IntERact: Preventing Risky Firearm Behaviors Among Urban Youth Seeking Emergency Department Care
Overview
- Phase
- Not Applicable
- Intervention
- Enhanced usual care + assessment
- Conditions
- Firearm Violence
- Sponsor
- University of Michigan
- Enrollment
- 373
- Locations
- 6
- Primary Endpoint
- Change in Risky Firearm Behaviors
- Status
- Completed
- Last Updated
- 5 days ago
Overview
Brief Summary
The present study is evaluating the efficacy of a behavioral intervention to reduce risky firearm carriage among a high risk sample of youth reporting recent firearm carriage and ownership of a smartphone.
Detailed Description
Firearms are the leading cause of death for U.S. youth; 60% due to homicide. This study will test the efficacy of a behavioral intervention at reducing risky firearm behaviors among a high-risk community sample of youth (age 16-24) that report past 3-month firearm carriage and smartphone ownership. The behavioral intervention consists of 3 remotely delivered therapy sessions integrating motivational interviewing (MI), cognitive behavioral therapy (CBT), and care management (CM), supported by a smartphone APP that facilitates therapist contact, conducts automated daily assessments, delivers between session tailored therapy content, delivers just-in-time Global Positioning System (GPS)-triggered notifications upon entry into high-risk locations, and aids with utilization of local resources. Recruitment will proceed in two high-risk communities (Flint, Saginaw), including through the main Emergency Departments/trauma centers that are located in both cities. Given elevated rates of firearm violence among socio-disadvantaged youth with disparities in access to community services, the proposed intervention, if found to be efficacious, has the potential for significant public health impact.
Investigators
Patrick Carter
Associate Professor of Emergency Medicine; Center Director, OVPR Institute of Firearm Research
University of Michigan
Eligibility Criteria
Inclusion Criteria
- •Flint or Saginaw Youth between the ages of 16 to 30 reporting past 3-month firearm carriage and ownership of a smartphone, including those seeking care for any reason at Hurley Medical Center or Covenant Medical Center Emergency Department.
- •Can provide consent (age: 18-30) or youth assent and parental consent (age: 16-17) for the study.
Exclusion Criteria
- •Incarcerated (i.e., in active policy custody and not able to provide informed consent)
- •Presenting to the ED for active suicide ideation or attempt, sexual assault, and/or child abuse
- •Unable to provide informed consent due to mental status (e.g., alcohol intoxication, acute psychosis) or medical instability.
- •Participants will be excluded if firearm carriage is exclusively for legal work (e.g., police), hunting, or target shooting.
Arms & Interventions
Enhanced usual care + assessment
Daily assessments (without delivery of intervention components) will be conducted with EUC participants and they will receive a brochure with violence, substance use, and mental health resources.
IntERact
Participants will receive three remotely delivered behavioral therapy sessions (combining motivational interviewing, cognitive behavioral skills training, and care management), with an smartphone APP supporting the therapy and delivering therapeutic content in-between therapy sessions.
Intervention: IntERact
Outcomes
Primary Outcomes
Change in Risky Firearm Behaviors
Time Frame: Baseline to 3 months and 6 months
Composite measure used in prior work (Carter 2019). Composite measure uses items from the Tulane University Youth Study and Conflict Tactics Scale capturing frequency and severity of risky firearm-related behaviors (e.g. carriage, threats, use, etc.). (0=Never; 6=20+ Times)
Change in Risky Firearm Behaviors
Time Frame: Baseline to 3 months and 6 months
Composite measure used in prior work (Carter 2019). Composite measure uses items from the Tulane University Youth Study and Conflict Tactics Scale capturing frequency and severity of risky firearm-related behaviors (e.g. carriage, threats, use, etc.). (0=Never; 6=20+ Times)
Secondary Outcomes
- Change in Aggression(Baseline to 3 months and 6 months)
- Change in Victimization(Baseline to 3 months and 6 months)