Substance Use Among Violently Injured Youth in an Urban Emergency Department: Services and Outcomes in Flint, Michigan, 2009-2013 (ICPSR 36558)

Alternate Title:   Flint Youth Injury (FYI) Study

Principal Investigator(s): Cunningham, Rebecca, University of Michigan

Summary:

This project was an investigation into the natural course of service needs, use, and trajectories among high-risk youth and young adults with drug use who presented to an inner-city Emergency Department with multiple risk behaviors (with and without acute violent injury). Eligible participants included youth/young adults (ages 14-24) who sought care at the Hurley Medical Center (HMC) Emergency Department (ED) located in Flint, Michigan between December 19, 2009 and September 7, 2011. Consenting youth completed a self-administered computerized screening survey. All participants who self-reported past year drug use were recruited for the longitudinal study. For a comparison group, a randomly selected sample of drug using youth seeking ED care for other reasons (e.g. abdominal pain, motor vehicle crash) were selected for longitudinal study (equilibrated monthly proportionally for age/gender with the acute violent injury group). Participants in the violent injury and comparison group completed a baseline assessment during their ED visit.

Dataset 1 (DS1) contains the Baseline Screener Data of both young adults and youth. This data file has 1,448 cases and 314 variables. Each case represents an individual seeking treatment in the emergency department.

Dataset 2 (DS2) contains the Baseline Youth Data. This data file has 89 cases and 531 variables. Of these 89 cases, 51 of the youths (ages 14-17) presented to the Emergency Department with a violent injury. The remaining 38 respondents reported to the Emergency Department for non-violent injury and are part of the comparison group.

Dataset 3 (DS3) contains the Baseline Young Adult Data. This file contains 511 cases and 483 variables. Of these 511 cases, 299 of the young adults (ages 18-24) presented to the Emergency Department with a violent injury. The remaining 212 respondents reported to the Emergency Department for non-violent injury and are part of the comparison group.

The Baseline Screener Data includes demographics and information about public assistance, income, work, marital status, insurance, the injury visit, school/grades, retaliation attitudes, fights, violence, gang affiliation, weapons, partner violence, nicotine use, alcohol use, drug use, HIV risk-taking behaviors, needle use, sexual behavior, STD/HIV, past adolescent injuries, age on onset of drug use, and current conflict and aggression.

The Baseline Youth and Young Adult Data include sexual behavior, threat of retaliation, brief symptom inventory/suicide risk, drug and alcohol refusal efficacy, drinking and driving (DUI), community involvement, peer influences, non-partner aggression, parental support, parent influence on drug and alcohol use, family conflict, mentors, fight self-efficacy, community violence, sexual risk behaviors, medical care, alcohol dependence/abuse, drug dependence/abuse, substance abuse service utilization, post traumatic stress disorder (PTSD), conduct disorder (youth) or antisocial personality disorder (young adult), legal system involvement, major depressive episodes, and mental health service utilization.

Access Notes

  • One or more files in this data collection have special restrictions ; consult the restrictions note to learn more. You can apply online for access to the restricted-use data. A login is required to apply.

    Access to this study is restricted. Users interested in obtaining these data must complete a Restricted Data Use Agreement, specify the reasons for the request, and obtain IRB approval or notice of exemption for their research.

    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.

    Any public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.

Dataset(s)

DS1:  Baseline Screener Data
Documentation:
Download:
No downloadable data files available.
DS2:  Baseline Youth Data
Documentation:
Download:
No downloadable data files available.
DS3:  Baseline Young Adult Data
Documentation:
Download:
No downloadable data files available.

Study Description

Citation

Cunningham, Rebecca. Substance Use Among Violently Injured Youth in an Urban Emergency Department: Services and Outcomes in Flint, Michigan, 2009-2013. ICPSR36558-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2016-09-23. https://doi.org/10.3886/ICPSR36558.v1

Persistent URL: https://doi.org/10.3886/ICPSR36558.v1

Export Citation:

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  • EndNote XML (EndNote X4.0.1 or higher)

Funding

This study was funded by:

  • United States Department of Health and Human Services. National Institutes of Health. National Institute on Drug Abuse (DA024646)

Scope of Study

Subject Terms:    adolescents, aggression, alcohol abuse, arrests, cocaine, controlled drugs, conviction records, domestic violence, drug abuse, drug use, family violence, gang members, gang violence, gun ownership, gun use, hallucinogens, heroin, HIV, inhalants, injuries, interpersonal conflict, intravenous drug use, methamphetamine, prescription drugs, sedatives, sexually transmitted disease, social behavior, social values, stimulants, violence, weapons offenses, youths at risk

Smallest Geographic Unit:    None

Geographic Coverage:    Flint, Michigan, United States

Time Period:   

  • 2009-12--2013-09

Date of Collection:   

  • 2009-12--2013-09

Unit of Observation:    Individual

Universe:    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 Type(s):    survey data

Data Collection Notes:

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.

Methodology

Study Purpose:   

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.

Study Design:   

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(~25 minutes) and chose a $1.00 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 (~90 minutes; $20 remuneration), and a urine drug screen ($5) as well as oral HIV testing ($5; 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.

Sample:   

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.

Time Method:    Longitudinal: Cohort/ Event-based

Weight:    The dataset contains no weight variables.

Mode of Data Collection:    computer-assisted self interview (CASI), face-to-face interview

Response Rates:    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.
  • Checked for undocumented or out-of-range codes.

Version(s)

Original ICPSR Release:   2016-09-23

Related Publications

Variables

Browse Matching Variables

DS1: Baseline Screener Data

Past 6 Months: Carried gun for crime
In the past 6 months, IF you have carried a gun outside your home, including in your car, what was the reason? Again, don't count the times you carried a gun for hunting or target shooting: Check all that apply: I used the gun in a crime

DS3: Baseline Young Adult Data

Number of times lifetime arrested and charged for: shoplifting / vandalism
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Shoplifting/Vandalism
Number of times lifetime arrested and charged for: parole / probation
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Parole/Probation
Number of times lifetime arrested and charged for: drug charges
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Drug Charges
Number of times lifetime arrested and charged for: forgery
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Forgery
Number of times lifetime arrested and charged for: weapons offense
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Weapons Offense
Number of times lifetime arrested and charged for: burglarly / larceny
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Burglary/Larceny/B&E
Number of times lifetime arrested and charged for: robbery
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Robbery
Number of times lifetime arrested and charged for: assault
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Assault
Number of times lifetime arrested and charged for: arson
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Arson
Number of times lifetime arrested and charged for: rape
How many times have you been arrested and charged with the following? Include total number of counts, not just convictions. Do not include juvenile (pre-age 18) crimes, unless they were charged as an adult. Include formal charges only. LIFETIME: Rape

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