Aggression Clinical Trial
Study Aims: 1) Assess the receptiveness of youth and families to injury prevention interventions initiated from the emergency department; 2) In a sample of high risk youth presenting to the ED with interpersonal assault injuries, determine the effectiveness of a home-based family intervention with community linkage compared to a control group.
The leading causes of death among U.S. children and adolescents are due to injuries. In the
US, homicide is the third leading cause of death for 10-14 year olds and second leading
cause of death for those 15-19 years. For African-Americans, homicide is the leading cause
of death for males and females ages 15-34. Findings from our city-wide surveillance of
adolescent injuries have found that for every death due to injury in youth, there were 8
hospitalizations and 102 ED visits. Non-fatal injuries represent significant morbidity and
may be a sentinel event and opportunity for prevention.
Assault-injured patients age 9-15 and their families seen in the ED or hospitalized will be
recruited into the study. Whenever possible, families will be recruited while they are still
in the hospital, others will be contacted by phone. We will randomize families to an
intervention group consisting of home visits involving a four session parental monitoring
curriculum for parents and a 6-8 session mentoring and problem solving curriculum for youth
occurring over 2-6 months. Both intervention and control groups will receive community
referrals to needed services. Interview assessments of parents and youth will occur in
person at baseline and 6 months, and by phone at 12 and 18 months after recruitment.
Assessments will include face to face and Walkman questioning, and phone questioning with
DigitGrabber touch tone response. The parent and youth assessments will include detail on
cause of injury, past experience risk factors, protective factors, perceived risk and
self-efficacy. Medical chart abstraction will be performed and aggregate data will be
obtained from the police department about the number of youth in the intervention and
control groups that have had contact with the police. We intend to recruit up to 400
families over 2-3 years in order to achieve follow-up with at least 198 families. Human
Subjects: Male and female adolescents 9-15 years of age and their parents who are residents
of the Washington Metropolitan area will be eligible for participation. Written parental
consent and youth assent will be obtained. There are no physical risks. Potential risks
include unintentional uses of the information gathered including disclosure of information
that may be potentially legally incriminating. All efforts will be made to protect
participant confidentiality. If information is revealed that places someone in immediate
danger, disclosure may be necessary which is explained in the consent form. There are
potential benefits including facilitated referral for therapeutic community-based
intervention, access to an intervention of demonstrated effectiveness without cost, and cash
incentives. In addition, they will contribute to knowledge about youth injury in the
community.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Prevention
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