Funded Research

Veterans bear a disproportionate share of the burden of firearm suicide. This study will analyze existing data from the longitudinal Study to Assess Risk and Resilience in Servicemembers Study (STARRS-LS), which includes more than 14,000 soldiers. The study will identify firearm behavioral practices that may predict suicidal behaviors; establish if there is a relationship between geographic location and suicide; identify the principal reasons for keeping a gun and the degree to which identified reasons mediate suicide risk; and establish if there is a relationship between storage practices and personality characteristics or other mental health issues. The broader impact of this study is anticipated to be the development of a comprehensive understanding of risks contributing to firearm mediated suicide, thus improving risk identification capabilities in both the military and civilian populations.

Firearm violence in the United States is a serious public health concern, and the rates are much higher among African American and Hispanic youth compared to White youth. This study will conduct integrative data analyses using data from two longitudinal studies on youth exposure to violence and subsequent weapons use in urban areas at high risk for gun violence. The analysis will examine how risk factors for gun violence at multiple levels of the social ecology (including self-report and geospatial crime coding of gun violence and other characteristics at the neighborhood level) affect the development of violence-related and weapons-related social cognitions that shape use of guns and other weapons into early adulthood. The findings are expected to have implications for enhancing the impact of community- and school-based prevention programs targeting firearm violence specifically and youth violence more generally.

Community violence is a recognized form of trauma that disproportionately impacts youth of color. There is growing consensus that community gun violence exposure and its consequences may extend to youth even if they do not report experiencing gun violence and even if they do not hear or see it in person. Existing studies have largely relied on self-reported survey items that prohibit examination of this broader conceptualization of exposure. The proposed project will use a unique combination of longitudinal data on a national, probability-based sample of youth and their families, schools, and neighborhoods geospatially linked with temporal and spatial information on deadly gun violence incidents. It will examine the population prevalence and health-related consequences of youths’ exposure to community gun violence, regardless of whether the violence was experienced firsthand. Results from this study are intended to help enhance the process of identifying individual, familial, school, and neighborhood-level factors associated with increased vulnerability or resilience to the adverse impacts of community gun violence exposure to guide efforts to disrupt the cycle of violence.

Gaps in available data measuring firearm ownership across population strata over time limit the ability to evaluate firearm safety policies and interventions. This study uses small-area estimation techniques to generate informative estimates of household firearm ownership within strata defined by gender, race, marital status, urbanicity, and state, over the period 1980-2020. The study will then use the new measures of firearm ownership to understand disparities in firearm mortality and to conduct innovative and more sensitive and precise evaluations of the effects of policies designed to improve firearm safety. Findings will be used to inform how firearm ownership varies across populations, communities, and time and how this variation relates to differential firearm homicide and suicide risk among subgroups.

Research on risky opioid use among firearm owners is limited, though evidence suggests the link between substance use and suicide extends to firearm owners. This study will incorporate multiple population-based sources of existing data, including but not limited to mortality and emergency department/hospital records. The study will use an individual-level case-control design and a population-level time series analysis to examine whether personal firearm ownership moderates the impact of individual and community opioid-related harm on individual firearm suicide risk. Similarly, the study will examine whether firearm availability moderates the impact of community opioid-related harm on firearm suicide rates. Results are intended to inform innovative and promising opportunities to enhance safety and prevent self-directed firearm-related injuries and deaths.

Firearm violence is a major public health issue; however, efforts to curb firearm injuries and deaths are hampered by incomplete and out-of-date data. This study will conduct a 3-year retrospective review of data on children and adults who were injured or killed by firearms and integrate data from trauma centers, the medical examiner’s office, and law enforcement. The analyses will identify and categorize individual-level and neighborhood-level geographic, demographic, temporal, social, and socioeconomic risk factors for firearm-related violence. The integration of firearm violence data from multiple data sources in a large and diverse population center is intended to provide a unique platform to analyze injury clusters and provide evidence-based prioritization of risk factors to help communities design targeted interventions.

There is a critical need for more information on the moment of crisis immediately before an act of firearm violence. This study will analyze data from the Crisis Text Line (CTL), a nonprofit organization that provides free around-the-clock text message support to anyone experiencing any crisis, to examine text conversations related to multiple types of firearm violence (e.g., impending acts of suicide, domestic violence, mass shootings). The study will conduct content analysis to examine how texters initiate and continue conversations related to firearm violence, compare texts related to firearm crises with those related to non-firearm crises, identify risk and protective factors for different types of firearm crises relative to those of non-firearm crises, and track the types of firearm texts before and after the coronavirus pandemic and consider how pandemic-specific anxieties are affecting the texts. The study is designed to provide insight about the best ways to stop firearm violence before it occurs.

Intervening early with youth who are engaged in risky firearm behaviors when they are seen in urban emergency departments has the potential to decrease subsequent firearm violence, but additional evidence of effectiveness is needed. This study will conduct a randomized controlled trial of IntERact, a technology-enhanced behavioral intervention program, in reducing risky firearm behavior and violence in youth ages 16-24 who are seen in the emergency department and have reported recent firearm carriage and smartphone ownership. IntERact uses remotely delivered behavioral therapy and care management combined with a supportive smartphone app to facilitate therapist contact, just-in-time GPS-triggered notifications upon entry into high-risk areas, and enhanced care management access. This study will determine the effectiveness, including cost benefits, of the IntERact intervention and the potential for broader public health impact.

Interventions in clinical settings, such as the emergency department (ED), are an opportunity for interpersonal firearm violence prevention, particularly among youth. A crucial prerequisite to successful clinical interventions is an accurate gauge of risk. This prospective longitudinal study will validate the SAFETY clinical screening tool by determining its ability to predict youth firearm violence involvement within the next year and improve the SAFETY score by conducting a comparative analysis of four powerful machine learning methods. The results from this work will lay the groundwork for future research involving the development and testing of interventions for interpersonal firearm violence both by identifying potential high-leverage modifiable predictive factors and by identifying youth most in need of intervention.

This study examines the implementation and impact of Gun Shop Projects (GSPs). GSPs are community-driven suicide prevention partnerships between the firearms community (retailers, ranges, and other businesses) and local public or community health agencies aimed at temporarily reducing access to firearms during times of crisis. The research team will identify the implementation core components of GSPs, examine the mechanisms for firearm safety behavior change, and examine the impact GSPs may have on suicide outcomes. Study results will advance scientific knowledge on involving the firearms community in suicide prevention efforts as a way to optimize implementation of community-level means reduction and safe storage strategies.

Current approaches to prevent gun injury are limited in their ability to reach those at highest risk, which may be due to the cultural disconnect between gun injury prevention strategies and the populations at greatest risk for violence and suicide. This study uses a mixed-methods participatory action research approach to improve understanding of the factors underlying risky gun-related attitudes, behaviors, and practices and to identify the acceptability of specific approaches to prevention for two distinct groups at risk for homicide (African American boys and young men) and suicide (older White men). Through the use of interviews and surveys, the research team will identify methods of gun access or acquisition, storage, and carrying; motivations for gun access, ownership, storage practices, use, and carrying; attitudes about ownership, storage safety, use, and carrying; acceptability of gun-focused prevention strategies; and ideas for novel prevention strategies. The results of this work will advance prevention science by creating a culturally grounded social-ecological model that can guide research on risk and protective factors for intentional gun-related injuries and inform the development of public health interventions.

Modifiable risk factors for youth firearm injury and death include unsafe storage of a firearm in the home, prior victimization/aggression, substance use, and depressive symptoms, yet there are few partnerships with firearm owners and firearm safety training programs to implement effective, non-policy-based preventive interventions for youth firearm injury. This study will conduct a hybrid effectiveness-implementation trial to evaluate the effectiveness of The Reframe, a bystander intervention designed to promote changes in firearm injury prevention norms , attitudes, intentions, and behaviors among a sample of 50 4-H Shooting Sports Club communities comprising both adults and youth. This project is designed to build the evidence base for interventions that promote safe behaviors related to youth firearm use and injury prevention and advance firearm injury prevention science by supporting a synergistic partnership between well-established firearm injury, suicide, and violence prevention researchers and the national 4-H Shooting Sports community.

Rural communities have high levels of firearm access and mortality, yet they are understudied and underserved. This study will utilize existing data and collect new data from rural adolescents to improve understanding of the cultural and environmental context within which handgun carrying occurs, identify developmental patterns of handgun carrying during adolescence and as youth transition to adulthood, examine the salient antecedents and consequences of this behavior, and test the effects of the Communities That Care prevention system. This project is intended to inform the development, adoption, and refinement of non-punitive prevention approaches to address factors that influence handgun carrying and reduce the burden of firearm-related injury among youth in rural communities.

Firearm-related injuries present a major pediatric public health challenge in the United States. This project will develop and evaluate ShootSafe, a website accessible by smartphone, tablet, or computer that engages children to learn firearms safety. ShootSafe will use interactive games, activities, and videos to teach children the knowledge and skills they need to hunt, shoot, and use firearms safely. It will also be designed to help children learn and hone the critical cognitive skills of impulse control and hypothetical thinking needed to use firearms safely and alter children’s perceptions about their own vulnerability and susceptibility to firearm-related injuries, the severity of those injuries, and their perceived norms about peer behavior surrounding firearms. Once developed, the website will be evaluated in a randomized controlled trial with children ages 10-12. Results from the study will have implications for strategies to reduce unintentional pediatric firearms-related injuries and deaths.

Many juvenile offenders become parents when young; their children are likely to be at significant risk for firearm involvement and victimization. Yet there are remarkably few data on how parents’ involvement with firearms during their own adolescence and young adulthood influences their children’s risk for firearm involvement. This prospective and intergenerational study will examine patterns of concordance and discordance between siblings; examine the influence of parents’ firearm involvement on their children’s involvement, focusing on differences between siblings; and identify risk and protective factors that explain within- and between-family differences. Findings are intended to help guide the development and adaptation of preventive interventions for the highest risk families.

Violently injured adults are not only victims in the present, but are also likely to be violently re-injured and at increased risk of committing retaliatory violence. Hospital-based violence intervention programs have become increasingly popular because of their success at engaging individuals who have suffered a violent injury. This study will conduct a randomized controlled trial to evaluate Bridging the Gap (BTG), a strategy that includes a hospital-based violence intervention, a firearm counseling program, and 6 months of community case management for victims of violence. The study will include a cost-benefit analysis to determine the economic benefits of implementing BTG. Results from this study will help determine the effectiveness of BTG as a firearm-related violence intervention for adult victims of violence.

Social media dominates the social lives of modern youth, and threats are now being expressed via social media in a phenomenon referred to as “cyberbanging.” While data suggest that cyberbanging is implicated in multiple forms of youth violence, including firearm-related violence, little is known about ways to prevent it. This study will gather formative data to develop a social media-based intervention to reduce cyberbanging implicated in youth violence by conducting focus groups with low-income urban adolescents and violence street outreach staff. It will explore social media behaviors, strategies to avoid cyberbanging, and preferences for social media-based interventions; leverage an existing study to gather survey data to describe social media habits, barriers/facilitators to cyberbanging and intervention preferences of this specific population; and draft messages and strategies for a future social media intervention to address threats implicated in violence. The study is designed to inform the development of a social media-based intervention that enhances street outreach programs to reduce cyberbanging implicated in youth violence.

Important gaps remain in understanding the relative importance and joint effects on risk for firearm violence of exposures that make up the neighborhood environment. This study will use data from an ongoing investigation of demolition and rehabilitation of decaying properties in Cleveland, Ohio, and Detroit, Michigan, to describe the range of neighborhood-level exposures in each of these cities and to identify how these exposures work together to impact firearm violence. The study will describe variations in programs and polices across neighborhoods from 2010-2019; identify the neighborhood-level exposures that are most predictive of high levels of neighborhood youth firearm violence; and estimate effects of neighborhood interventions on rates of neighborhood violent crime, firearm-related crime, firearm homicides, and firearm suicides among youth and young adults ages 10 to 29. Describing the range of neighborhood exposures and their importance in predicting youth firearm violence can help improve understanding of how “place” affects violence and inform broad-based interventions with widespread and lasting impacts.