Firearm Safety Training for Gunshot Wound Prevention

(ACTFAST Trial)

Enrolling by invitation at 1 trial location

Overseen By Katherine Hoops, MD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Prisoner, Suicide attempt, Acute conditions

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve firearm safety and prevent gunshot wounds by teaching safety practices in trauma centers. It will compare standard care with a new program, Adopting Comprehensive Training for FireArm Safety in Trauma Centers, which includes screening for firearm access and counseling on safe storage. Trauma patients admitted to certain hospitals in the mid-Atlantic, who are fluent in English or Spanish and can consent, may be eligible. Participants will help researchers assess the program's effectiveness in real-life settings.

As an unphased trial, this study offers participants the chance to contribute to innovative safety practices that could save lives.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this firearm safety training is safe for trauma patients?

Studies have shown that firearm safety training programs like ACTFAST teach people how to store guns safely and practice other safety measures. This training involves no medication or medical procedures, so it carries no known physical side effects or medical risks.

Research indicates that ACTFAST provides information and guidance rather than physical treatment. Participants learn to prevent gun injuries by safely storing firearms and understanding the risks. As an educational program, it is generally well-received.

Experiences with similar programs in trauma centers have demonstrated that the main goal is to improve safety practices without harming participants. This suggests that ACTFAST is safe for participants, as it aims to raise awareness and promote safety without medical intervention. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it focuses on a proactive approach to gunshot wound prevention through comprehensive firearm safety training. Unlike standard trauma care, which may include some basic screening and counseling, the ACTFAST Intervention goes further by incorporating systematic firearm access screening and personalized counseling on safe storage practices. Additionally, participants receive referrals to community resources, aiming to reduce gun-related injuries by addressing safety at the source. This method represents a shift from reactive treatment to preventive education, potentially leading to a significant decrease in gunshot incidents.

What evidence suggests that the ACTFAST program is effective for firearm injury prevention?

Research has shown that the ACTFAST program, tested in this trial, could reduce gun-related injuries by teaching firearm safety. Participants in the ACTFAST intervention arm will receive firearm access screening, counseling on safe storage practices, and referrals to community resources. Past efforts have demonstrated that teaching safe gun storage and offering advice can change storage habits, making environments safer. Studies indicate that programs like ACTFAST can change attitudes and increase knowledge about gun safety. The program aims to educate trauma patients on safe gun storage and connect them with community resources for additional support. Early results suggest these strategies effectively encourage safer gun behaviors. ^{1 2 3 5 6}

Who Is on the Research Team?

Katherine Hoops, MD, MPH

Principal Investigator

Johns Hopkins University

Are You a Good Fit for This Trial?

This trial is for individuals treated at level 1 trauma centers in the mid-Atlantic states, specifically those impacted by gunshot wounds or who have safety concerns related to firearms. The study aims to improve knowledge and practices around gun safety.

Inclusion Criteria

Trauma patients admitted to adult trauma inpatient services at participating institutions

Trauma service physician, physician assistant, nurse practitioner, nurse, or social worker at participating pediatric trauma center

I am 18 or older, injured, speak English or Spanish, and can consent.

Exclusion Criteria

Prisoner or in police custody

Admitted due to suicide attempt

N/A

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation and Maintenance

Implementation and maintenance of the ACTFAST program, including firearm access screening, counseling on safe storage practices, and referral to community resources

48 weeks

Visits as per trauma center protocol

Follow-up

Participants are monitored for safety and effectiveness after treatment, including survey responses gathered during admission and 2 weeks post-discharge

2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Adopting Comprehensive Training for FireArm Safety in Trauma Centers

Trial Overview The ACTFAST program is being tested for its ability to be adopted and maintained in trauma centers. It focuses on educating patients about firearm injury prevention and promoting safe storage practices.

How Is the Trial Designed?

Group I: ACTFAST Intervention Experimental Treatment 1 Intervention

During the implementation and maintenance periods, all trauma patients will receive study activities including firearm access screening, counseling on safe storage practices, and referral to safe storage and other community resources as appropriate.

Group II: No Intervention: Standard Care Active Control 1 Intervention

All trauma patients will receive standard routine care which may include some screening and counseling on gun safety.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

Rhode Island Hospital

Collaborator

Trials

275

Recruited

71,400+

National Institute on Minority Health and Health Disparities (NIMHD)

Collaborator

Trials

473

Recruited

1,374,000+

Published Research Related to This Trial

A survey of 218 medical residents and fellows revealed significant barriers to discussing firearm safety with patients, including uncertainty about how to respond to patients' firearm access answers (72.1%) and lack of time (66.2%).

Over 90% of respondents expressed a desire for more training on firearm injury prevention, indicating that improved education could enhance clinicians' ability to assess risk and counsel patients effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Talking about firearm injury prevention with patients: a survey of medical residents. Pallin, R., Teasdale, S., Agnoli, A., et al.[2022]

Only 16% of family practice residency programs in the U.S. provide formal training in firearm safety counseling, indicating a significant gap in education on this important public health issue.

Many residency directors perceive barriers to implementing firearm safety counseling, including a lack of trained personnel and educational resources, and less than 14% believe such counseling would effectively reduce firearm-related injuries or deaths.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training in firearm safety counseling in family practice residency programs. Price, JH., Bedell, AW., Everett, SA., et al.[2022]

A six-lecture series on firearm safety significantly increased psychiatric residents' interest and confidence in firearm safety guidance, as shown by a pre- and post-lecture survey involving 27 participants.

The educational intervention effectively improved residents' understanding of risk assessment, safety guidance, and relevant legislation related to firearms, highlighting the need for such training in psychiatric education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Longitudinal Curriculum to Improve Psychiatry Residents' Attitudes Regarding Firearm Anticipatory Guidance. Stillman, I., Ehrman, S., Amalfitano, A., et al.[2023]

The 5 A's of Firearm Safety Counseling significantly improved the comfort level and quality of counseling provided by clinical trainees on firearm injury prevention, with only 4% feeling uncomfortable after training compared to over 60% before.

The study involved 29 participants in a simulation-based randomized controlled trial, showing that specific training on the 5 A's led to a notable enhancement in the counseling quality compared to didactic education alone, indicating its potential as an effective tool for clinicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The 5 A's of firearm safety counseling: Validating a clinical counseling methodology for firearms in a simulation-based randomized controlled trial. Hoops, K., McCourt, A., Crifasi, CK.[2023]

Firearm-related injuries are a significant public health issue in the U.S., and there is a critical need for systematic data collection to inform research and policy development.

The development of state and local surveillance systems for firearm-related injuries is essential for linking injury data to actionable public health measures, but challenges remain in standardizing data collection and integrating health and criminal justice information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Firearm-related injury surveillance. An overview of progress and the challenges ahead. Mercy, JA., Ikeda, R., Powell, KE.[2019]

In a 2015 survey of 3932 participants, 61% of firearm owners reported receiving formal firearm training, which is similar to estimates from 1994, indicating no significant change in training rates over two decades.

The most common training topics included safe handling, safe storage, and accident prevention, but only 15% of firearm owners received training on suicide prevention, highlighting a gap in critical safety education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Formal firearm training among adults in the USA: results of a national survey. Rowhani-Rahbar, A., Lyons, VH., Simonetti, JA., et al.[2019]

Citations

1. publichealth.jhu.edu publichealth.jhu.edu/center-for-gun-violence-solutions/actfast

ACTFAST | Center for Gun Violence Solutions We're studying the implementation and effectiveness of ACTFAST, a comprehensive approach to firearm safety in US-based Pediatric and Adult Trauma Centers.

2. withpower.com withpower.com/trial/firearm-safety-training-for-gunshot-wound-prevention-5e353

Firearm Safety Training for Gunshot Wound Prevention ... The goal of this interventional study is to evaluate the implementation and effectiveness of a comprehensive a universal firearm injury prevention program, ...

3. reporter.nih.gov reporter.nih.gov/search/RlawXY9xfUiMXGOhfMF-Zw/project-details/10812044

Urban and Rural Trauma Centers RE-AIM at Firearm Injury ... PROJECT NARRATIVE The proposed study will refine a feasible, comprehensive training strategy for improving the implementation of a universal trauma-center based ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT06712940

Supportive Hospital-Based Intervention for Firearm Trauma The hypothesis of this study is that this harm reduction intervention will be more effective in changing firearm-related behaviors and beliefs than the control ...

5. nature.com nature.com/articles/s41599-024-02883-z

a student-led initiative to prevent firearm violence Firearm violence continues to substantially increase, yet medical education is largely devoid of firearm injury prevention efforts.

6. reporter.nih.gov reporter.nih.gov/project-details/10790742

RFA-CE-23-006, Pediatric Trauma Centers RE-AIM at Gun ... Our long-term goal is to demonstrate best practices for pediatric trauma center-based firearm injury prevention strategies that promote safe storage practices ...