TOP 65 - Breaking the Cycle: Outcomes of Pediatric Patients with Penetrating Injuries in a Hospital-Based Violence Intervention Program

Publication Number: 1824.TOP 65

Emma Strode, Children's Wisconsin/Medical College of Wisconsin, Milwaukee, WI, United States; Tyler Lennon, Medical College of Wisconsin, Milwaukee, WI, United States; Michael L. Levas, Medical College of Wisconsin, Pewaukee, WI, 53072, WI, United States; Katherine Flynn-O’Brien, Children's Hospital of Wisconsin, Milwaukee, WI, United States; Mark Nimmer, Children's Wisconsin, Milwaukee, WI, United States; Carisa Bergner, Medical College of Wisconsin, Wauwatosa, WI, United States

Background: Firearm-related injuries are now the leading cause of death for individuals ages 0–24 in the United States. These and other penetrating injuries disproportionately affect children from disadvantaged communities, reflecting systemic influences and socioeconomic disparities. Experiencing interpersonal violence also influences the likelihood of re-exposure to violence and recidivism, perpetuating a cycle of violent reinjury. Hospital-Based Violence Intervention Programs (HVIPs) provide trauma-informed, multidisciplinary care to disrupt this cycle and address psychosocial risk factors. Our Children's Hospital sponsors a Hospital-Based Violence Intervention Program specifically serving youth ages 7–18 with violence-related injuries through bedside crisis intervention, advocacy, and wraparound services addressing medical, mental health, and social needs. While HVIPs have demonstrated success in reducing recidivism among adults and older adolescents, evidence in younger pediatric populations, specifically children under 10 years old, remains limited. This study seeks to expand the evidence for pediatric-specific HVIPs and to inform hospital policies, resource allocation, and encourage program development.

Objective: This study aims to compare outcomes among pediatric patients with penetrating injuries enrolled in a Hospital-Based Violence Intervention Program versus those not enrolled. Primary objectives include evaluating the HVIP’s impact on 12-month and 24-month recidivism rates, healthcare utilization, follow-up engagement, and mental health outcomes. Secondary objectives plan to assess how the level of engagement in the HVIP, including time enrolled and services received, correlates with these outcomes.

Design/Methods: This IRB approved, retrospective cohort study, includes patients ages 0–18 years presenting to a Level I Pediatric Emergency Department with a gunshot or stab wound between 01/01/2018 and 12/31/2024. Initial data collection was completed using electronic medical records and the HVIP's case management system, Osnium, yielding approximately 1400 records. Differences between HVIP participants and a non-participant control group are the primary outcomes of interest that will be analyzed using appropriate statistical methods. Among HVIP participants, outcomes will be assessed in relation to level of engagement. Statistical analysis is expected to be completed by December 2025.