Top

Published in:

01-02-2021 | Care | Original Paper

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

Authors: Joseph B. Richardson Jr., William Wical, Nipun Kottage, Nicholas Galloway, Che Bullock

Published in: Journal of Prevention | Issue 1/2021

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 non-emergency 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.

Blome, A., Rosenbaum, J., Lucas, N., & Schreyer, K. (2020). Ridesharing as an alternative to ambulance transport for voluntary psychiatric patients in the emergency department. Western Journal of Emergency Medicine, 21(3), 618. https://doi.org/10.5811/westjem.2020.2.45526.CrossRefPubMedCentral

Bonne, S., & Dicker, R. A. (2020). Hospital-based violence intervention programs to address social determinants of health and violence. Current Trauma Reports. https://doi.org/10.1007/s40719-020-00184-9.CrossRef

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2017). Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Data. Accessed Retrieved 30 September 2019.

Chaiyachati, K. H., Hubbard, R. A., Yeager, A., Mugo, B., Lopez, S., Asch, E., et al. (2018a). Association of rideshare-based transportation services and missed primary care appointments: A clinical trial. JAMA Internal Medicine, 178(3), 383–389. https://doi.org/10.1001/jamainternmed.2017.8336.CrossRefPubMed

Chaiyachati, K. H., Hubbard, R. A., Yeager, A., Mugo, B., Shea, J. A., Rosin, R., et al. (2018b). Rideshare-based medical transportation for Medicaid patients and primary care show rates: A difference-in-difference analysis of a pilot program. Journal of General Internal Medicine, 33(6), 863–868. https://doi.org/10.1007/s11606-018-4306-0.CrossRefPubMedPubMedCentral

Cooper, C., Eslinger, D., Nash, D., Al Zawahri, J., & Stolley, P. (2000). Repeat victims of violence: Report of a large concurrent case-control study. Archives of Surgery, 135(7), 837–843. https://doi.org/10.1001/archsurg.135.7.837.CrossRefPubMed

Cooper, C., Eslinger, D. M., & Stolley, P. D. (2006). Hospital-based violence intervention programs work. Journal of Trauma and Acute Care Surgery, 61(3), 534–540. https://doi.org/10.1097/01.ta.0000236576.81860.8c.CrossRef

Cristancho, S., Garces, D. M., Peters, K. E., & Mueller, B. C. (2008). Listening to rural Hispanic immigrants in the Midwest: A community-based participatory assessment of major barriers to health care access and use. Qualitative Health Research, 18(5), 633–646. https://doi.org/10.1177/1049732308316669.CrossRefPubMed

Davis, R. G., Ressler, K. J., Schwartz, A. C., Stephens, K. J., & Bradley, R. G. (2008). Treatment barriers for low-income, urban African Americans with undiagnosed posttraumatic stress disorder. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 21(2), 218–222. https://doi.org/10.1002/jts.20313.CrossRef

Dixon, L. E., Ahles, E., & Marques, L. (2016). Treating posttraumatic stress disorder in diverse settings: Recent advances and challenges for the future. Current psychiatry reports, 18(12), 108. https://doi.org/10.1007/s11920-016-0748-4.CrossRefPubMedPubMedCentral

Drainoni, M. L., Lee-Hood, E., Tobias, C., Bachman, S. S., Andrew, J., & Maisels, L. (2006). Cross-disability experiences of barriers to health-care access: Consumer perspectives. Journal of Disability Policy Studies, 17(2), 101–115. https://doi.org/10.1177/10442073060170020101.CrossRef

Flores, G., Abreu, M., Olivar, M. A., & Kastner, B. (1998). Access barriers to health care for Latino children. Archives of Pediatrics and Adolescent Medicine, 152(11), 1119–1125. https://doi.org/10.1001/archpedi.152.11.1119.CrossRefPubMed

Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research (Ser. Observations). London: Aldine Publishing.

Goins, R. T., Williams, K. A., Carter, M. W., Spencer, M., & Solovieva, T. (2005). Perceived barriers to health care access among rural older adults: A qualitative study. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 21(3), 206–213. https://doi.org/10.1111/j.1748-0361.2005.tb00084.x.CrossRef

González, H. M., Vega, W. A., Williams, D. R., Tarraf, W., West, B. T., & Neighbors, H. W. (2010). Depression care in the United States: Too little for too few. Archives of General Psychiatry, 67(1), 37–46. https://doi.org/10.1001/archgenpsychiatry.2009.168.CrossRefPubMedPubMedCentral

Hankerson, S. H., Fenton, M. C., Geier, T. J., Keyes, K. M., Weissman, M. M., & Hasin, D. S. (2011). Racial differences in symptoms, comorbidity, and treatment for major depressive disorder among Black and White adults. Journal of the National Medical Association, 103(7), 576–584. https://doi.org/10.1016/s0027-9684(15)30383-7.CrossRefPubMedPubMedCentral

Hanson, R. F., Sawyer, G. K., Begle, A. M., & Hubel, G. S. (2010). The impact of crime victimization on quality of life. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 23(2), 189–197. https://doi.org/10.1002/jts.20508.CrossRef

Hines-Martin, V., Malone, M., Kim, S., & Brown-Piper, A. (2003). Barriers to mental health care access in an African American population. Issues in Mental Health Nursing, 24(3), 237–256. https://doi.org/10.1080/01612840305281.CrossRefPubMed

Kelly, V. G., Merrill, G. S., Shumway, M., Alvidrez, J., & Boccellari, A. (2010). Outreach, engagement, and practical assistance: Essential aspects of PTSD care for urban victims of violent crime. Trauma, Violence, & Abuse, 11(3), 144–156. https://doi.org/10.1177/1524838010374481.CrossRef

Leitch, L. (2017). Action steps using ACEs and trauma-informed care: A resilience model. Health & Justice, 5(1), 5. https://doi.org/10.1186/s40352-017-0050-5.CrossRef

Liebschutz, J., Schwartz, S., Hoyte, J., Conoscenti, L., Christian, A. B., Sr., Muhammad, L., et al. (2010). A chasm between injury and care: Experiences of Black male victims of violence. The Journal of Trauma, 69(6), 1372. https://doi.org/10.1097/ta.0b013e3181e74fcf.CrossRefPubMedPubMedCentral

Lincoln, Y. S., & Guba, E. G. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Program Evaluation, 1986(30), 73–84. https://doi.org/10.1002/ev.1427.CrossRef

Motley, R., & Banks, A. (2018). Black males, trauma, and mental health service use: A systematic review. Perspectives on Social Work: The Journal of the Doctoral Students of the University of Houston Graduate School of Social Work, 14(1), 4.

Pesata, V., Pallija, G., & Webb, A. A. (1999). A descriptive study of missed appointments: Families’ perceptions of barriers to care. Journal of Pediatric Health Care, 13(4), 178–182. https://doi.org/10.1016/s0891-5245(99)90037-8.CrossRefPubMed

Peterson-Besse, J. J., Walsh, E. S., Horner-Johnson, W., Goode, T. D., & Wheeler, B. (2014). Barriers to health care among people with disabilities who are members of underserved racial/ethnic groups: A scoping review of the literature. Medical Care. https://doi.org/10.1097/mlr.0000000000000195.CrossRefPubMed

Powers, B. W., Rinefort, S., & Jain, S. H. (2016). Nonemergency medical transportation: Delivering care in the era of Lyft and Uber. JAMA, 316(9), 921–922. https://doi.org/10.1001/jama.2016.9970.CrossRefPubMed

Purtle, J., Dicker, R., Cooper, C., Corbin, T., Greene, M. B., Marks, A., et al. (2013). Hospital-based violence intervention programs save lives and money. Journal of Trauma and Acute Care Surgery, 75(2), 331–333. https://doi.org/10.1097/ta.0b013e318294f518.CrossRef

Rask, K. J., Williams, M. V., Parker, R. M., & McNagny, S. E. (1994). Obstacles predicting lack of a regular provider and delays in seeking care for patients at an urban public hospital. JAMA, 271(24), 1931–1933. https://doi.org/10.1001/jama.1994.03510480055034.CrossRefPubMed

Ravenell, J. E., Johnson, W. E., Jr., & Whitaker, E. E. (2006). African-American men’s perceptions of health: A focus group study. Journal of the National Medical Association, 98(4), 544.PubMedPubMedCentral

Rich, J. A., & Grey, C. M. (2005). Pathways to recurrent trauma among young Black men: Traumatic stress, substance use, and the “code of the street”. American Journal of Public Health, 95(5), 816–824. https://doi.org/10.2105/AJPH.2004.044560.CrossRefPubMedPubMedCentral

Richardson, J. B., Vil, C. S., Sharpe, T., Wagner, M., & Cooper, C. (2016). Risk factors for recurrent violent injury among Black men. Journal of Surgical Research, 204(1), 261–266. https://doi.org/10.1016/j.jss.2016.04.027.CrossRef

Rust, G., Ye, J., Baltrus, P., Daniels, E., Adesunloye, B., & Fryer, G. E. (2008). Practical barriers to timely primary care access: Impact on adult use of emergency department services. Archives of Internal Medicine, 168(15), 1705–1710. https://doi.org/10.1001/archinte.168.15.1705.CrossRefPubMed

Scheer, J., Kroll, T., Neri, M. T., & Beatty, P. (2003). Access barriers for persons with disabilities: The consumer’s perspective. Journal of Disability Policy Studies, 13(4), 221–230. https://doi.org/10.1177/104420730301300404.CrossRef

Shibru, D., Zahnd, E., Becker, M., Bekaert, N., Calhoun, D., & Victorino, G. P. (2007). Benefits of a hospital-based peer intervention program for violently injured youth. Journal of the American College of Surgeons, 205(5), 684–689. https://doi.org/10.1016/j.jamcollsurg.2007.05.029.CrossRefPubMed

Solomon, E. M., Wing, H., Steiner, J. F., & Gottlieb, L. M. (2020). Impact of transportation interventions on health care outcomes: A systematic review. Medical Care, 58(4), 384–391. https://doi.org/10.1097/MLR.0000000000001292.CrossRefPubMed

Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: Transportation barriers to health care access. Journal of Community Health, 38(5), 976–993. https://doi.org/10.1007/s10900-013-9681-1.CrossRefPubMedPubMedCentral

Valentine, S. E., Dixon, L., Borba, C. P., Shtasel, D. L., & Marques, L. (2016). Mental illness stigma and engagement in an implementation trial for Cognitive Processing Therapy at a diverse community health center: A qualitative investigation. International journal of culture and mental health, 9(2), 139–150. https://doi.org/10.1080/17542863.2015.1123742.CrossRefPubMedPubMedCentral

Vella, M. A., Warshauer, A., Tortorello, G., Fernandez-Moure, J., Giacolone, J., Chen, B., et al. (2020). Long-term functional, psychological, emotional, and social outcomes in survivors of firearm injuries. JAMA Surgery, 155(1), 51–59. https://doi.org/10.1001/jamasurg.2019.4533.CrossRef

Vil, C. S., Richardson, J., & Cooper, C. (2018). Methodological considerations for research with Black male victims of violent injury in an urban trauma unit. Violence and Victims, 33(2), 383–396. https://doi.org/10.1891/0886-6708.vv-d-17-00065.CrossRef

Watkins, D. C., & Neighbors, H. W. (2007). An initial exploration of what ‘mental health’ means to young Black men. The Journal of Mens Health & Gender, 4(3), 271–282. https://doi.org/10.1016/j.jmhg.2007.06.006.CrossRef

Wical, W., Richardson, J., & Bullock, C. (2020). A credible messenger: The role of the violence intervention specialist in the lives of young Black male survivors of violence. Violence and Gender. https://doi.org/10.1089/vio.2019.0026.CrossRef

Wong, E. C., Marshall, G. N., Shetty, V., Zhou, A., Belzberg, H., & Yamashita, D. D. R. (2007). Survivors of violence-related facial injury: Psychiatric needs and barriers to mental health care. General Hospital Psychiatry, 29(2), 117–122. https://doi.org/10.1016/j.genhosppsych.2006.10.008.CrossRefPubMedPubMedCentral

Title: 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
Authors: Joseph B. Richardson Jr.
William Wical
Nipun Kottage
Nicholas Galloway
Che Bullock
Publication date: 01-02-2021
Publisher: Springer US
Keyword: Care
Published in: Journal of Prevention / Issue 1/2021
Print ISSN: 2731-5533
Electronic ISSN: 2731-5541
DOI: https://doi.org/10.1007/s10935-020-00611-2

At a glance: The STEP trials

Springer Medicine

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

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2021

Editorial Introduction: Effects of Gun Violence on Communities and Recent Theoretical Developments

Perceptions of Active Shooter Prevention and Preparation Strategies in Pennsylvania: Links to Self-Protective Behavior

Rising Gun Sales in the Wake of Mass Shootings and Gun Legislation

Firearm Use in Violent Crime: Examining the Role of Premeditation and Motivation in Weapon Choice

Acknowledgment of Reviewers of Volume 40

Predictive Extrinsic Factors in Multiple Victim Shootings