Surgeon awarded grant to study impact of hospital violence intervention programs in SE

May 31, 2024
Woman stands in doorway. She is wearing hospital scrubs. A sign beside her says Ashley Hink.
Dr. Ashley Hink at the door to her office at MUSC Health in Charleston. Photo by Joshua Steadman

Trauma surgeon Ashley Hink, M.D., has made it her life’s mission to create meaningful change for victims of gun violence. As founder of South Carolina’s only hospital violence intervention program (HVIP), part of her effort to create this change involves understanding the impact of HVIPs, particularly in underinvested communities.

Hink was awarded a three-year $600,000 grant from the Kaiser Permanente Center for Gun Violence Research and Education for her study titled “Advancing the Evidence for HVIPs in the Southeast: Comprehensive Patient-Centered Outcomes and Stakeholder Insights.” The study aims to evaluate the MUSC Turning the Tide Violence Intervention Program (TTVIP), one of the few HVIPs in the Southeast.

The evaluation will include comprehensive patient outcomes, perceived benefits of HVIPs from the perspectives of multiple stakeholders and opportunities for HVIP improvement. “Getting feedback directly from the patients and families we serve and understanding how our work impacts their recovery and well-being after injury is critical to providing patient-centered care, both in the hospital and the community,” said Hink.

HVIPs provide intensive wrap-around services to victims of predominantly firearm violence and increase supportive services to survivors. Although evidence demonstrates that HVIPs reduce violent injury recidivism and PTSD symptoms and demonstrate cost savings for health care systems in large urban settings, it is not known if these outcomes can be replicated in under-studied communities in the Southeast, where few HVIPs have been implemented and communities disproportionately suffer from gun violence.

“It was a very competitive field of applicants, and we are honored to have been accepted into this cohort of researchers supported by the Kaiser Permanente Center for Gun Violence Research and Education,” said Hink. “These grants are essential to our collective research efforts to advance the field of community violence intervention, which will not only benefit MUSC’s patients and families but make all of our communities safer.”

Three people stand in a hospital room. They are looking at a computer monitor. 
TTVIP client advocates, from left, Cat Yetman, Chantelle Mitchell and Keith Smalls. Photo by Lauren Hooker

Hink and her team, including TTVIP program director Christa Green, MPH, who is co-PI on the grant, are excited to begin the rigorous evaluation of the first hospital-based violence intervention program (HVIP) in the Carolinas and one of the only HAVI member programs in the Southeast. This study will evaluate comprehensive outcomes of participation in a southeastern United States hospital violence intervention program through a prospective cohort study involving patients receiving TTVIP services at MUSC Health compared with those who do not. Dulaney Wilson, Ph.D., an MUSC public health researcher, will provide her expertise in study design and statistical analysis for their research.

MUSC’s TTVIP is uniquely situated across two free-standing Level 1 trauma centers in downtown Charleston: one dedicated to pediatrics and the other adults. Level 1 Trauma Center. The program primarily serves violently injured youth and young adults ages 12 to 30 collectively. As the only American College of Surgeons Level 1 trauma centers in the state, the primary catchment area spans the surrounding three counties, but TTVIP also supports patients transferred to MUSC Health for a higher level of care, which increases their reach and impact across the state.

“Importantly, South Carolina’s geographic characteristics include deeply rural regions with pockets of urbanicity,” said Green. “This creates an opportunity to study the unique implementation challenges of community violence intervention  strategies, like HVIPs, in low-density vast urban sprawls that are common in the Southeast and suffer a disproportionately high rate of gun violence.”

Other potential outcomes related to HVIPs remain understudied. which this research aims to explore. That would include improving the health care experience, such as advancing equity in treatment, reducing bias and improving communication;  building self-esteem; reducing overall violence risk and other injuries that might be related to risky behaviors; and improving overall recovery. In addition, there are other individuals, including family members, loved ones and health care staff, who likely experience benefits from the implementation of HVIPs that need to be better studied and understood.

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