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November 20, 2007

Breaking the Cycle

The November 2007 issue of the Journal of the American College of Surgeons provides the results of a study evaluating whether, "Caught in the Crossfire," a hospital-based, peer intervention program for young victims of violence can be a cost-effective tool for reducing the impact of violence on later behaviour. The study used a retrospective design to examine patients admitted to a university-based urban trauma centre between January 1998 and June 2003 with an 18 month follow-up. The patients in the study were 12 to 20 years of age and were hospitalized for intentional violent trauma. The treatment group had a minimum of five interactions with an intervention specialist while a control group was selected from the hospital database. All patients were matched for age, socioeconomic status and ethnic background. The total sample size was 154 patients .

The results indicated that participating in the hospital-based program lowered the risk of later criminal justice involvement (relative risk=0.67; 95% CI, 0.45, 0.99; p=0.04) but there was no effect on risks of reinjury and death. Later violent criminal offending was reduced by 7% (p=0.15). Statistical analysis showed that age had a confounding effect on the association between program participation and criminal justice involvement (relative risk=0.71; p=0.043). When compared with juvenile detention center costs, the total cost reduction from the intervention program annually was $750,000 to $1.5 million. The researchers concluded that hospital-based peer intervention programming can meaningfully reduce the risk of criminal justice system involvement, is more effective with younger patients, and is cost effective. The potential of such programs for breaking the cycle of violence found in inner cities is self-evident.

Click here for the abstract.

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