Violence intervention program to expand to rural counties

It’s basic human nature: When it comes to violent crime, the bigger the number, the more we pay attention. But when you start to look at crime on a more granular level, for instance looking at it in terms of rates of occurrence as it relates to population density – effectively allowing one to compare apples to apples – it becomes apparent that it’s the rural areas, at least in South Carolina, that experience more violent crime.

“Just because some of these towns are smaller doesn’t mean they aren’t as impacted by violence,” said Ashley Hink, M.D., MUSC Health trauma surgeon and medical director of the Turning the Tide Violence Intervention Program (TTVIP).

That’s why MUSC Health is attempting something a little out of the box – taking a relatively new, yet already proven program and expanding it to serve residents of some of the state’s smaller counties. Thanks to a Rural Innovations grant from the South Carolina Center for Rural and Primary Healthcare, TTVIP will now expand its services to patients of Orangeburg and Hampton counties that are treated for violent injuries at MUSC Health-Charleston’s Level 1 Trauma Center.

It's something those communities desperately need. According to South Carolina’s State Law Enforcement Division, using data obtained in 2021, Orangeburg County had the fifth highest homicide rate in the state, whereas Charleston County was 15th. Likewise, Orangeburg County has the second highest rate of aggravated assaults in the state – twice as high as Charleston County, which ranks 24th.

“This is something really worth trying because these people have just as great a need – if not more – than the people of Charleston,” Hink said.

 

What they’re trying, or piloting, as TTVIP program director Christa Green calls it, is an extension of the hospital’s already successful violence intervention program. Launched in July of 2021, TTVIP – the first and only hospital-based violence intervention program in the state – has supported more than 350 patients, 100-plus of whom have accepted long-term intervention services post-discharge. Outside of direct patient care, the team educates and trains health care providers and students and works to raise awareness of community gun violence prevention through outreach and advocacy activities.

With the Rural Innovations grant, Hink and her team – featuring Green and three violence intervention client advocates who take patients under their wings and walk them through all of the challenges, setbacks and breakthroughs experienced after traumatic, often life-threatening violent injuries – will expand the program’s eligibility criteria to include patients who live in Orangeburg and Hampton counties, whereas the original criteria directs services to patients from the Tri-county. Additionally, with the recent acquisition of MUSC Health-Orangeburg, Hink and her team will provide technical assistance to its trauma team to increase the trauma program’s capacity to support violently injured patients. Orangeburg’s trauma center cares for a disproportionately high rate of firearm-injured patients. In 2021, nearly 400 patients were treated at the now MUSC Health Orangeburg Medical Center, with nearly 20% of its patients treated for penetrating trauma, such as firearms and stabbings.

“Because of the distance between our Charleston-based team members and rural counties like Hampton and Orangeburg, there’s going to be more of a dependence on texting, calling and virtual meetings, whereas with patients here, we have the luxury to provide more support in person,” Green said. “Working with patients that live counties away is a bit of a deviation from the evidence-based model. Will it be as effective? That’s what we’re hoping to learn from this grant project.”

The expansion of TTVIP’s eligibility criteria will be rolled out immediately, and the team hopes to reach about a dozen more patients and families during the following year – families that would not have traditionally been served post-discharge. Through stakeholder engagement and resource mapping within the Orangeburg and Hampton communities, they hope to build a network of supportive services for violently injured patients in these areas treated at both MUSC Health-Charleston and MUSC Health-Orangeburg. 

For more information about the grant, as well as to see a list of past recipients, visit the S.C. Center for Rural and Primary Healthcare's web page.