Can hospital violence intervention programs prevent repeat injury? Experts say yes

Clinical takeaway: Trauma centers and hospitals caring for patients with violent injuries should consider implementing or referring eligible patients to a hospital-based violence intervention program, with services extending beyond the acute encounter to address reinjury risk, mental health, substance use, housing, employment, education, and other social needs.

Hospital-based violence intervention programs (HVIPs) connect survivors of violent injury with services that address social, psychological, educational, and behavioral factors associated with future harm. In this 2026 update, the Eastern Association for the Surgery of Trauma (EAST) reviewed evidence from 17 North American studies and found that participation in an HVIP was associated with a meaningful reduction in violent reinjury compared with usual care.

Programs varied substantially across studies but commonly included case management, mental health support, educational assistance, employment resources, social services, and community-based interventions initiated during or shortly after hospitalization. Because the period immediately following a violent injury may represent a critical opportunity for engagement, the hospital encounter remains a key point for intervention.

The guideline's pooled analysis showed a roughly 40% lower odds of violent injury recidivism among patients receiving HVIP services. However, EAST notes that confidence in the evidence remains limited because of study heterogeneity, variable program structures, and methodological limitations across the literature.

"Results favored HVIP programs for the prevention of violent injury recidivism," the authors reported, while also stressing the need for continued research and more consistent outcome measures.

Based on the available evidence, EAST conditionally recommends HVIPs in urban trauma centers with substantial violent-injury volumes for adult-only or mixed adult-pediatric populations in the US and Canada. The guideline encourages institutions to evaluate local needs, resources, and program design when implementing these services.

The update focuses on system-level interventions that address the broader social and mental health drivers of recurrent violence. For clinicians, the message is straightforward: referral to a structured HVIP may be an important component of postinjury care for patients at risk of future violence.

Source: Leeper CM, et al. (2026 Aug 18) J Trauma Acute Care Surg. Hospital-based violence intervention programs in the United States and Canada: A systematic review, meta-analysis, and practice management guideline from EAST