Firearm Safety Training for Pediatric Trauma

(ACTFAST Trial)

Overseen By Julie Bromberg, MPH

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Prisoners, Suicide attempt, Acute conditions, others

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

Compensation: Varies

Number of Visits: Unknown

1000 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Adopting Comprehensive Training for FireArm Safety in Trauma centers?

The 5 A's of Firearm Safety Counseling, a similar training framework, showed that after specific training, participants felt more comfortable and provided better quality counseling on firearm safety. This suggests that structured training programs can improve the effectiveness of firearm safety counseling. ^{1 2 3 4 5}

Is firearm safety training generally safe for children?

The research on ShootSafe, an educational website for teaching children firearm safety, focuses on teaching safe firearm use and improving cognitive skills like impulse control. While it aims to prevent injuries, the studies do not provide specific safety data on the training itself. ^{3 5 6 7 8}

How is the Firearm Safety Training for Pediatric Trauma treatment different from other treatments?

This treatment is unique because it focuses on training pediatric providers in firearm safety guidance to prevent unintentional injuries, which is not typically covered in standard pediatric residency programs. Unlike other treatments that might focus on medical interventions after an injury, this program aims to prevent injuries through education and safe storage practices. ^{4 5 9 10 11}

What is the purpose of this trial?

Universal firearm injury and violence prevention counseling of parents and patients has been recommended by multiple national organizations for over a decade, yet clinicians rarely deliver this counseling. Barriers to its implementation must be addressed in order to effectively deliver firearm related injury prevention efforts. This study will implement a universal firearm injury prevention initiative within a national cohort of three pediatric trauma centers. The investigator's long-term goal is to demonstrate best practices for pediatric trauma center-based firearm injury prevention strategies that promote safe storage practices and reduce firearm related injury and death. This research will test the effectiveness of a comprehensive training strategy for improving the implementation of a universal firearm injury prevention effort, ACTFAST (Adopting Comprehensive Training for FireArm Safety in Trauma centers), to 1) increase the adoption, implementation and sustainability of a universal firearm injury prevention initiative within participating pediatric level 1 trauma centers; 2) increase firearm safety knowledge, attitudes and safe firearm storage practices among parents of pediatric trauma patients and youth patients treated within participating pediatric level 1 trauma centers, and 3) increase trauma center clinicians' firearm safety knowledge and confidence in delivering a firearm safety intervention.

Research Team

Katherine Hoops, MD, PhD

Principal Investigator

Johns Hopkins School of Medicine

Eligibility Criteria

This trial is for English or Spanish-speaking individuals living with a pediatric trauma patient admitted to one of the participating level 1 trauma centers. It aims to educate these individuals on firearm safety.

Inclusion Criteria

I live with a child in trauma care and speak English or Spanish.

I am a youth aged 11-17, injured and admitted for trauma care, and can consent in English or Spanish with my parent's consent.

Exclusion Criteria

For parents/guardians of pediatric trauma patients: family members who do not live with the admitted pediatric trauma patient

For youth trauma patients: Youth who are prisoners or in police custody, Youth who are admitted due to suicide attempt, Youth with acute conditions that would preclude provision of informed consent (i.e., acute psychosis, altered mental status, cognitive impairment)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

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

3 years

Follow-up

Participants are monitored for the effectiveness of the intervention, including clinician and parent surveys on firearm safety knowledge and attitudes

3 years

Treatment Details

Interventions

• Adopting Comprehensive Training for FireArm Safety in Trauma centers

Trial Overview The study tests ACTFAST, a comprehensive training strategy for firearm injury prevention at pediatric trauma centers. It seeks to improve safe storage practices and reduce gun-related injuries and deaths among children.

Participant Groups

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: Standard Care Active Control 1 Intervention

In the pre-implementation period, 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+

Children's Hospitals and Clinics of Minnesota

Collaborator

Trials

67

Recruited

5,022,000+

University of Utah

Collaborator

Trials

1,169

Recruited

1,623,000+

Yale University

Collaborator

Trials

1,963

Recruited

3,046,000+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

Findings from Research

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]

The ShootSafe program aims to teach children aged 10-12 about firearms safety through interactive games and educational videos, focusing on knowledge, impulse control, and perceptions of firearms-related risks.

The effectiveness of ShootSafe will be evaluated in a randomized controlled trial with 162 participants, measuring outcomes such as firearms safety knowledge and simulated behavior, which could lead to improved safety practices among children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study protocol: developing and evaluating an interactive web platform to teach children hunting, shooting and firearms safety: a randomized controlled trial. Schwebel, DC., Long, DL., Gowey, M., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Pediatric firearm injuries, Kansas City, 1992: a population-based study. [2013]

2. United States 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. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Firearm injuries in the pediatric population: A tale of one city. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Implementation of a firearm safety guidance training program for pediatric providers. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Evaluation of a firearm injury prevention web-based curriculum. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Study protocol: developing and evaluating an interactive web platform to teach children hunting, shooting and firearms safety: a randomized controlled trial. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Pediatric firearm mortality in the United States, 2010 to 2016: A National Trauma Data Bank analysis. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

In harm's way: Unintentional firearm injuries in young children. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

Training in firearm safety counseling in pediatric residency programs. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Firearm Practices, Perceptions of Safety, and Opinions on Injury Prevention Strategies Among California Adults. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

A Resident-Led Firearm Curriculum for Pediatrics Residents Improves Safe Storage Counseling. [2023]