Violence prevention involvement among trauma surgeons: Description and preliminary evaluation

Violence has become a primary focus for the national agenda and a growing public health concern in the medical community. Although prevention is a major component of public health policy, it is unclear what contribution trauma surgeons and trauma centers are making toward violence prevention. Purpose: The purpose of this study was to assess the extent of violence prevention activity at trauma centers, the involvement and attitudes of trauma surgeons toward violence prevention, and the perceived need for a formal violence prevention curriculum. Methods: Self-report postal surveys were sent to trauma directors and associate directors at 430 Level I and Level II trauma centers throughout the United States. A descriptive analysis was performed using the 230 (53%) returns. Results: 55% of Centers reported an active violence prevention program,vith surgeons participating in these existing programs 47% of the time. Overall, only 26% of surgeons reported being active in violence prevention activities, although 71% thought that violence prevention should be an integral part of trauma center activity. Trauma surgeon involvement in violence prevention and the presence of an active institutional program was demonstrated significantly (p < 0.001, chi(2)). Lack of available time and ''not knowing where to start'' were cited as the most common reasons for lack of involvement in violence prevention activity. Conclusion: There is strong support among trauma surgeons for violence prevention programs and for the integration of these programs into the trauma center. A relatively small number of surgeons actually are engaged in violence prevention activity, hut most (69%) are willing to become personally involved. The data suggest that established violence prevention programs facilitate involvement of trauma surgeons in violence prevention activity. The discrepancy between actual involvement in, and general support for, violence prevention efforts may be explained by a lack of established roles and previous experience for surgeons and by limited guidance outside of existing programs.