RFA-CE-23-006, Pediatric Trauma Centers RE-AIM at Gun Safety

项目摘要 普遍火器伤害和暴力预防咨询的父母和病人已建议， 十多年来，多个国家组织，但临床医生很少提供这种咨询。阻碍其 必须解决执行问题，以便有效地开展预防火器相关伤害的工作。的 研究小组已经证明了酒精筛查的成功实施和可持续性，简要 两项联邦资助的多中心儿科创伤试验中的干预和转诊治疗方案 中心.该团队还拥有基于临床的火器伤害预防和教育策略的专业知识 程序开发。我们将运用我们的实施科学和主题专业知识， 在三个儿科创伤中心的国家队列中开展了普遍的火器伤害预防倡议， 我们以前曾合作进行多地点研究。我们的长期目标是展示最佳实践， 以儿科创伤中心为基础的火器伤害预防策略，促进安全储存做法， 减少与枪支有关的伤亡。本提案是为响应RFA-CE-23-006资助而提交的 备选方案B将检验一项全面培训战略在改进执行《联合国宪章》方面的有效性， 普遍火器伤害预防工作，ACTFAST（采用火器安全综合培训， 创伤中心），通过以下主要目标：1）增加采用，实施和 在参与的儿科1级创伤中普遍预防火器伤倡议的可持续性 （2）增加枪支安全知识，态度和安全枪支储存的做法，父母之间的 在参与的儿科1级创伤中心接受治疗的儿科创伤患者，并通过以下方式 次要目标：1）增加创伤中心临床医生的枪支安全知识和信心， （2）加强枪支安全知识、态度和枪支安全实践; 参与的儿科1级创伤中心的青少年创伤患者（11-17岁）。使用RE- AIM方法，我们将评估我们在采用领域的全面战略， 在制度层面上的执行和维护。我们将衡量临床医生的枪支安全知识 参加临床医生培训计划后， 通过培训前和培训后调查衡量。此外，我们将收集和分析父母（n=560）和 青少年患者（n=280）在ACTFAST实施前后的知识变化数据， 在基线和出院后2周和3个月时的态度和最重要的实践。

PROJECT SUMMARY 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. The research team has demonstrated success in the implementation and sustainability of alcohol screening, brief intervention and referral to treatment protocols in two federally funded multi-site trials at pediatric trauma centers. The team also has expertise in clinically-based strategies for firearm injury prevention and educational program development. We will apply our implementation science and subject matter expertise to implement a universal firearm injury prevention initiative within a national cohort of three pediatric trauma centers with which we have previously collaborated on multisite research. Our 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 proposal, submitted in response to RFA-CE-23-006 funding option B, 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), through the following primary aims: 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 treated within participating pediatric level 1 trauma centers, and through the following secondary aims: 1) increase trauma center clinicians’ firearm safety knowledge and confidence in delivering a firearm safety intervention; 2) increase firearm safety knowledge, attitudes and firearm safety practices of adolescent trauma patients (11-17 years) within participating pediatric level 1 trauma centers. Using the RE- AIM methodology, we will evaluate our comprehensive strategy across the domains of adoption, implementation, and maintenance at the institutional level. We will measure clinician firearm safety knowledge and confidence in delivering firearm prevention counseling after participation in the clinician training program as measured by pre and post training surveys. In addition, we will collect and analyze parent (n=560) and adolescent patient (n=280) data before and after ACTFAST implementation for changes in knowledge, attitudes and, most importantly, practices at baseline and at 2 weeks and 3 months after hospital discharge.