates were highest during the first two weeks after release, and among former inmates who were 26-50 years of age, men, White, had three or more prior prison terms, and received long term substance abuse and mental health treatment while incarcerated. Former inmates are highly vulnerable population and need urgent prevention measures.
Epidemiology Protection of the public in relation to communicable diseases including prevention or control Public health or related organizational policy, standards, or other guidelines Public health or related research
Abstract
Violence in four types of intimate relationships: Policy implications of gun use by unmarried intimate partners
Susan B. Sorenson, PhD and Devan Spear
University of Pennsylvania, Philadelphia, PA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background. Romantic and sexual pairings have changed in recent decades in terms of marriage age, cohabitation patterns, and childbearing. Little research has examined intimate partner violence (IPV) prevalence in current and former adult dating relationships.
Methods. We examined assaultive behaviors by the type and status of the relationship – i.e., current marital, former marital, current non-marital, and former non-marital relationships – in a retrospective cohort study of 31,206 IPV incidents responded to by police. Bivariate and multivariate analyses were undertaken after diagnostic statistical tests were conducted.
Results. Over 80% of the IPV incidents involved individuals in non-marital relationships: 44.3% involved current non-marital partners, 37.8% involved former non-marital partners. Incidents involving current non-marital partners had the highest percentage of every violent behavior examined: pushing and shoving, grabbing, hair pulling, slapping, punching, kicking, biting, strangling, and throwing objects. When covariates were taken into account, victims in current non-marital partnerships were more likely than current spouses to have visible injuries (AOR=1.30).
Although bivariate analyses indicated that gun use was about twice as common when the offender was a former non-marital partner, multivariate analyses documented no differences in gun use by type of relationship.
Conclusions and implications. Findings suggest that non-marital partners present risks in terms of assault and injury due to IPV. Nonfatal gun use, associated with heightened victim fear, does not differ by the type of relationship (i.e., current or former, marital or non-marital). Findings provide no evidence for provision of a “boyfriend loophole” in federal gun laws related to domestic violence.
Public health or related public policy Public health or related research Social and behavioral sciences
Abstract
Risk of readmission after firearm and motor vehicle injury
Bindu Kalesan, PhD MPH1, Yi Zuo, MPH1, Ramachandran Vasan, MD2 and Sandro Galea, MD, DrPH3
(1)Boston University School of Medicine, Boston, MA, (2)Boston University Schools of Medicine and Public Health, Boston, MA, (3)Boston University School of Public Health, Boston, MA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Annually, about 75,000 Americans survive firearm injury. Consequences of surviving firearm violence has not been investigated adequately. We compared the risk of hospital readmission, hospitalization length of stay (LOS) and costs within 90-days after surviving an index firearm injury versus pedestrians and occupants involved in motor vehicle crash (MVC) using 2013 and 2014 Nationwide Readmission Database.
Methods: The primary outcome was time-to-first all-cause readmission within 90-days after discharge from index hospitalization. Secondary outcomes were length of stay (LOS) in days and costs related to readmission.
Results: There were 3,334 (10.5%), 3,818 (10.6%) and 24,672 (9.4%) firearm injury, pedestrian, and occupant MVC readmissions within 90-days. The risk of 90-day readmission among firearm was 20% (HR=1.20, 95%CI=1.09-1.32) and 34% (HR=1.34, 95%CI=1.26-1.44) greater than the MVC patients. The primary causes of firearm readmission were surgical complications, intestinal disorders and open wounds. The mean total costs were lower among firearm versus occupant patients ($9,357 versus $11,032, p=0.028) but mean total LOS was greater (4.48 versus 4.38 days, p=0.003). Medicaid insured firearm as compared to occupant patients had longer LOS at a total lower cost during index injury while increased LOS and lower costs of 90-day readmissions were irrespective of insurance.
Conclusions and Relevance: Patients surviving a firearm injury have a substantial risk of subsequent hospitalizations, higher than pedestrian or occupant MVC injuries. Medicaid is disproportionately burdened by the costs of treatment of firearm injury.
Clinical medicine applied in public health Conduct evaluation related to programs, research, and other areas of practice Epidemiology Public health or related research