Proposed Project and Purpose: The Arizona Department of Health Services (ADHS) through a successful application to the “Advancing Violence Epidemiology in Real-time (AVERT)” grant will focus its efforts to systematically increase the comprehensiveness and timeliness of surveillance data on emergency department (ED) visits for all firearm injuries (regardless of intent), other violence-related injuries, and mental health conditions in Arizona by executing four strategies. First, we aim to establish a team that will comprise a program coordinator and violence epidemiologist (PC), a business intelligence analyst, and a violence prevention program manager to increase the timeliness of aggregate reporting of violence related ED visits. We will leverage our state’s NSSP Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) to rapidly identify changes in the frequency of violence, identify geographic areas and populations within Arizona that are experiencing a high burden and changes in in frequency of violence-related ED visits, and examine additional context surrounding these types of events. Arizona has over 100 facilities participating in syndromic surveillance (representing >90% of all emergency departments and acute inpatient settings), reporting approximately 10,000 hospital visits per day. Second, we will leverage existing, and forge new partnerships, with ADHS’ capability to share timely data with community partners to maximize timely data sharing via existing and new networks as well as dynamic dashboards. ADHS will disseminate findings in a timely way to partners through existing collaboratives like the Injury Prevention Advisory Council (IPAC). ADHS and IPAC will coordinate and facilitate a new IPAC sub-group focused on reviewing, discussing, and synthesizing data to inform key priorities for efforts. Third, we propose implementing optional activity 1 (data linkage) by partnering with the Arizon
a Violent Death Reporting System (AZ-VDRS) at the Arizona State University’s Center for Violence Prevention and Community Safety to explore novel ways to link violence related ED visit data with other sources to improve the accuracy of our ED data. As of 2023, AZ-VDRS has agreements with 71 law enforcement partners and medical examiners, representing about 98% of violent deaths in Arizona. Lastly we propose implementing optional activity 2 (REDIRECT Prevention Activity) by establishing and maintaining structures and partnerships that 1) facilitate the sharing of timely, accurate, and local violence data with diverse and multidisciplinary community partners including Arizona’s county health departments, hospitals and hospital systems, law enforcement agencies, city planning officials, and community organizations, 2) inform more tailored prevention and response efforts among partners, 3) guide the allocation of resources at state and local levels, and 4) address inequities in risk for violence.
Outcomes: ADHS aims to accomplish the following outcomes by the end of the period of performance: 1) Increase the timeliness of aggregate reporting of ED visits for violence related indicators; 2) Increase the opportunities to disseminate surveillance findings in a timely way to the public and key partners working to prevent and respond to violence; 3) Introduce at least one innovative data linkage project, linking visit-level ED data with a novel data source such as the AZ-VDRS; 3) Strengthen our capacity to establish multisectoral partnerships utilize the merged data; and 4) Increase opportunities to develop data to action models or frameworks that support sharing timely, accurate, and local violence data with diverse and multidisciplinary community partners to inform violence prevention strategies.