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Funded Injury Control Research Centers (ICRCs)

The Johns Hopkins Injury Control Research Center

FOA Number: CE 09 001
Project Period: 07/31/09-7/30/14
Application/Grant Number: 1 R49 CE001507-01
Principal Investigator: Gielen, Andrea C.
Johns Hopkins School of Public Health
624 North Broadway, Room 557
Baltimore, MD 21205
Phone 410-955-2397
E-mail aqielen@jhsph.edu

Abstract

The Administrative Core (AC) is responsible for administration, management, general support services, research development and communications. Although our seed project program, per the CDC FOA instructions, is "housed" in the AC, the objectives for the seed project program are better reflected in our research objectives previously presented. The objectives for the AC focus on the provision of infrastructure and its importance in facilitating interdisciplinary work, disseminating new knowledge, and professional leadership: Objective #1: To promote an environment conducive to: a) conducting high quality research; b) providing enriching learning opportunities; and c) offering opportunities for collaboration and the exchange of new ideas for preventing injuries and improving trauma outcomes. Objective #2: To translate and disseminate injury information to stakeholders, including the media, public agencies, policymakers, private sector organizations, other researchers, and the public through the use of strategic communication, partnerships and other mechanisms. Objective #3: To provide leadership and service to the injury field, both domestically and internationally.

Large Project: Housing Characteristics and Child Injury Risks: A New Tool for Researchers and Policy Makers

Despite the strong empirical evidence that girls with histories of maltreatment are at greater risk than other adolescents of engaging in youth violence and interpersonal violence as adults, there are no reports of violence prevention programs tailored for female adolescents in foster care. The proposed study will adapt the CBITS program for use with girls in foster care who have experienced previous maltreatment, and evaluate its impact in preventing future youth violence and intimate partner violence. The study will utilize a randomized clinical trial that evaluates the effectiveness of a 10-session Cognitive-Behavioral Therapy for Foster Care (CBT-FC) for adolescent girls compared with a usual care group. The CBT-FC experimental condition will include elements of trauma-focused cognitive behavioral therapy such as stress inoculation skills, thought stopping, social problem solving, relationship between thoughts, feelings, and behaviors, creating and processing the trauma, and relapse prevention. The specific aims of the proposed study are to
1. To adapt the CBITS program for female foster care youths (CBT-FC) that targets mental health problems as they relate to youth violence, sexual and drug risk behaviors, and future intimate partner violence. 2. Utilizing a randomized controlled design, implement the CBT-FC prevention program with 150 adolescent girls in foster care compared with 150 girls who received usual care. 3. Conduct a process evaluation that will monitor treatment integrity through ratings of session content delivered, participants' attendance, program relevance and satisfaction, and tracking comparison and experimental group adolescents to reduce study attrition. 4. Conduct an outcome evaluation to compare the effectiveness of both conditions on primary outcomes such as trauma symptoms (PTSD, depression, internalizing and externalizing behaviors), problem-solving skills, and violence-related behaviors, intentions, beliefs, self-efficacy, and prevention knowledge. This study will advance knowledge of both trauma treatment and violence prevention by adapting an evidence based approach for the unique needs of adolescent girls with histories of maltreatment. The real-world utility of this study is enhanced by the fact that the intervention will be refined and delivered through collaborative efforts with the Children's Advocacy Services of Greater St. Louis, an organization that currently conducts assessments and delivers services to adolescents for the Children's Division. Thus, there is potential for the intervention to be adopted and disseminated among providers of treatment for youths in foster care.

Small Project: Residential Sprinkler Policy in the U.S.: Implementation Research to the Rescue

To understand the landscape of residential sprinkler policies in the United States and the factors that lead to successful development, enactment, and implementation of these policies for the purpose of informing future research and policy advocacy efforts. Background and Significance: Fire-related injuries are a leading cause of injury death in the United States. While most (76%) of fires occur outside the home, residential fires accounted for 81% of fire-related deaths and 79% of fire-related injuries in 2006. Sprinklers are an effective strategy for reducing residential fire-related injuries, yet they are not present in most single family homes. Policies that mandate sprinklers in new home construction are one approach to assuring translation of this important intervention to communities throughout the U.S., however, little is known about how to effectively develop, enact and implement such policies.

Small Project: Using Driving Simulators to Improve Teen Driver hazard Recognition and Response

The goal of this project is to validate the ability of a driving simulator to detect a teen's propensity to crash by comparing experienced with novice teen drivers. Background and Significance: Teen crash rates are high and graduated driver's licensing programs are yielding improvements. However, regardless of the age at which a teen starts driving, their crash rate falls between 2-and 4-fold during their first 12 months of independent driving. Interventions like parental involvement, better instruction, and monitoring devices are believed to improve teen driving. None of these interventions, however, has been shown to reduce crashes in a field trial. A field trial powered to detect a reduction in crashes would require over 10,000 teenagers and cost has been prohibitive. Driving simulators could be an interim way to assess whether a teen driving intervention merits the large investment required for a field trial, Prior studies of teen driving performance in simulators have been based on small samples that did not have the statistical power to differentiate good drivers from bad drivers. The significance of this study is in developing a tool that will make the development of new interventions for teen drivers less costly, and to validate it with sufficient sample size.

Small Project: Effects of Multi-agency Program to Reduce Repeat Violence of Intimate Partners

The specific aims of the project are to determine whether: 1) the Lethality Assessment Program (LAP) affects risks for repeat intimate partner violence (IPV) and, if so, the degree to which risks are affected; 2) program implementation or augmentation are associated with IPV re-assault risks; and 3) LAP effects are modified by victim, perpetrator, or contextual variables connected with the index IPV incident. Background and Significance: Most lethal and near-lethal incidents of IPV are preceded by prior assaults that come to the attention of police, but not to agencies offering services for victims. In the LAP, police officers administer a brief screen based on the Danger Assessment - a validated risk assessment tool designed to identify those at greatest risk for lethal and near-lethal IPV- to IPV victims at the time of the incident. Those deemed at highest risk are informed of their increased risk for being killed. Officers use their cell phones to immediately connect high risk victims to a hotline counselor at a local agency providing a range of services for IPV victims. The counselors help victims manage their immediate needs and encourage victims to come in for additional assessment and services. Many jurisdictions augment these practices by conducting follow-up visits, or use danger assessment information to inform decisions made by prosecutors, judges, and probation officers dealing with abusers. All parties are trained to coordinate their response to these high-risk cases.

Small Project: Implementation of the Trauma Survivors Network

The proposed research has three specific aims: 1) Identify trauma center structures and processes that constitute the core elements and key characteristics of successful implementation of the Trauma Survivors Network (TSN); 2) Contribute to translation science theory by developing conceptual models of TSN implementation and integrating these models with the evolving literature of implementation research; and 3) Assess the extent to which key indicators, identified in the previous two aims, are present in trauma centers nationwide, in order to evaluate their capacity to adopt the TSN. The resulting knowledge will be used to aid the American Trauma Society (ATS) in the development of a detailed implementation manual and in targeting resources as they roll out this initiative to trauma centers nationwide. Background and Significance: The Trauma Survivors Network (TSN), developed as a collaboration between the ATS and the Center, aims to provide key follow-up services for injured patients. These services include peer visitation, peer support groups, self-management classes, and on-line resources. The ultimate goal is the implementation of the TSN at all trauma centers in the U.S. However, while development of the program has been conducted in close collaboration with survivors, clinicians and trauma centers, little is known about the determinants of successful implementation of this program. The dissemination of the TSN presents a unique opportunity to study the adoption and growth of a national program from its inception. This work will yield valuable information about how to translate and disseminate this specific program, and evidence based interventions to trauma centers in general.

 

 
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