Editor’s Note: As part of a pediatric healthcare organization, the Violence Prevention Initiative (VPI) within the Research Institute addresses the antecedents to violence and supports an environment where children feel safe to learn, play, and develop. VPI accomplishes this by implementing hospital-wide and community-based programs, performing clinical research in bullying and violence prevention, providing trauma-informed trainings, and advocating for public policy changes that have implications for children and families. In this guest blog, VPI Co-directors Stephen Leff, PhD a psychologist at Children’s Hospital of Philadelphia, and Joel Fein, MD, MPH, an attending physician in CHOP’s emergency department, recognize that many disciplines at CHOP are needed to make a real impact on violence in our communities locally and nationally.
The week after the mass school shooting at Stoneman Douglas High School that took 17 lives and injured another 14, a uniquely powerful group of Fellows and communicators at CHOP gathered for a fifth annual retreat hosted by the VPI. The time we spent together reinforced the importance of this initiative to CHOP, the local community, and across the nation. We were only too aware that the motivation for forming the VPI in 2013 was a response to the mass school shooting that took place at Sandy Hook Elementary in December 2012, taking 27 lives and injuring another two. Here we were again.
Our retreat attendees have expertise in social work, health education and communication, web-based communications, the media, community engagement, policy and legislation, behavioral health research and nursing, in addition to medicine. Each year, the VPI Retreat focuses on topical areas — last year it specifically addressed gun violence. Since that retreat, progress has been made to promote programs that can, in several ways, reduce the potential for and perceived need for youth to access a gun. With a dedicated workgroup, we have advanced formative research and development of a safe gun storage program that would distribute gun locks and lock boxes from CHOP clinical locations.
Through federal and foundation funding, we also have increased our capacity to provide case management and peer-support groups for youth treated for assault injuries in the ED. VPI Fellows are actively seeking ways to improve screening and support for patients regarding depression and suicidality.
Additionally, we have been developing frameworks for trauma-informed healthcare teams to improve patient family experience, especially for those with prior trauma.
VPI also has obtained new external funding to scale a CHOP-developed school-based program proven to reduce aggressive behaviors in third to fifth-grade female students, leading to improved classroom climate.
We are sponsoring the addition of violence-specific questions to a regional survey about adverse childhood experiences that will help us better understand how the children in our community are being exposed to and affected by violence and how those experiences are associated with their health status.
Looking Into the Next Year
At the 2018 retreat, the Fellows and communicators focused on the topics of adverse childhood experiences, intimate partner violence in the home, and suicide prevention in CHOP clinical settings. We discussed current activities, challenges, and potential paths for future change. In addition, we explored how to integrate our trauma-informed care training into our hospital’s efforts to improve the patient and family experience. We hope to report progress in these areas a year from now.
For those who work in public health prevention, the following comments may sound familiar.
We are challenged to make the case for policies and funding that support public health in general — and violence specifically. It’s hard to prove that prevention works and is cost-effective. It’s hard to quantify social determinants of health and violence despite its clear importance.
Our violence prevention programs at CHOP are all at different stages of research development and dissemination. We will to continue to collect evidenced-based proximal clinical outcomes for all of our efforts, in order to demonstrate that they are having their intended impact over time.
We are so proud of the work that our faculty, staff, Fellows, and communicators are doing to make VPI even more effectual than we could have imagined five years ago. We appreciate and laud their efforts, as well as our CHOP Executive Sponsors and the Research Institute for their leadership and support of the VPI infrastructure since our inception.