Reframing Firearm Injury Prevention Through Bystander Interventions for Youth Shooting Sports Participants

项目摘要 枪支伤害和死亡率是美国1-19岁青少年的主要公共卫生问题。可改变的风险 青少年火器伤害和死亡的因素包括在家中不安全地储存火器， 受害/攻击，物质使用和抑郁症状。由于政治局势紧张， 缺乏研究资金，与枪支拥有者和枪支安全培训计划的伙伴关系， 缺乏对青年火器伤害实施有效、非政策性预防干预措施。旁观者 干预（BI）是一种植根于社会心理学理论的干预框架，如 计划行为（TPB），具有针对个人和社区的有效性和有效性 行为改变“The Reframe”是一个由三部分组成的、已经试点的干预措施，它使用BI框架， TPB机制促进成人和青年社区关于枪支安全，BI和伤害的规范变化 还原技术（例如，安全储存、减少获得致命手段的机会、解决冲突）。认识到 当由可信的信使领导时，BI是最严格的，The Reframe使用指导性的，点对点的， 与与枪支有密切联系的社区组织合作的社会媒体战略 安全努力。我们的社区合作伙伴，国家4-H射击运动计划是一个国家的领导者， 安全可靠的枪支信使根据RFA的研究目标二，资助选择 B，我们建议进行第一类混合的可靠性实施试验，以评估Reframe的 改变样本中火器伤害预防规范、态度、意图和行为的有效性 50个4-H射击运动俱乐部社区（成人和青年）。我们建议：（1）开展一系列重点工作， 与由20名主要利益相关者（青少年和成人4-H射击运动）组成的咨询委员会进行了知情人访谈 代表一系列社区和4-H经验的领导人），以确保重新框架解决4-H- 可接受性、可行性和适当性的具体问题;（2a）评估重新框架的有效性， 与常规训练相比，在改变个人和社区水平、近端和远端行为方面， 在0、3和6个月时与火器伤害预防有关的结果;（2b）检查障碍和促进因素， 采用混合方法（定性和定量）实施“重新框架”干预措施; (2c)使用人口水平数据探索所有50个社区的伤害模式。意义：这 该提案将通过支持以下方面的协同伙伴关系来推进火器伤害预防科学： 建立了火器伤害，自杀和暴力预防研究人员和国家4-H射击运动 社区与疾病预防控制中心的优先事项相一致，该提案将为以下方面的最佳做法建立证据基础： 易于实施的个人和社区一级的干预措施，促进青年周围的安全行为 枪支使用和伤害预防。

PROJECT SUMMARY Firearm injury and mortality are a major public health concern for American youth age 1-19. Modifiable risk factors for youth firearm injury and death include unsafe storage of a firearm in the home, prior victimization/aggression, substance use, and depressive symptoms. Due to the fraught political landscape and lack of research funding, partnerships with firearm owners and firearm safety training programs to create and implement effective, non-policy-based preventive interventions for youth firearm injury are lacking. Bystander intervention (BI) is an intervention framework rooted in social psychological theories such as the Theory of Planned Behavior (TPB), with proven efficacy and effectiveness targeting both individual and community behavior change. “The Reframe” is a three-part, already-piloted intervention that uses the BI framework and TPB mechanisms to promote adult and youth community norms change about firearm safety, BI, and harm reduction techniques (e.g., safe storage, reducing access to lethal means, conflict resolution). Recognizing that BI is most rigorous when led by credible messengers, The Reframe uses instructional, peer-to-peer, and social-media strategies in conjunction with community organizations that are deeply connected to firearm safety efforts. Our community partner, the National 4-H Shooting Sports Program is a national leader and trusted messenger for firearm safety. In accordance with this RFA’s Research Objective Two, Funding Option B, we propose to conduct a Type I Hybrid Effectiveness-Implementation Trial to evaluate The Reframe’s effectiveness in changing firearm injury prevention norms, attitudes, intentions, and behaviors among a sample of fifty 4-H Shooting Sports Club communities (adults and youth). We propose to: (1) Conduct a series of key informant interviews with an advisory board of 20 key stakeholders (youth and adult 4-H Shooting Sports leaders representing a range of communities and 4-H experience) to ensure The Reframe addresses 4-H- specific issues of acceptability, feasibility, and appropriateness; (2a) Evaluate The Reframe’s effectiveness, compared to usual training, in changing individual- and community-level, proximal and distal behavioral outcomes related to firearm injury prevention at 0, 3, and 6 months; (2b) Examine barriers and facilitators to The Reframe intervention’s implementation using a mixed-methods (qualitative and quantitative) approach; (2c) Explore injury patterns among all 50 communities using population-level data. SIGNIFICANCE: This proposal will advance firearm injury prevention science by supporting a synergistic partnership between well- established firearm injury, suicide, and violence prevention researchers and the national 4-H Shooting Sports community. Consistent with CDC priorities, this proposal will build an evidence base for best practices for easy-to-implement individual- and community-level interventions that promote safe behaviors around youth firearm use and injury prevention.