Development of a National Youth Firearm Risk and Safety Assessment Tool

项目摘要 2013年，1258名儿童(每10万人中有1.71人)死于枪击，另有6103人(每10万人中有8.29人)死于枪击 非致命性枪伤。此外，2010年，与青年枪支有关的致命和非致命伤害导致 估计医疗和工作损失合计成本为26亿美元。承认这些惊人的数字，广泛的 已经制定了一系列政策干预措施，以帮助减少此类暴力犯罪，结果好坏参半。不过， 令人惊讶的是，我们对儿童接触枪支以及这种接触对儿童感染风险的影响知之甚少 暴力、伤害和死亡。尽管有政策声明和像 美国儿科学会和USDHHS健康人2020强调 寻找减少与儿童接触和接触枪支有关的风险的战略。过去的研究 关于青少年枪支暴露，只集中在有限范围内的暴露，如继续使用枪支 然而，青少年接触枪支并不局限于学校或携带枪支。事实上，没有 涵盖儿童枪支暴露的所有范围的仪器。如此缺乏以年轻人为重点的调查 限制评估暴露的发展影响和确定最重要的目标的能力 旨在减少儿童中与枪支有关的致命和非致命伤害的政策和方案。这一差距是 值得注意的是，有儿童特有的考虑因素，如不适当或非法获取枪支， 暴露在涉及照顾者的枪支暴力中，这可能会造成特别严重的创伤，以及发育 暴露于有效的枪支安全做法的影响。除了关于暴露的不同考虑之外， 对青年来说，还有一些重要的方法调整是必要的，包括更加谨慎 注意阅读水平，避免使用法律术语。目前的研究将允许收集 以及分析与整个儿童和青春期有关的枪支暴露信息。 具体地说，我们的目标是：1)制定第一个全面的、以发展为重点的青年枪支风险和 安全工具(青年优先)；和2)试点测试青年优先，在两个枪支高危社区内 暴力--田纳西州阿巴拉契亚农村和宾夕法尼亚州费城。青年优先项目将通过 采取混合方法，包括与青少年和家长的焦点小组、暴力专家的审查、 并与10-15岁的儿童进行认知访谈，以求理解。来自300名青年的试点社区数据， 10-17岁，以及2-9岁儿童的300名照顾者(代理面谈)将被用来确定 青少年先锋心理测量学的内部一致性、因素结构和结构效度 运用项目反应理论(IRT)和差异项目功能(DIF)等技术。调查结果将 帮助外地解决青年接触枪支和相关暴力暴露的问题，使用更综合的 接近， 直接促进我们的最终结果目标，即增加对真理的欣赏 枪支暴露和枪支暴力给人口中最脆弱的部分带来了负担。

Project Summary In 2013, 1,258 children (1.71 per 100,000) died by gunshot and an additional 6,103 (8.29 per 100,000) had a nonfatal gunshot injury. Additionally, in 2010 youth firearm-related fatal and nonfatal injuries resulted in an estimated $2.6 billion in combined medical and work loss costs. Acknowledging these striking numbers, a wide range of policy interventions have been developed to help reduce such violent crimes, with mixed-results. Still, we know surprisingly little about children's exposure to guns and the implications of that exposure on risk for violence, injury, and death. This is despite policy statements and recommendations from groups like the American Academy of Pediatrics and the USDHHS Healthy People 2020 emphasizing the importance of finding strategies for reducing the risks associated with children's firearm access and exposure. Past research on youth firearm exposure has focused on only a limited range of exposures, such as firearm carrying on school property, yet youth firearm exposure is not limited to schools or to carrying. Indeed, there are no instruments that cover the full spectrum of childhood firearm exposure. Such a lack of youth-focused surveys limits the ability to assess the developmental impact of exposure and identify the most important targets for policy and programs that aim to reduce firearm-related fatal and non-fatal injury among children. This gap is notable given there are considerations unique to childhood, such as inappropriate or illegal access to firearms, exposure to gun violence involving caregivers which may be particularly traumatic, and the developmental impact of exposure to effective gun safety practices. In addition to different considerations regarding exposure, there are also important methodological adaptations that are necessary for youth, including more careful attention to reading level and avoiding use of legalistic terms. The present research will allow for the collection and analysis of firearm exposure information relevant to the entire span of childhood and adolescence. Specifically, we aim to: 1) Develop the first comprehensive, developmentally focused Youth Firearm Risk and Safety Tool (Youth-FiRST); and 2) Pilot test the Youth-FiRST within two communities at high-risk for gun violence – rural Appalachia, TN and urban Philadelphia, PA. The Youth-FiRST items will be developed through a mixed-methods approach, including focus groups with teenagers and parents, review by violence experts, and cognitive interviews with children (ages 10-15) for comprehension. Pilot community data from 300 youth, ages 10-17, and 300 caregivers of children, ages 2-9 (proxy interviews), will be used to establish psychometrics of the Youth-FiRST including internal consistency, factor structure, and construct validity utilizing techniques such as Item Response Theory (IRT) and Differential Item Functioning (DIF). Findings will help the field address youth exposure to firearms and associated violence exposure using a more integrative approach, directly facilitating our ultimate outcome objectives which are to increase appreciation of the true burden of firearm exposure and firearm violence on the most vulnerable segment of the population.