A System Dynamics Model of Violent Trauma and the Role of Violence Intervention Programs.
Interpersonal violence
System dynamics model
Violence intervention program
Journal
The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
03
07
2019
revised:
26
09
2019
accepted:
02
10
2019
pubmed:
11
11
2019
medline:
11
6
2020
entrez:
11
11
2019
Statut:
ppublish
Résumé
Violence intervention programs (VIPs) can reduce interpersonal violence (IPV); however, optimizing the implementation of VIPs is challenging, given the complex dynamics of IPV. System dynamics models (SDMs) provide a means of visualizing dynamic and causal relationships in such complex systems. We use the IPVSDM to characterize and examine the relationship between IPV, VIPs, and the social determinants of health (SDH). The simulation model was created from a diagram that links putative causal relationships between VIPs, SDH, and IPV events. Simulation rules are then used to calculate a risk of violence parameter based on the SDH, which drives the transition from low-risk to high-risk populations and in turn influences IPV event rates. A qualitative relational approach was used to evaluate long-term effects of VIP on IPV events. The model produced qualitatively plausible behavior with respect to IPV events, population transitions, and relative overall VIP effect. Simulation runs converged to stable steady states with an exponential benefit of VIP on reducing IPV that is best appreciated after 1-2 y. The VIP functioned in a recognizable fashion by slowing the shift from low-risk to high-risk populations. This initial implementation of the IPVSDM produced recognizable baseline behavior while incorporating the possible effects of a VIP. The model allows causality and counterfactual testing, which is impractical in vivo. Community-level VIP efforts should show benefit particularly after a couple years. Future work will emphasize adding complexity to the IPVSDM and identifying real-world metrics to aid in testing, validation, and prediction of the model.
Sections du résumé
BACKGROUND
Violence intervention programs (VIPs) can reduce interpersonal violence (IPV); however, optimizing the implementation of VIPs is challenging, given the complex dynamics of IPV. System dynamics models (SDMs) provide a means of visualizing dynamic and causal relationships in such complex systems. We use the IPVSDM to characterize and examine the relationship between IPV, VIPs, and the social determinants of health (SDH).
MATERIALS AND METHODS
The simulation model was created from a diagram that links putative causal relationships between VIPs, SDH, and IPV events. Simulation rules are then used to calculate a risk of violence parameter based on the SDH, which drives the transition from low-risk to high-risk populations and in turn influences IPV event rates. A qualitative relational approach was used to evaluate long-term effects of VIP on IPV events.
RESULTS
The model produced qualitatively plausible behavior with respect to IPV events, population transitions, and relative overall VIP effect. Simulation runs converged to stable steady states with an exponential benefit of VIP on reducing IPV that is best appreciated after 1-2 y. The VIP functioned in a recognizable fashion by slowing the shift from low-risk to high-risk populations.
CONCLUSIONS
This initial implementation of the IPVSDM produced recognizable baseline behavior while incorporating the possible effects of a VIP. The model allows causality and counterfactual testing, which is impractical in vivo. Community-level VIP efforts should show benefit particularly after a couple years. Future work will emphasize adding complexity to the IPVSDM and identifying real-world metrics to aid in testing, validation, and prediction of the model.
Identifiants
pubmed: 31706544
pii: S0022-4804(19)30732-2
doi: 10.1016/j.jss.2019.10.015
pmc: PMC7028446
mid: NIHMS1545760
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
258-263Subventions
Organisme : NCATS NIH HHS
ID : TL1 TR002388
Pays : United States
Organisme : NIBIB NIH HHS
ID : U01 EB025825
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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