Family Safety Net: Universal firearm safety to keep youth safe at home

Summary

Intentional and unintentional firearm injuries are major public health problems in the United States. Firearm injuries are the leading cause of serious and fatal injuries to children and youth in Alaska. Such injuries and fatalities are far more likely to occur in households with unlocked and loaded, ‘unsafely stored’ firearms. In Alaska firearms are the top cause of serious and fatal youth injuries (intentional and unintentional) for children and teens, and represent a health disparity for Alaska Native (AN) children and youth living in rural and remote communities. A previous study in rural and remote Alaska documented over 90% of the households with firearms, stored at least 1 gun unlocked. In the remote study region, AN suicide rates are consistently triple the national rate and youth suicide rates are 18 times greater than for other American young people. Unintentional AN youth injuries are also significantly higher in the participating region. The proposed exploratory research builds on cultural strengths and family-centric values of AN people, integrating AN preference for family involvement in healthcare and wellness programming. Counseling all adults on how to make their households safer by ensuring all firearms in their homes are locked, unloaded with inaccessible ammunition is a potentially acceptable and impactful way to reduce youth fatalities and serious injuries in a firearm-owning population that suffers disproportionality from these health outcomes. Using a community-based participatory approach, the study will identify important considerations to encourage, and support consistent, safe firearm storage practices relevant to AN people. Our proposed research will inform the development of an innovative intervention, the Family Safety Net (FSN). Our central hypothesis is that a universal approach to engage AN adults in safe household gun storage will be an effective way to reduce children and teen risk of injury and fatality by firearm in people's homes.

IMPACT: Reducing household access to firearms can save lives in a population with disproportionately high rates of firearm access and related youth injuries and fatalities. Our approach builds on the strong family bonds of AN people and utilizes existing tribal primary care settings to engage adults in known-effective simple interventions to increase home safety by limiting access to firearms. This formative research will set the stage for a larger randomized clinical trial to reduce the stark firearm-related health disparities of AN youth (e.g. RFA-MH-20-505).

Abstract

Aim 1: Describe the firearm safety practices, key attitudes and values, and social and family roles that affect household firearm storage practices among AN (Inupiaq) men, women and youth, and get feedback to improve the Family Safety Net (3 focus groups with men, women, and youth, ages 12-17; total 9 focus groups).

Aim 2: Iteratively develop and focus test the Family Safety Net (FSN) intervention with 20 participants to refine the intervention and maximize feasibility and cultural acceptability. The proposed research aligns with the UM Injury Prevention Center’s goal to advance prevention science through a universal family-focused approach to reduce young people’s access to firearms, which can reduce a key environmental risk factor associated with intentional and unintentional AN youth mortality and morbidity.