1. Livingston DH, Lavery RF, Lopreiato MC, Lavery D,
Passannante M. Unrelenting violence: An analysis of
6,322 gunshot wound patients at a Level I trauma center.
J Trauma Acute Care Surg. 2013; 76( 1): 2-9.
2. Juillard C, Cooperman L, Allen I, et al. A decade of
hospital-based violence intervention: Benefits and
shortcomings. J Trauma Acute Care Surg. 2016; 81( 6):1156-
3. Cunningham R, Knox L, Fein J, et al. Before and after
the trauma bay: The prevention of violent injury among
youth. Ann Emerg Med. 2009; 53( 4):490-500.
4. The Law Center to Prevent Gun Violence. Healing
communities in crisis: Lifesaving solutions to the urban
gun violence epidemic. March 1, 2016. Available at: http://
Communities-in-Crisis-URL.pdf. Accessed August 9, 2017.
5. Cooper C, Eslinger DM, Stolley PD. Hospital-based
violence intervention programs work. J Trauma.
2006; 61( 3):534-537.
6. Smith R, Dobbins S, Evans A, Balhotra K, Dicker RA.
Hospital-based violence intervention: Risk reduction
resources that are essential for success. J Trauma Acute Care
Surg. 2013; 74( 4):976-980.
7. Juillard C, Smith R, Anaya N, Garcia A, Kahn JG, Dicker
RA. Saving lives and saving money: Hospital-based
violence intervention is cost-effective. J Trauma Acute Care
Surg. 2015; 78( 2):252-257.
8. Smith R, Evans A, Adams C, Cocanour C, Dicker RA.
Passing the torch: Evaluating exportability of a violence
intervention program. Am J Surg. 2013;206( 2):223-228.
disease or, in the case of HVIPs, violence, on an already
affected population. Recidivism seems to be the most
obvious outcome measure on which to base the success
of these programs. However, after spending a week
immersed in the Wraparound Project and speaking
with case managers, staff, and clients, I learned that
prevention outcomes are more complex than simply
tracking whether a person is injured again. Uptake of
resources, reentry into school or the workforce, positive mental health outcomes, or qualitative outcomes
like increased self-esteem, goal-setting behavior, and
life outlook are all much more meaningful than recidivism alone.
The portability of HVIPs has been more challenging, as each program, while drawing from the same
essential structure, needs to be tailored to the community in which it is implemented. 8 Visiting a successful
program was essential to my understanding of the
functional aspects of the program, but I also learned
that it is important to create a program that is a good
fit specifically for Newark. A one-size-fits-all program
does not exist, as the individuals involved in providing
these services need to be keenly aware of the unique
needs of the communities they serve and the forces at
play in them. This knowledge comes from the time
dedicated to assessing the “lay of the land” of the hospital and the city in which the program is intended
In summary, having this firsthand opportunity to
see a mature program in action solidified my understanding of the functional aspects I need to set in place
to create a successful HVIP in Newark, and the ways
in which I can build a successful academic career by
implementing and evaluating HVIPs from a public
I cannot thank the ACS enough for the tremendous
opportunity afforded me by the Claude H. Organ, Jr.,
MD, FACS, Traveling Fellowship, and I look forward to
building a robust program so that I may mentor others
in the future, thereby carrying on Dr. Organ’s legacy. ♦