3082.0 - Increases in youth knowledge about US firearm injury from Guardians 4 Health: A cluster-randomized bystander intervention with 4-H Shooting Sports
Program: Injury Control and Emergency Health Services
Session: Special Topics in Firearm Injury Prevention Posters
Authors: Adrianne Katrina Nelson, Megan L. Ranney
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Abstract
Background
Firearm injury is the leading cause of death for American youth. Few firearm injury prevention (FIP) interventions have been co-designed with communities with high rates of firearm ownership. Given the excellent firearm safety record within 4-H Shooting Sports (4HSS) and the influence 4HSS youth have in their communities, we conducted a CDC-funded cluster randomized controlled trial of a bystander FIP intervention, Guardians 4 Health (G4H), with 4HSS youth ages 12-18, in collaboration with national 4HSS leadership. This abstract reports on the secondary outcome of change in youth knowledge of firearm injury in the United States (US).
Methods
Fifty sites from 28 states were recruited, consented, and randomized to immediate (N=26 sites; N=250 youths) or delayed (N=24 sites; N=174 youths) intervention groups; total youth sample size was 424. Youth in both groups responded to eight knowledge questions related to US firearm injury at baseline, three-month, and six-month follow-up surveys. Response options included true/false (e.g., “There are 100 gun deaths every day in the US”), agreement ratings (e.g., “Having access to a gun at home increases the likelihood of suicide.”), and multiple choice (e.g., “For every 10 people who survive a suicide attempt, how many will later die by suicide?”). A sum score of total correct items was computed for each participant. Linear mixed-effects models were fitted while adjusting for baseline knowledge score. Exploratory subgroup analyses were performed on key sociodemographic subgroups.
Results
Intervention youth demonstrated significant increases in knowledge at the three-month follow-up (β=1.98, p<0.001) as well as six month follow-up (β=1.81, p<0.001). At both time points, youth with a significant knowledge increase were more likely to be: aged 12-14 (3m: 1.69, p<0.001; 6m: 1.74, p<0.001), female (3m: 1.97, p<0.002; 6m: 1.58, p<0.001), from the Midwestern US (3m: 2.43, p<0.001; 6m: 2.20, p<0.001), and from families with parents who were married (3m: 1.86, p<0.001; 6m: 1.57, p<0.001), nonveterans (3m: 1.87, p<0.001; 6m: 1.66, p<0.001), and with only high school education, (3m: 1.91, p<0.001; 6m: 1.81, p=0.03).
Discussion
The intervention yielded a strong, sustained impact on youth knowledge about firearm injury at 3 and 6 months. Subgroup results may reflect demographic differences in receptiveness in intervention material and in 4HSS activities. Family background also appeared to shape the impact of the program. These findings underscore the importance of tailoring interventions to consider demographic and familial contexts