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Penn Medicine CAREs Grant Helps Prevent Youth Violence

IMG_0909MostPenn Medicine CAREs grants expand existing programs or start new ones thatsupport community health. In the case of the Children’s Hospital ofPhiladelphia (CHOP) Violence Intervention Program, a CAREs grant extends aprogram already making a difference that may not have received enoughfunding otherwise.

After a young boy was assaulted in school by a group ofpeers, he was promptly treated in the ED. After receiving the medical care, heagreed to enroll in CHOP’s Violence Intervention program.  Duringsubsequent meetings with an assigned case manager, the patient and his familyshared his history of trauma and a record of numerous fights in school.

Soon that child’s long history of trauma and neglect wasovershadowed by strength, as he progressed through several meetings with thecase manager as well as some group sessions. Now the young man consistentlysticks up for others at his school who are bullied.

“We are addressing the violence issues faced by children intheir lives by identifying kids who are assaulted or injured,” said JoelFein, MD, MPH, professor of Pediatrics, Perelman School of Medicine, director of The Philadelphia Collaborative ViolencePrevention Center and an attending physician in the Emergency Department atCHOP.  “We work with a fairly high risk group within a high riskcommunity. The goals are both immediate needs, in terms of retaliation, safety,and traumatic stress and longer term needs that are identified by the patients,families and case managers.”

The group’s focus is strictly on youth (ages 8-19)non-partner violence, and non-child abuse cases.  Fein explained thatgoals are set for the patient within the first month after his/her injury tomost effectively prevent future violence.   A CHOP research grantstarted the project, but the group notes that the Penn Medicine CAREs grant isintegral to continuing the initiative’s effectiveness.

In the late 90s and early 2000s, Fein worked with a teamdoing similar research at HUP and CHOP and had more than 1400 kidsenrolled.  Recognition that there were many other similar programs acrossthe country led to the formation of the National Network of Hospital-basedViolence Intervention Programs (www.nnhvip.org). 

 “We know from our colleagues around the country, aswell as the work we did earlier, that this is important work and has thepotential to save lives and dollars,” said Fein.

The VIP team currently handles five high intensity cases and threelow-intensity cases at a time.  Sixty kids been contacted since theprogram started a year ago. VIP promotes  trauma-informed care, whichinvolves understanding what people have gone through to see how that impactshow they register and process what is happening to them in the hospital andafterward.  Youth come in through the ED or trauma unit with injuries.

Most prospective participants are not enrolled in personwhen an event happens.  Rather, the social work staff in the ED or on thetrauma unit gives the families a brochure and informs the team that they cancontact the patient within a couple weeks if the patient is interested injoining the program.

“It’s a vulnerable moment for them, and it’s a goldenopportunity to give them resources to help,” said Ayana Bradshaw, programmanager. 

That opening up process often reveals different perspectives in a variety ofcases. Nadja Peter, MD, a adolescent medicine specialist and consultant on theproject, echoes Bradshaw’s sentiment. “A lot of people think that sick kids inthe hospital don’t want to talk, but then we don’t give them the opportunity totalk,” said Peter. “They are feeling stressed and anxious. If you actually try,most of those kids are thrilled to have a chance to tell what happened.”

We have some kids who are considered bullies and we havesome kids that were victims of bullies, but either way, we see a lot of kidstalk about their feelings in a healthy and safe way,” said Laura Vega, MSW, theviolence prevention specialist. “We have seen former bullies sticking up forother kids.”

Progress with the kids helps relieve stressors on theirfamily as well. Beyond emotional support, the group assists with schooltransfers, victim assistance, medical or insurance issues, and mental healthreferrals. The team collaborates with the Department of Human Services, assistskids on probation, and explores available legal services if needed.  Inaddition, they collaborate with Drexel University’s Healing Hurt People programto provide trauma-informed group therapy.

“Families are dealing with so many of their own financialburdens and health issues, and the program helps provide relief knowing there’ssomeone else out there to support their child,” said Vega.

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