intravenous drug use,
youths at risk
Smallest Geographic Unit:
Date of Collection:
Unit of Observation:
High-risk youth (ages 14-17) and young adults (ages 18-24) with drug use who present to an inner-city emergency department with multiple risk behaviors.
Data Collection Notes:
This collection reflects the public-use version of ICPSR #36558. Large differences in the datasets are due to additional ICPSR processing in the interests of minimizing disclosure risk and sensitivity of subject matter.
This data collection provides the baseline data collected between December 19, 2009 and September 7, 2011.
Followups were conducted with the cohort at 6, 12, 18, and 24 months. These data are not currently part of this collection.
The variable DEID should be used to link respondents between the screener and wave data.
ICPSR created all of the variable labels for each dataset.
Substance Use Among Violently Injured Youth in an Urban Emergency Department was an investigation into the natural course of service needs, use, and trajectories among high-risk youth with drug use who present to an inner-city Emergency Department with multiple risk behaviors (with and without acute violent injury). By over-sampling of a violently injured group, the study was able to obtain a sufficient sample size that has been lacking in prior work limiting conclusions and intervention development. The specific aims of the study included:
Specific Aim 1: To describe multiple risk behaviors of youth/young adults (ages 14-24) who report illicit drug use and who present to an urban Emergency Department for an acute violent injury (e.g., laceration, gun shot wound), compared to youth with drug use who seek non-violence related Emergency Department care (for unintentional injury and illness, e.g., motor vehicle crash, abdominal pain).
Specific Aim 2: To identify the trajectories of participants' interactions with health services during the two years following their Emergency Department visit for an acute violent injury or for non-violence related care, and the key characteristics (i.e., predisposing, enabling, and need factors) associated with types of service use and barriers to these services. Such services include substance abuse treatment, mental health services, and medical services including Emergency Department recidivism and HIV testing.
Specific Aim 3: To identify key sociodemographic and clinical characteristics, including HIV risk behaviors, for substance using youth who have poor outcomes in the two years after an Emergency Department visit for acute violent injury or non-acute violence related care.
This study was designed to oversample youth (14-24 years) presenting to the ED for violent injury (i.e., assault related) and reporting past 6 month substance use. Patients completed screening and surveys during their ED visit. However, those with violent injuries too severe to participate in the ED were recruited if they stabilized in the hospital within 72 hours. Based on the age block (14-17, 18-20, 21-24) and sex (male/female) of enrolled youth presenting with violent injury, a proportionally selected comparison group was sampled of youth who presented for non-assault related complaints (e.g., abdominal pain, fever) and reported past 6 month substance use. Comparison youth were approached based on triage time, to mirror the proportion of participants in each age/sex group of violently injured participants. Patients were approached by research assistants to participate in a screening survey to determine eligibility. Patients presenting to the ED for an acute sexual assault, child abuse, or suicidal ideation or attempt were excluded. Upon written consent/assent from the patient (and parent/guardian if age was less than 18), participants self-administered a computerized screening survey(about 25 minutes) and chose a one-dollar gift (i.e., cards and lotion). Participants completed the surveys in treatment spaces without others present, in order to ensure confidentiality. Screened participants in the violently injured and comparison group reporting past 6 month substance use on the ASSIST (i.e., marijuana, cocaine, prescription stimulant, opiates, or sedatives/sleeping pills, methamphetamine, inhalants, hallucinogens, street opiates; World Health Organization ASSIST Working Group, 2002) were enrolled in the longitudinal study and completed a baseline assessment (about 90 minutes; 20 dollars remuneration), and a urine drug screen (5 dollars) as well as oral HIV testing (5 dollars; not reported here). The baseline interview included self-administered and research assistant administered portions (e.g., Time Line Follow Back [TLFB] interview). Our IRB did not allow for collection of additional data from refusals without written informed consent.
Emergency department patients aged 14-24 presenting for violent injury and a similarly aged comparison population of patients presenting for any medical reason were eligible for screening. During screening, participants were included on the basis of self-reported drug use in the previous year.
Exclusions from study participation included:
Patients who presented with acute sexual assault (CSC)
Child abuse (CPS)
Suicidal ideation or attempt
Altered mental status precluding consent
Diagnosis of schizophrenia
No parent/guardian available to give consent for minors
Abnormal vitals that did not stabilize during entire length of stay
Blood pressure 85/x
Heart Rate greater than 130
Oxygen Saturation less than 85 percent
If the patient was intubated or on a ventilator
Active participation in another study
If the patient was in police custody / currently incarcerated
Already in the Flint Youth Injury study
An ineligible screen for Flint Youth Injury within the past 6 months
If the patient did not understand English
If the patient had been seen for a violent injury that happened more than 72 hours prior to presenting to the ED
Recruitment started on December 20, 2009 between the hours of 2 p.m. and 12 a.m. with additional weekend sampling between 5 a.m. to 7 a.m. Violently injured patients who were still in the ED at the time of shift start or who triaged up to shift end and were sent into a waiting room or put in a patient room were recruited. Potential comparison group participants with triage times one hour after the time of shift start and up to one hour before shift end were recruited.On January 14 recruitment hours changed to 4 p.m. to 2 a.m. seven days a week. On January 22 recruitment hours were changed to 3 p.m. through 1 a.m. Starting April 15 recruitment hours were 5 a.m. through 2 a.m. On April 27 recruitment times were between 5 a.m. and 1 a.m. except for Tuesdays and Wednesdays when shifting began at 7 a.m. On September 2, a third shift (11 p.m. - 7 a.m.) was added 5 days a week, which provided 24 hour a day coverage Thursday through Monday. Winter holidays were excluded. However, recruitment days included summer holidays.
Longitudinal: Cohort/ Event-based
The dataset does not contain weight variables.
Mode of Data Collection:
computer-assisted self interview (CASI),
The baseline survey had a response rate of 85.4 percent.
Presence of Common Scales:
Established scales used for this study include:
Conflict Tactics Scale (CTS)
Alcohol Smoking and Substance Involvement Screening Test (ASSIST)
Mini International Neuropsychiatric Interview (MINI-adult)
Mini International Neuropsychiatric Interview for Adolescents and Children (MINI-kid)
Extent of Processing: ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of
disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major
statistical software formats as well as standard codebooks to accompany the data. In addition to
these procedures, ICPSR performed the following processing steps for this data collection:
Created variable labels and/or value labels.
Standardized missing values.
Performed recodes and/or calculated derived variables.
Checked for undocumented or out-of-range codes.
Users are reminded that these data are to be used solely for statistical analysis and reporting of aggregated information, and not for the investigation of specific individuals or organizations.
Users interested in obtaining the restricted use version of the data should refer to ICPSR #36558 and must complete a Restricted Data Use Agreement, specify the reasons for the request, and obtain IRB approval or notice of exemption for their research.