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HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between\u2010group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi\u2010square and logistic regression. ACEs were approximated using a novel approach with administrative data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study highlights a novel approach to understanding ACEs among a hard\u2010to\u2010reach population and illuminates the significant level of ACEs faced by violence\u2010exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma\u2010informed and healing\u2010centered interactions during recruitment and later stages of engagement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14920","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T05:11:15Z","timestamp":1712898675000},"page":"870-882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Examining adverse childhood experiences and <scp>Black<\/scp> youth's engagement in a hospital\u2010based violence intervention program using administrative data"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-418X","authenticated-orcid":false,"given":"Laura 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