DOI: 10.3886/icpsr37282.v1
title: Reducing Youth Access to Firearms Through the Healthcare Setting, Denver, Colorado, 2018-2019
title: Version 1

description: The purpose of this project was to determine whether the health care setting can be utilized to decrease firearm access for adolescents, including those who are demonstrating a higher risk probability of accessing firearms that would result in harmful consequences. This project evaluated firearm access screening for youth and parents, means restriction counseling education for health care providers, the delivery of means restriction counseling to parents by health care providers, the effectiveness of means restriction counseling on parental storage practices, and whether the distribution of firearm storage devices decreased adolescent access to firearms.
description: The purpose of this project was to determine whether the health care setting can be utilized to decrease firearm access for adolescents, including those who are demonstrating a higher risk probability of accessing firearms that would result in harmful consequences. No studies have evaluated whether addressing firearm safety and storage in a primary care adolescent setting can reduce access to firearms. This project evaluated firearm access screening for youth and parents, means restriction counseling education for health care providers, the delivery of means restriction counseling to parents by health care providers, the effectiveness of means restriction counseling on parental storage practices, and whether the distribution of firearm storage devices decreased adolescent access to firearms.
description: Researchers used a randomized control trial to examine the questions and hypotheses listed above. Study subjects were randomized using a random number generator to one of the three study groups: (1) A "no-treatment" or usual care control group; (2) a treatment group that received means restriction counseling alone; and (3) a treatment group that received means restriction counseling plus gun locking devices to safely lock up all guns in the home. For youth assigned to one of the intervention groups, the research assistant entered a notification into the electronic medical record to alert the provider as to which group the youth was assigned, and imbedded the results of the firearm screen. Health care providers were not notified if patients were assigned to the control group. Parents and youth answered online questionnaires that included self-reported outcome measures at baseline, 1 week, 1 month (parents only), and 1 year. Health care providers answered online questionnaires at pre-training, post-training and two-year follow-up that included measures about their attitudes and beliefs toward means restriction counseling, their efficacy toward providing means restriction counseling, their satisfaction with the means restriction counseling training and the usefulness of the means restriction counseling.
description: Variables include survey data from parents, youths, and health care providers with self-reported outcome measures.
description: Not applicable.
description: Response Rates: Youth Enrollment and Survey Response Rates:Researchers screened 1475 youth or one of their parents for eligibility in the study. Of these youth 139 (9.4%) had a firearm in the home and were eligible to participate in the study. Of the eligible youth, 76 (5.2%) were enrolled, 43 (2.9%) declined to participate, and we were unable to enroll 20 (1.4%) youth prior to their appointment. The youth survey data were based on the 64 youth that completed the study (11 withdrawals, 1 screen failure) resulting in the following survey response rates: baseline 85.5%; 1 week 81.6%; 1 year 59.2%. Parent Enrollment and Survey Response Rates:Researchers screened 1478 parents of the youth with an appointment who were potentially eligible to participate in the study. Of these parents 141 (9.5%) had a firearm in the home and were eligible to participate in the study. Of the eligible parents, 79 (5.3%) were enrolled, 44 (2.9%) declined to participate, and we were unable to enroll 18 (1.2%) prior to the youth's appointment. The parent survey data were based on the 65 parents that completed the study (13 withdrawals, 1 screen failure) resulting in the following survey response rates: baseline 86.1%; 1 week 81%; 1 month 78.5%; 1 year 67.1%. Health Care Providers Response Rates: Researchers surveyed Health Care Providers about the training and use of the Violence Injury, Protection and Risk Screening (VIPRS) and Means Restriction Counseling. Researchers trained 147 health care providers. The Health Care Provider survey data were based on the following survey response rates: baseline 81.6%; post-test 49.7%; follow-up 43.5%. Chart Review Data:These data were based on the 76 youth enrolled in the study: Response rates are not applicable and do not include chart review data for screen failures and those youth that withdrew from the study. The data also includes chart review data from siblings that researchers enrolled as part of the study.
description: Presence of Common Scales: The Violence, Injury, Protection and Risk Screen (VIPRS) (Sigel, 2014) tool consists of 14 items measuring youth risk and protective factors for future violence perpetration. The Strengths and Difficulties Questionnaire (SDQ) (Goodman, 1997) consists of 34 items asking youth to respond to attitudes and behaviors about their mental health. The Patient Health Questionnaire (PHQ-9) (Kroenke K et al. 2001) is a 9 item tool that is used to measure the severity of depression. See the Chart Review Instrument for the list of items. All of these scales are scored and included in the Chart Review Dataset.
description: Datasets: DS0: Study-Level Files DS1: Firearm Chart Review DS2: Healthcare Provider Review DS3: Parent Review DS4: Youth Review
description: Youth ages 12-18 being seen for a routine physical exam or mental health visit at the Children's Hospital Colorado Adolescent Medicine Clinic, and one of their parents were eligible to participate in the initial screening. These youth had an appointment during the study period. Smallest Geographic Unit: None
description: web-based survey