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Abstract
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BACKGROUND: Firearm injuries--fatal and nonfatal--disproportionately affect younger Americans, have increased in recent years (1, 2), and are the leading cause of death among children and adolescents (3). The 4-item (fighting; friend weapon carrying; hearing gunshots in one's neighborhood; received firearm threats), 10-point SaFETy score is the only clinical screening tool specific to firearm violence (4). Yet, its association with firearm violence is unexamined outside of the single-site study (4) describing its development.
Objective: To estimate the association between the SaFETy score and past 6-month self-reported firearm violence among young adults presenting to emergency departments (EDs) in 3 cities.
Methods: We analyzed baseline data from an ongoing cohort study of young adults presenting to Level-1 trauma centers in 3 cities. English-speaking persons aged 18 to 24 years who were medically able to consent were eligible; those requiring intensive psychosocial services (for example, for sexual assault, psychosis, or active suicidality) or in active police custody were excluded. Recruiters identified potentially eligible persons using the electronic health record and approached them in waiting areas or treatment rooms. Recruitment occurred in Seattle, Washington (1 ED; 26 August 2021 through 25 May 2023); Flint, Michigan (1 ED; 24 January 2022 through 9 May 2023); and Philadelphia, Pennsylvania (2 EDs; 26 July 2021 through 31 May 2023). Across sites, 25.4% of those approached declined study participation prior to receiving the baseline survey. Consenting participants were remunerated $40 for baseline survey completion. A certificate of confidentiality was obtained, and all procedures were approved by the University of Michigan Institutional Review Board.
As in the original SaFETy score study (4), past 6-month firearm violence was measured with firearm victimization and aggression frequency, self-reported separately for partner and nonpartner violence. The primary outcome was the binary indicator of any past 6-month firearm violence. We contrasted participants in each previously derived (4) risk strata (SaFETy = 0, 1 to 5, 6+) on past 6-month firearm violence, demographics, and ED service utilization, followed by adjusted logistic regression of past 6-month self-reported firearm violence. We used R 4.3.2 for all analyses. ...
Language: en |