F.Y.I.: Flint Youth Injury Study

The provision of medical services in an inner city Emergency Department (ED) provides a
critical opportunity to identify and characterize future timing and pattern of service use
among youth with drug use, who may be missed in school-based samples, and who may not yet be
in the criminal justice system. Currently, there is a paucity of data on the timing,
pattern, barriers, and trajectory of youth with multiple risks (illicit drug use and ED
visit for acute violence related injury) in terms of their intersection with health services
(substance use treatment, mental health, medical) and criminal justice system, which limits
the development of optimal timing and setting for interventions. Youth treated in the ED may
have exacerbated rates of illicit drug use, and other risk behaviors (i.e. delinquency, HIV
risk behaviors, weapon carriage) and different trajectories of outcomes and interactions
with service use sectors based on presentation for intentional injury as compared to other
complaints (medical, unintentional injuries). Understanding the outcomes and service
utilization among inner-city youth with drug use with and without acute violent injury is
critically important in developing prevention and treatment services to address these
multiple risk factors. The investigators propose a prospective observational study over a
two-year period to identify a high risk group of youth with past year illicit drug use
(N=650) seeking care in an inner city ED. The specific aims of the study, chosen to obtain
data necessary to determine the location and content of subsequent interventions, are: (1)
To describe characteristics of youth (ages 14-24; n=650) who report illicit drug use
presenting to an urban ED for an acute violent injury (n=350), compared to youth with drug
use who seek non-violence related ED care (n=300), including demographic characteristics,
problem severity (e.g., substance use, violence, HIV risk behaviors, etc.), enabling
factors, and service utilization (i.e., substance use treatment, mental health, and
medical); (2) To identify the trajectories of participants' interactions with health
services during the two years following their ED visit and the key characteristics (i.e.,
predisposing, enabling, and need factors) associated with types of service use (substance
abuse treatment, mental health, and medical/ ED) and barriers to these services; and, (3) To
measure two-year outcomes for this cohort and to identify key demographic and clinical
characteristics of youth with drug use, who have poor outcomes in the two years after ED
visit for intentional injury and other medical care.