Funded Projects

Preventing Firearm-related Injury in Under-resourced Communities

Project Year

2023

City & State

Cincinnati, Ohio

Program Name

CATCH Resident

Topic

Injury & Violence (LHI)

Program Description

Problem: In 2020, firearms became the leading cause of death for children in the United States (U.S.). Youth comprise 20% of all gun-related fatalities and 43% of all non-fatal firearm related injuries across the U.S. Approximately 1 in 3 U.S. households contains at least one firearm, which is a risk factor for firearm injury and death in children. Research has shown that increased neighborhood socioeconomic deprivation is associated with more firearm-related injuries requiring hospitalization (1). Hospitalization rates for firearm-related assaults among those aged 15-19 years are 8 times higher in urban as compared to suburban areas (2). The American Academy of Pediatrics (AAP) states that the safest home is one without firearms and recommends pediatricians counsel families on firearm safety. Research has shown that gun safety counseling with the provision of gun locks is more effective than counseling alone (3). Primary Setting and Number of Children Affected: The Pediatric Primary Care Center (PPCC) and Hopple Street Health Center (HSHC) are two large, urban, pediatric primary care centers operated by Cincinnati Children’s Hospital Medical Center (CCHMC). These clinics collectively serve over 23,000 children annually who live in under-resourced neighborhoods, Avondale and South Fairmount, with 93% of patients being publicly insured or uninsured, and 83% identifying as minorities. Patients at both clinics are significantly impacted by adverse social determinants of health and often experience food and housing insecurity. These communities are also disproportionately affected by gun violence. Within Avondale, the mortality rate secondary to firearms is significantly higher than that in greater Cincinnati (23.72 vs. 14.71 per 100,000, p=0.02)(4). In 2021 alone, 2 children and 11 teens were killed or injured secondary to gun violence in these neighborhoods. Both cases involving children were unintentional (5). Project Goal: The goal of our project is to improve access to firearm safety equipment and resources for children who seek preventative care at PPCC and HSHC, thereby reducing firearm injury in this under-resourced and minoritized population. By collaborating with community partners, we aim to broaden the reach of this project by improving firearm safety education and access to safety equipment across the Cincinnati community. Proposed Intervention: To meet this goal, we aim to purchase firearm safety equipment, including cable locks and lockboxes, that can be given to families for free during clinic well-visits. We also plan to develop firearm safety resources including: a QR code with instructions for appropriate use of distributed firearm safety equipment; a Firearm Safety Resource Map of the Cincinnati community that identifies sites for safe gun disposal, gun buyback, and locations where families can obtain free/inexpensive safe storage devices; and firearm safety handouts to be distributed during clinic visits and through our community partners. Anticipated Outcomes: We are applying for a CATCH grant to reduce firearm-related injury in children from the under-resourced and minoritized communities who receive care at our pediatric primary care centers. As primary care pediatricians, we have an important advocacy role in educating patients on firearm safety. Data demonstrate that counseling and providing gun safety mechanisms are more effective at implementing safe storage practices than counseling alone. By providing firearm safety equipment to patients, as well as by disseminating firearm safety resources, we hope to reduce firearm-related injury in this high-risk population and provide sustainable resources that can be used to keep children safe. We plan to evaluate the impact of the provision of the above resources and adherence with safe firearm practices using a retrospective survey on families from PPCC and HSHC. We also plan to evaluate family preference for safety devices provided (cable locks vs. lockboxes) to inform the purchase of future materials for the clinics.

Project Goal

The goal of our project is to improve access to firearm safety equipment and resources for children who seek preventative care at PPCC and HSHC, thereby reducing firearm injury in this under-resourced and minoritized population. By collaborating with community partners, we aim to broaden the reach of this project by improving firearm safety education and access to safety equipment across the Cincinnati community.

Project Objective 1

Develop firearm safety educational materials and resources including: a QR code with instructions for appropriate use of firearm safety equipment and a Firearm Safety Resource Map of the Cincinnati community that identifies sites for safe gun disposal, gun buyback, and locations where families can obtain free/inexpensive safe storage devices by November of 2023.

Project Objective 2

Provide 100 PPC and HSHC families with firearm safety equipment (cable lock or lockbox, based on family preference) and record family preferences and barriers to safe firearm storage during clinic appointments by March of 2024.

Project Objective 3

Evaluate the impact of firearm safety equipment provision and firearm safety counseling and resources (QR code with instructions for appropriate use of firearm safety equipment and Firearm Safety Resource Map) on caregiver adherence with firearm safe storage practices and knowledge of community resources available via survey offered to the 100 families from PPSC and HSHC who received safety equipment by May of 2024.

AAP District

District V

Institutional Name

Cincinnati Children's Hospital Medical Center

Contact 1

Kristen Humphrey

Contact 2

Margaret Carney