Journal of Urban Health

, Volume 95, Issue 3, pp 361–371 | Cite as

Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments

  • Alison J. Culyba
  • Elizabeth Miller
  • Kenneth R. Ginsburg
  • Charles C. Branas
  • Wensheng Guo
  • Joel A. Fein
  • Therese S. Richmond
  • Bonnie L. Halpern-Felsher
  • Douglas J. Wiebe


Strengths-based strategies to reduce youth violence in low-resource urban communities are urgently needed. Supportive adolescent-adult relationships may confer protection, but studies have been limited by self-reported composite outcomes. We conducted a population-based case-control study among 10- to 24-year-old males in low-resource neighborhoods to examine associations between supportive adult connection and severe assault injury. Cases were victims of gunshot assault injury (n = 143) and non-gun assault injury (n = 206) from two level I trauma centers. Age- and race-matched controls (n = 283) were recruited using random digit dial from the same catchment. Adolescent-adult connections were defined by: (1) brief survey questions and (2) detailed family genograms. Analysis used conditional logistic regression. There were no significant associations between positive adult connection, as defined by brief survey questions, and either gunshot or non-gun assault injury among adolescents with high prior violence involvement (GSW OR = 2.46, 95% CI 0.81–7.49; non-gun OR = 1.59, 95% CI 0.54–4.67) or low prior violence involvement (GSW OR = 0.92, 95% CI 0.34–2.44; non-gun OR = 1.96, 95% CI 0.73–5.28). In contrast, among adolescents with high levels of prior violence involvement, reporting at least one supportive adult family member in the family genogram was associated with higher odds of gunshot assault injury (OR = 4.01, 95% CI 1.36–11.80) and non-gun assault injury (OR = 4.22, 95% CI 1.48–12.04). We were thus unable to demonstrate that positive adult connections protected adolescent males from severe assault injury in this highly under-resourced environment. However, at the time of injury, assault-injured adolescents, particularly those with high prior violence involvement, reported high levels of family support. The post-injury period may provide opportunities to intervene to enhance and leverage family connections to explore how to better safeguard adolescents.


Youth violence Violence victimization Adult support Family connection Case-control 



The study was supported by NIH grants F32 HD084028 and R01 AA014944.

Compliance with Ethical Standards

Financial Disclosure

The authors have no financial relationships relevant to this article to disclose.

Supplementary material

11524_2018_260_MOESM1_ESM.docx (19 kb)
ESM 1 (DOCX 18 kb)


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Copyright information

© The New York Academy of Medicine 2018

Authors and Affiliations

  • Alison J. Culyba
    • 1
    • 2
  • Elizabeth Miller
    • 2
  • Kenneth R. Ginsburg
    • 1
  • Charles C. Branas
    • 3
    • 4
  • Wensheng Guo
    • 3
  • Joel A. Fein
    • 5
  • Therese S. Richmond
    • 6
  • Bonnie L. Halpern-Felsher
    • 7
  • Douglas J. Wiebe
    • 3
  1. 1.Craig-Dalsimer Division of Adolescent MedicineThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Department of Biostatistics and Epidemiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  5. 5.Division of Emergency MedicineThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  6. 6.Biobehavioral and Health Systems Department, School of NursingUniversity of PennsylvaniaPhiladelphiaUSA
  7. 7.Division of Adolescent MedicineStanford UniversityPalo AltoUSA

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