# Identifying the causal mechanisms of a hospital-based violence intervention program.

> **NIH NIH R03** · CASE WESTERN RESERVE UNIVERSITY · 2021 · $80,500

## Abstract

ABSTRACT
Black and Latinx youth bear an unequal burden of adversity and trauma and are over-represented in
emergency departments with severely violent injuries and gunshot wounds, which have long-reaching
developmental impacts on their health and well-being, including an increased risk of revictimization, retaliatory
actions, and death. Efforts to address the tragic nature and profound effects of youth's severe violence
exposure have resulted in an emerging standard of care in which hospital-based violence intervention
programs (HVIPs) provide case management services upon hospital discharge. Yet, few studies have
examined causal mechanisms facilitating the reduction of revictimization and the promotion of well-being
among violence-exposed youth in HVIPs. Limitations stymieing the HVIP field include underdeveloped
guiding theoretical orientations, a narrow scope of risk and protective factors under study, and measurement
limitations of patient data and comparison groups. Our proposed research will integrate secondary data to
examine novel risk and protective factors grounded in a trauma and resilience framework that may prevent
future victimization, juvenile delinquency, and poor school performance among 6–15-year-olds exposed to
severe assaults and gunshot wounds. The Antifragility Initiative (AI) is a newly developed HVIP that provides
case management services, focusing on the promotion of resilience and posttraumatic growth (PTG) with
violence-exposed youth for 12 months post-violent injury. It is the first intervention designed to promote PTG
with this population. Given the early stage of program development, we will test (Aim 1) the hypothesis that
fewer adverse childhood experiences (ACEs), and higher rates of resilience and PTG among youth
participating in AI will significantly predict lower rates of violent victimization recidivism and juvenile
delinquency and better academic outcomes when controlling for developmental risk factors, using a
longitudinal, prospective design. We will also (Aim 2) employ propensity score matching techniques to
examine if HVIP-participant youth have lower rates of violent victimization recidivism and juvenile delinquency
and better academic outcomes compared with a matched comparison group at 12 months post-hospital
admission. Secondary data include youth self-report on resilience, post-traumatic growth (PTG), and ACEs
collected at baseline, 6, and 12 months; hospital records; and longitudinal, prospective social service records
of adversity and social complexity indicators beginning at birth from a comprehensive integrated data system.
This study will be the first to advance a trauma and resilience framework using a unique longitudinal,
integrated dataset to evaluate a program aimed at behavioral and health promotion for youth of color in
pediatric emergency care, and will serve as a stepping stone for future studies. This study aligns with the
Pediatric Trauma and Critical Illness Branch's priority to exami...

## Key facts

- **NIH application ID:** 10221761
- **Project number:** 5R03HD102452-02
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Laura Aisha Voith
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $80,500
- **Award type:** 5
- **Project period:** 2020-07-22 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10221761

## Citation

> US National Institutes of Health, RePORTER application 10221761, Identifying the causal mechanisms of a hospital-based violence intervention program. (5R03HD102452-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10221761. Licensed CC0.

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