Firearm Safety Training for Gunshot Wound Prevention

(ACTFAST Trial)

Recruiting 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

1776 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 framework showed promise in improving the quality and comfort of clinicians in delivering firearm injury prevention counseling, suggesting that structured training can enhance the effectiveness of firearm safety education. ^{1 2 3 4 5}

Is firearm safety training generally safe for participants?

The available research does not specifically address the safety of firearm safety training programs, but they focus on improving counseling and prevention strategies, which suggests that these programs are designed to be educational and non-invasive. ^{1 2 6 7 8}

How is the treatment 'Adopting Comprehensive Training for FireArm Safety in Trauma Centers' different from other treatments for gunshot wound prevention?

This treatment is unique because it focuses on comprehensive firearm safety training specifically in trauma centers, aiming to prevent gunshot wounds through education and guidance, unlike other treatments that may not emphasize training or prevention. ^{9 10 11 12 13}

What is the purpose of this trial?

The goal of this interventional study is to evaluate the implementation and effectiveness of a comprehensive a universal firearm injury prevention program, ACTFAST (Adopting Comprehensive Training for FireArm Safety in Trauma centers), in level 1 trauma centers. The main aims of the study are: 1. (Primary Aim 1) Increase the adoption, implementation, and maintenance of a universal firearm injury prevention intervention at three participating trauma centers in the mid-Atlantic states; 2. (Primary Aim 2) Assess firearm injury prevention knowledge, attitudes, and safe storage practices among trauma patients treated within participating trauma centers.

Research Team

Katherine Hoops, MD, MPH

Principal Investigator

Johns Hopkins University

Eligibility Criteria

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

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

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

Exclusion Criteria

N/A

Prisoner or in police custody

Admitted due to suicide attempt

Timeline

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

Treatment Details

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.

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: 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+

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]

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]

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]

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]

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]

References

1. 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]

2. England pubmed.ncbi.nlm.nih.gov

Talking about firearm injury prevention with patients: a survey of medical residents. [2022]

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

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

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

Consensus-Driven Priorities for Firearm Injury Education Among Medical Professionals. [2023]

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

Taking Aim at the Injury Prevention Curriculum: Educating Residents on Talking to Patients About Firearm Injury. [2022]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Firearm-related injury surveillance. An overview of progress and the challenges ahead. [2019]

7. England pubmed.ncbi.nlm.nih.gov

A mixed methods protocol to implement universal firearm injury risk screening and intervention among youth and adults in emergency departments across a large US health system. [2022]

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

Firearm Injuries treated at Trauma Centers in the United States. [2023]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Training in firearm safety counseling in family practice residency programs. [2022]

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

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

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

Using Longitudinal Curriculum to Improve Psychiatry Residents' Attitudes Regarding Firearm Anticipatory Guidance. [2023]

12. England pubmed.ncbi.nlm.nih.gov

Formal firearm training among adults in the USA: results of a national survey. [2019]

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

Physician-driven or self-directed safe firearm storage guidance: Which one is best? [2022]