A Multicenter Qualitative Stakeholder Evaluation of the Hospital-Based Violence Intervention Programs in the Los Angeles County Safety-Net Healthcare System

Violent injury is a leading cause of death and non-fatal injury among individuals aged 5 to 35 in the USA, with reinjury rates ranging from 29 to 37%. This study explores the barriers and facilitators to an intervention designed to prevent violent reinjury, the Los Angeles County Hospital Violence Intervention Program (LAHVIP), through key informant interviews. This qualitative study evaluated LAHVIP through interviews with 16 stakeholders from three hospitals and their community-based organization (CBO) partners. Interviews were coded into themes based on Braun and Clarke's methodology. Data were analyzed within the RE-AIM QuEST framework. Our results suggest that stakeholders were confident in the ability of LAHVIP to recruit patients engaged at the hospital. They also felt patients benefited from the mentorship provided by the program. Several barriers impeded program effectiveness, however, including poor integration between LAHVIP and their partner hospitals, as well as funding constraints and consequent staffing shortages. The limitation of resources in Los Angeles was also a constraint as patients had to wait several months before the services HVIP had connected them with were provided. Key factors for successful implementation included strong patient engagement, effective referrals, and the vital role of community health workers (CHWs) with lived experience. Barriers such as poor coordination between hospitals and community-based organizations, limited CHW staffing, lack of stable housing resources, and staff turnover hindered program effectiveness. Future efforts should focus on shared funding responsibility, enhanced hospital staff training, and better integration of workflows and technology to ensure long-term success.