Firearm Safety Interventions for Suicide Prevention

(FSN Trial)

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Prior household participation

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

Compensation: Varies

Number of Visits: 2

86 Participants Needed

Trial Summary

What is the purpose of this trial?

Our parallel group clinical trial of the Family Safety Net (FSN) intervention addresses two main questions: * Is the Family Safety Net (FSN) intervention feasible and acceptable in two formats: motivational interviewing (FSN MI) counseling session and scripted psychoeducational session (FSN Scripted), with a primarily Alaska Native population in Northwest Alaska? * Secondarily, are there signals of efficacy at improving home safety (firearms unloaded, locked with ammunition separate) and dangerous medication locked? All participants will complete a baseline survey with firearm storage questions as well as 3 questions about mental health concerns in their family (e.g. 'Are you worried that someone in your home is at risk of suicide?'). * If participants answer "yes" to any of these questions, they will be randomly assigned to one of the two FSN intervention groups (1 and 2 below). * If they do not endorse any of the three family-focused mental health questions, they will be randomly assigned to one of two general firearm safety conditions (3 and 4 below). 1. FSN MI group will participate in a 15-20-minute motivational interviewing (MI) session conducted by trained research staff focused on suicide lethal means reduction. 2. FSN Scripted group will participate in a 10-minute scripted session focused on suicide lethal means reduction. Both FSN groups (1 and 2): * Can take home trigger locks, cable locks, ammo boxes, medication boxes and mental health resources * Receive 4 weeks of tailored text message reminders and encouragement. * Complete 1-month follow-up survey consisting of items related to firearm storage, and facilitating factors hypothesized to contribute to this behavior. * Participants in both FSN conditions will be invited to participate in a semi-structured interview at follow-up focused on satisfaction and perceptions of the program. 3 General gun safety intervention group will participate in a 10-minute scripted conversation about safe gun storage practice, and: * Can take home trigger locks, cable locks, and ammo boxes. * Receive 4 weeks of tailored text message reminders and encouragement. * Complete 1-month follow-up survey consisting of items related to firearm storage, and facilitating factors hypothesized to contribute to this behavior. 4. General gun safety comparison group: * Can take home trigger locks, cable locks, and ammo boxes. * Complete 1-month follow-up survey.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on firearm safety and does not mention medication changes.

What data supports the effectiveness of the treatment Firearm Safety Interventions for Suicide Prevention?

Research shows that strategies focusing on safe firearm storage and limiting access to firearms, known as means safety strategies, are effective in preventing suicide. These interventions include lethal means counseling and promoting safe storage practices, which have been shown to reduce the risk of suicide by firearms. ^{1 2 3 4 5}

Is the Firearm Safety Intervention for Suicide Prevention safe for humans?

The research on firearm safety interventions for suicide prevention focuses on promoting safe storage and reducing access to firearms, which are generally considered safe practices for humans. These interventions aim to prevent suicide by encouraging responsible firearm handling and storage, and there is no indication of harm from these safety measures. ^{3 4 5 6 7}

How does the Firearm Safety Interventions for Suicide Prevention treatment differ from other treatments for suicide prevention?

This treatment is unique because it focuses specifically on firearm-related lethal means safety, which involves strategies to reduce access to firearms and promote safe storage practices to prevent suicide. It addresses cultural and identity barriers, especially among military personnel and veterans, making it a tailored approach compared to general suicide prevention methods. ^{2 3 4 6 7}

Research Team

Lisa M Wexler, PhD, MSW

Principal Investigator

University of Michigan

Eligibility Criteria

This trial is for adults over 18 who have lived in Northwest Alaska for at least 5 years, can read and understand English, live with a gun in the house, have a text-capable phone, and where young people are present. It excludes households that already participated.

Inclusion Criteria

I am over 18 and can read and understand English.

I am over 18 and have a phone that can receive texts.

I am over 18 and live with someone under 29.

Exclusion Criteria

Someone else in the household has already participated in the study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Baseline Survey and Intervention

Participants complete a baseline survey and are assigned to one of the intervention groups based on their responses. They participate in either a motivational interviewing session or a scripted session focused on firearm safety.

1 day

1 visit (in-person)

Text Message Follow-up

Participants receive 4 weeks of tailored text message reminders and encouragement related to firearm safety and mental health support.

4 weeks

Follow-up Survey and Interview

Participants complete a follow-up survey and are invited to participate in a semi-structured interview to assess satisfaction and perceptions of the program.

1 day

1 visit (virtual or phone)

Treatment Details

Interventions

• Comparison
• FSN Intervention
• General Firearm Comparison - General Firearm Safety
• General Firearm Safety Intervention - General Firearm Safety
• MI FSN - Lethal Means Reduction
• Scripted FSN - Lethal Means Reduction

Trial Overview The study tests two versions of the Family Safety Net (FSN) intervention on firearm safety: one using motivational interviewing and another using scripted education. Both aim to improve home safety by keeping firearms unloaded, locked away, and separate from ammunition.

Participant Groups

Group I: FSN Lethal Means Reduction Experimental Treatment 2 Interventions

\* Participants will be screened into the lethal-means reduction-focused FSN program if they answer "yes" to one or more of the following questions: 1. In the past two months, has anyone in your household been going through a rough time? 2. In the past two months, has someone in your home seemed down, sad, or depressed? 3. Are you worried that someone in your home is at risk of suicide? Participants are then assigned to either the MI FSN intervention or the Scripted FSN intervention

Group II: General Firearm Safety Comparison Active Control 2 Interventions

General Firearm Safety \* Participants will be screened into the general firearm safety arm of the program if they do not answer "yes" to any of the following questions: 1. In the past two months, has anyone in your household been going through a rough time? 2. In the past two months, has someone in your home seemed down, sad, or depressed? 3. Are you worried that someone in your home is at risk of suicide? Participants are then assigned to either the General Firearm Safety Intervention or General Firearm Comparison

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Maniilaq Association

Collaborator

Trials

2

Recruited

1,200+

Findings from Research

The SAFER intervention was implemented successfully at 18 community events, reaching 1175 participants, with 61% finding it highly valuable, indicating its acceptability among those at higher risk for suicide.

Following the SAFER intervention, there was a significant increase in safe firearm storage practices (from 51.2% to 66.0%) and safe medication storage (from 14.8% to 21.6%), along with improved awareness that most firearm fatalities are due to suicide (from 33.4% to 45.8%).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SAFER brief community intervention: a primary suicide prevention strategy to improve firearm and medication storage behaviour. Stuber, JP., Massey, A., Meadows, M., et al.[2022]

References

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

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

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

Firearms Access among Pediatric Patients at Risk for Suicide. [2023]

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

A pilot randomized clinical trial of a lethal means safety intervention for young adults with firearm familiarity at risk for suicide. [2022]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Firearm suicide: pathways to risk and methods of prevention. [2022]

5. England pubmed.ncbi.nlm.nih.gov

SAFER brief community intervention: a primary suicide prevention strategy to improve firearm and medication storage behaviour. [2022]

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

Engaging stakeholders to develop a suicide prevention learning module for Louisiana firearm training courses. [2023]

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

Firearm Lethal Means Safety with Military Personnel and Veterans: Overcoming Barriers using a Collaborative Approach. [2022]