Multi-site External Validation and Improvement of a Clinical Screening Tool for Future Firearm Violence
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Michigan
- Enrollment
- 1,506
- Locations
- 4
- Primary Endpoint
- Firearm Violence Involvement
Study Overview
Brief Summary
The purpose of the proposed work is to harness cutting-edge machine learning methods to optimize prediction of future firearm violence in youth ages 18-24 so that prevention resources can be allocated efficiently.
Detailed Description
Firearm violence is a public health crisis in the United States, and new epidemiological data suggest we may have reached a new endemic level of firearm mortality in recent years. Youth are disproportionately affected by firearm violence, with those age 18-24 being demonstrably the highest risk group. This study will recruit 1,500 youth age 18-24 from urban emergency departments (EDs) in three broadly different locales-Flint, Philadelphia, and Seattle-and administer a baseline survey covering several domains of potential risk factors for future violence, and follow up with those youth at 6- and 12-months to ascertain the primary outcome-firearm violence involvement (as victim or perpetrator, including threats and sub-clinical injuries)-as well as the secondary outcomes: high-risk firearm behaviors, non-firearm violence, and violent injury. This work will generate new insights into the prediction of firearm violence, and will lay the ground for future research involving the development and testing of interventions for interpersonal firearm violence both by identifying potential high-leverage modifiable predictive factors, and by focusing on youth most in need of intervention.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to 24 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Flint, Philadelphia, or Seattle Youth between the ages of 18-24 seeking care for any reason at Hurley Medical Center, the Hospital of University of Pennsylvania, Penn Presbyterian Medical Center, or Harborview Medical Center Emergency Department
- •Can provide consent for the study
Exclusion Criteria
- •Do not understand English (<1% in prior work)
- •Unable to provide consent due to mental status (e.g., alcohol intoxication, acute psychosis) or medical instability.
- •ED visit requiring intensive psychosocial services (e.g., sexual assault, psychosis, active suicidal ideation, or child abuse)
- •In active police custody/prisoners (as they cannot provide consent)
Outcomes
Primary Outcomes
Firearm Violence Involvement
Time Frame: 1 Year After Baseline ED Visit
The primary outcome for this study is firearm violence involvement, as perpetrator or victim. This will be measured in part by the Conflict Tactics Scale 2, as established by Straus et al. CTS-2 is comprised of a 6-point scale, measuring how often the respondent has experienced each type of violence, ranging from never to more than 20 times. The primary outcome here will be a binary indicator comprised of any affirmative response to the questions asked as part of items 1-3 below, or any firearm events found from the objective chart review. 1. Two self-reported measurements of firearm violence perpetration adapted from the modified conflict tactics scale (CTS-2). 2. Two self-reported measurements of firearm violence victimization adapted from the modified conflict tactics scale (CTS-2). 3. Presentation to the emergency department for a firearm injury (ICD-10 codes: X72-X74, W32-W34, X93-X95), measured based on objective chart review during the one year following baseline.
Secondary Outcomes
- Risky Firearm Behaviors(1 Year After Baseline ED Visit)
- Non-Firearm Violence(1 Year After Baseline ED Visit)
- Violent Injury(1 Year After Baseline ED Visit)
Investigators
Jason E. Goldstick
Research Associate Professor
University of Michigan