Staying Out of the Way: Perceptions of Digital Non-Emergency Medical Transportation Services, Barriers, and Access to Ca
- PDF / 638,316 Bytes
- 16 Pages / 439.37 x 666.142 pts Page_size
- 30 Downloads / 145 Views
Staying Out of the Way: Perceptions of Digital Non‑Emergency Medical Transportation Services, Barriers, and Access to Care Among Young Black Male Survivors of Firearm Violence Joseph B. Richardson Jr., et al. [full author details at the end of the article] Accepted: 25 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract With a reduction in primary barriers to healthcare access as a result of the Affordable Care Act, there is an increased need to address secondary barriers faced by low-income young Black male survivors of violent injury. While transportation is often characterized as a barrier for individuals with chronic disease and disability, it also acts as a significant barrier in accessing cognitive behavioral therapy and mentoring services through hospital-based violence intervention programs (HVIPs). These services address the traumatic stress associated with surviving gun violence. Although there are many challenges associated with the current practices of nonemergency medical transportation, participants in HVIPs face additional risk factors. We highlight the application of a digital transportation intervention to increase the use of psychosocial services among low-income young Black male survivors of violent injury participating in an HVIP. Digital non-emergency medical transportation services (DNEMT) address issues concerning financial barriers, personal safety, program credibility, and program participation. We conducted qualitative interviews and a focus group with this population to assess the impact of Uber Health, a DNEMT service, on their participation in an HVIP located in a suburban Maryland hospital immediately outside of Washington, D.C. Survivors identified the use of Uber Health as essential to addressing the multifaceted and interconnected barriers to treatment. These barriers included reluctance to use alternative forms of transportation services (i.e., bus or subway) due to potential encounters with rivals, increased risk of repeat violent victimization, the need to carry a weapon for protection, stigmatization, and symptoms associated with traumatic stress. We found that integrating digital transportation services into the standard practices of HVIPs, as a part of a patient-centered outcomes framework, contributes to a reduction in violent injury and re-traumatization by addressing the multi-layered risks experienced by survivors of gun violence. Keywords Violent injury · Gun violence · Hospital-based violence intervention programs · Non-emergency medical transportation · Barriers to care · Post-traumatic stress disorder · Uber Health · Patient-centered outcomes research
13
Vol.:(0123456789)
The Journal of Primary Prevention
Introduction In 2017, homicide was the leading cause of death for Black males ages 15–34, and the second leading cause of death for Black males aged 1–14 (CDC, 2017). For each of the 67,299 Americans who died from violence-related injuries, nearly 19 additional emergency department visits were attributed to a non-fatal
Data Loading...
