Violence Prevention

AEM Early Access 20: Tracking Assault-Injured, Drug-Using Youth in Longitudinal Research

Welcome to the twentieth episode of AEM Early Access, a FOAMed podcast collaboration between the Academic Emergency Medicine Journal and Brown Emergency Medicine. Each month, we'll give you digital open access to an recent AEM Article or Article in Press, with an author interview podcast and suggested supportive educational materials for EM learners.

Find this podcast series on iTunes here.

DISCUSSING (click on link for full text, open access through november 30):

Tracking Assault-Injured, Drug-Using Youth in Longitudinal Research: Follow Up Methods. Jessica S. Roche, MPH, Michael J. Clery, MD, MPP, Patrick M. Carter, MD, Aaron Dora-Laskey, MD, MS, Maureen A. Walton, MPH, PhD, Quyen M. Ngo, PhD, and Rebecca M. Cunningham, MD.



Jessica Roche, MPH

Managing Director

University of Michigan Injury Prevention Center


Objectives: Violence is one of the leading causes of death among youth ages 14-24. Hospital and ED-based violence prevention programs are increasingly becoming a critical part of public health efforts; however, evaluation of prevention efforts is needed to create evidence-based best practices. Retention of study participants is key to evaluations, though little literature exists regarding optimizing follow-up methods for violently-injured youth. This study aims to describe the methods for retention in youth violence studies and the characteristics of hard-to-reach participants.

Methods: The Flint Youth Injury (FYI) Study is a prospective study following a cohort of assault-injured, drug-using youth recruited in an urban ED, and a comparison population of drug using youth seeking medical or non-violence-related injury care. Validated survey instruments were administered at baseline and four follow-up time points (6, 12, 18, 24 months). Follow-up contacts used a variety of strategies and all attempts were coded by type and level of success. Regression analysis was used to predict contact difficulty and follow-up interview completion at 18 24 months.

Results: 599 patients (ages 14-24) were recruited from the ED (mean age=20.1 years, 41.2% female, 58.2% African American), with follow-up rates at 6, 12, 18, and 24 months of 85.3%, 83.7%, 84.2%, and 85.3%, respectively. Participant contact efforts ranged from 2 to 53 times per follow-up timeframe to complete a follow-up appointment, and more than 20% of appointments were completed off-site at community locations (e.g., participants' homes, jail/prison).Participants who were younger (p<.05) and female (p<.01) were more likely to complete their 24-month follow-up interview. Participants who sought care in the ED for assault injury (p<.05) and had a substance use disorder (p<.01) at baseline required fewer contact attempts to complete their 24-month follow-up, while participants reporting a fight within the immediate 3 months before their 24-month follow-up (p<.01) required more intensive contact efforts.

Conclusions: The FYI study demonstrated that achieving high follow-up rates for a difficult-to track, violently-injured ED population is feasible through the use of established contact strategies and a variety of interview locations. Results have implications for follow-up strategies planned as part of other violence prevention studies.