Pediatric Trauma Centers RE-AIM at Gun Safety

Not Applicable

• Conditions: Firearm Injury; Safety Issues
• Interventions: Behavioral: Adopting Comprehensive Training for FireArm Safety in Trauma centers

• Registration Number: NCT06123611
• Lead Sponsor: Johns Hopkins University

Brief 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. This study will implement a universal firearm injury prevention initiative within a national cohort of three pediatric trauma centers. The investigator's 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 research 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), to 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 and youth patients treated within participating pediatric level 1 trauma centers, and 3) increase trauma center clinicians' firearm safety knowledge and confidence in delivering a firearm safety intervention.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-11-01
• Study First Submitted QC: 2023-11-08
• Study First Posted: 2023-11-09
• Study Start: 2024-02-25
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-07
• Last Update Posted: 2025-03-11
• Primary Completion: 2026-09-30
• Study Completion: 2027-09-30

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 1000

Inclusion Criteria

• live with an admitted pediatric trauma patient at a participating trauma center
• be fluent in English or Spanish

Exclusion Criteria

• family members who do not live with the admitted pediatric trauma patient

For youth trauma patients:

Inclusion Criteria:

• Must be between the ages of 11-17 years
• admitted to a participating trauma inpatient service for an injury
• fluent in English or Spanish
• able to provide written assent and parent able to provide written consent

Exclusion Criteria:

• Youth who are prisoners or in police custody
• Youth who are admitted due to suicide attempt
• Youth with acute conditions that would preclude provision of informed consent (i.e., acute psychosis, altered mental status, cognitive impairment)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ACTFAST Intervention	Adopting Comprehensive Training for FireArm Safety in Trauma centers	During the implementation and maintenance periods, all trauma patients will receive study activities including firearm access screening, counseling on safe storage practices, and referral to safe storage and other community resources as appropriate.

Primary Outcome Measures

Name	Time	Method
Parent firearm safety attitudes and behaviors	3 years	This outcome will be measured using parent survey and interview adapted from prior work by the study team.
Implementation of Intervention	3 years	This outcome will be measured using chart review protocols examining rates of firearm access screening, documentation of firearm safety counseling, documentation of referral to community based resources and connection to medical homes as well as patient hospitalization characteristics including admission diagnosis, injury severity and patient demographic characteristics.

Secondary Outcome Measures

Name	Time	Method
Adolescent patient firearm safety attitudes and behaviors	3 years	Measure firearm injury prevention knowledge, attitudes and safe firearm practices of adolescent trauma patients (11-17 years) within participating pediatric level 1 trauma centers. This outcome will be measured using patient survey and interview adapted from prior work by the study team.
Clinician firearm safety knowledge and confidence	3 years	This outcome will be measured using clinician surveys derived from multiple sources developed through the prior work of members of the study team.

Trial Locations

Locations (1)

Johns Hopkins Medicine; 🇺🇸 Baltimore, Maryland, United States