Adapting a digital intervention to prevent youth violence and depressive symptoms from the emergency department for community violence interventions

Firearm injury is the leading cause of death among youth in the US direct and indirect exposure is associated with increased mental health needs, particularly depression, yet few community-based interventions led by credible messengers exist to address co-occurring violence and depression among youth. This paper describes a pilot study to adapt a digital intervention for youth exposed to firearm violence. iDOVE3.0 was adapted from an evidence-based emergency department intervention for youth (ages 13-17) into a community setting (defined as a community-based organization outside an institutional setting) in Indianapolis, Indiana. This single-arm pilot study aimed to recruit 20 youth between September 1, 2024 and December 31, 2025. Participant recruitment is ongoing, and to-date we have screened 16 youth for mild to moderate depression and violence exposure and enrolled five youth. Violence patterns and depressive symptoms were assessed at baseline and follow-up at 2, 4 and 8 months. This descriptive study offers insights into the adaptation of a clinical intervention and implementation process into a community setting. Understanding how digital-based interventions can expand community violence interventions and how credible messengers can improve the acceptability of digital interventions are promising approaches to address co-occurring depression and violence among youth in need. Future studies will examine feasibility, acceptability and preliminary efficacy among the pilot study cohort.