RFA-CE-23-006, Store Safely: Firearm injury prevention for rural families

项目总结/摘要 枪支伤害是美国青年死亡的主要原因， 农村青年的自杀率正在以惊人的速度上升。减少枪支的获得是一个关键 这是自杀预防的一个组成部分，因为91%的自杀企图是致命的。虽然安全 枪支储存减少了枪支伤害和死亡的风险，但很少有针对农村地区的干预措施。 枪支盛行的社区，枪支是社区和家庭文化的重要组成部分， 获得保健服务的机会不均等，限制了安全储存教育的机会。安全存储是一个多组件 通过大学-社区伙伴关系专门为农村火器设计的在线初级预防战略 在可接受性、可行性和初步影响方面显示出希望的家庭。中 在43个农村家庭的样本中，98%的人报告参与了所有干预措施，86%的人完成了 家庭安全检查表40%的家庭自我报告改变了他们的存储，例如购买枪支 锁、保险箱或锁箱;将弹药与武器分开;审查当前存储的安全性 以及将枪支转移到其子女较难接触的地点。80%的人认为商店安全 文化敏感，并会向其他家长推荐这些材料。为了满足这一迫切需要， RFA-CE-23-006（资助方案B）我们将采用基于社区的参与式研究（CBPR）方法 和一个混合的两个有效性实施框架，以测试这种创新的，高度可扩展的在线 干预我们的具体目标包括：1）完善商店安全干预，纳入反馈 从试点试验和我们的社区合作伙伴，2）试点随机对照试验的20个家庭，以完善措施， 程序，以及3）一个混合两个试验与800个农村枪支拥有家庭随机接受商店安全 或等待列表控件，以提供安全存储对主要干预的影响的明确评估 锁定枪支储存的目标以及干预机制，包括知识、态度和 行为意图以及家庭安全行为，如家庭安全检查。执行 问题的目的是确定接触和招募家庭参与干预的最有效手段。 我们的研究人员团队是唯一准备成功地领导这项研究，因为我们长期的跟踪记录， 以社区为基础的参与性研究，为有自杀风险的青年制定干预措施， 火器伤害和实施科学如果发现有效，安全储存有可能减少 通过利用农村社区的优势加强安全，降低农村地区的自杀死亡率。

Project Summary/Abstract Firearm injuries are the leading cause of death among youth in the United States and rates of firearm-related suicides among rural youth are increasing at an alarming rate. Reducing access to firearms is a key component of suicide prevention because 91% of suicide attempts with a firearm are fatal. Although safe firearm storage reduces risk of firearm injury and death, few interventions exist that are tailored to rural communities where firearms are prevalent and an important part of community and family culture and where health care access disparities limit opportunities for safe storage education. Store Safely is a multi-component online primary prevention strategy designed via a university-community partnership specifically for rural firearm owning families that has shown promise in terms of its acceptability, feasibility, and preliminary impact. In a sample of 43 rural families, 98% reported engaging with all intervention components and 86% completed a home safety checklist. 40% of families self-reported making a change to their storage, such as purchasing gun locks, safes, or lockboxes; separating ammunition from weapons; reviewing the safety of current storage practices; and relocating firearms to a location harder to access by their children. 80% found Store Safely to be culturally sensitive and would recommend the materials to other parents. In response to this urgent need and RFA-CE-23-006 (Funding Option B) we will use a community-based participatory research (CBPR) approach and a hybrid two effectiveness-implementation framework to test this innovative, highly scalable online intervention. Our specific aims include: 1) refinement of the Store Safely intervention, incorporating feedback from the pilot trial and our community partners, 2) a pilot RCT of 20 families to refine measures and procedures, and 3) a hybrid-two trial with 800 rural firearm owning families randomized to receive Store Safely or a wait list control to provide definitive assessment of the impact of Store Safely on the primary intervention target of locked firearm storage as well as mechanisms of intervention to include knowledge, attitudes, and behavioral intentions as well as family safety behaviors, such as home safety checks. Implementation questions are designed to identify the most fruitful means of reaching and recruiting families to the intervention. Our team of investigators is uniquely poised to successfully lead this study given our lengthy track record of community-based participatory research, the development of interventions for youth at risk for suicide and firearm injury, and implementation science. If found to be effective, Store Safely has the potential to reduce suicide mortality in rural areas by capitalizing on the strengths of rural communities to enhance safety.