Social Workers Addressing Firearm Risk

Evaluating the Social Workers Addressing Firearm Risk (SAFR) Intervention: A Pilot Study

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05784662

Acronym

SAFR

Enrollment

111

Registered

2023-03-27

Start date

2023-08-21

Completion date

2024-05-31

Last updated

2025-02-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Gun Violence Prevention

Keywords

firearms, guns, social work

Brief summary

Aim 2: Evaluate the preliminary efficacy of the SAFR intervention using a randomized controlled trial. An additional 100 practicing social workers (excluding participants from Aim 1) will be recruited, with n = 50 allocated to each arm of the study utilizing block randomization. Participants in the control arm will receive invitations to all surveys but not to the SAFR intervention itself. We will utilize the validated measures from Aim 1 to assess changes on study variables. Results will be analyzed using either mixed linear models or generalized estimating equations as appropriate. Analyses will be performed with a focus on estimation of parameters for use in the planning of a subsequent comparative trial designed to fully assess intervention efficacy with a national sample. Supportive analyses that adjust for participant covariates will also be considered. We will also ask participants for feedback on the intervention and will track indicators of feasibility and acceptability (recruitment rates, completion of intervention and measurement tools).

Detailed description

Specific Aim 2: Evaluate the efficacy of the SAFR intervention. Once measurement tools have been validated, we will begin to recruit for the pilot test of the SAFR intervention. Recruitment methods will be similar to those in Aim 1; individuals who participate in Aim 1 will not be eligible to participate in the trial of SAFR. Participants will be randomized equally to the control and intervention groups. Participants will be invited to enroll in the study by clicking on links in advertisement materials. The link will take them to a brief webpage with information about the study and questions screening for eligibility. Once screened, they will complete the informed consent document and await randomization. Participants in the intervention group will receive an email with instructions on how to access the pre-test measurements and the course. Because the course is online and self-paced, they will be given six weeks to complete the course, with reminders coming once a week to encourage completion. The UB SSW Continuing Education website allows us to track information about participants, including time to completion for all users; this information will be utilized to assess the acceptability of the course. The pre-test survey will include the scales assessing knowledge, attitudes, and behaviors towards assessing for risks of firearm violence among clients, in addition to a demographic survey and the Gun Control Attitudes and Gun Behaviors and Beliefs Scales. The post-test, which will be sent out one month after the pre-test, assuming that the course was successfully completed, will contain the measures regarding knowledge, attitudes, and behaviors. We will also be assessing for acceptability of the intervention by including questions that ask participants for their thoughts on the course. Finally, the follow-up will be sent three months after the completion of the post-test and will assess knowledge, attitudes, and behaviors a final time. The control group will receive the three surveys (without course feedback items) on the same timeline. At the conclusion of the study, they will be invited to receive the SAFR intervention at no cost. Data analysis plan. To describe the observed variability in the data and test for differences between randomized groups, linear or generalized linear models will be utilized depending on the nature of the outcome. Once a given model is fit, a linear contrast based on the estimated model parameters will be constructed and used to test for the overall effect of random assignment. Point estimates and corresponding confidence intervals to quantify treatment differences will be provided. Since the comparability of randomized groups may be questioned due to chance imbalances in confounding variables, subject-level covariates known to be predictive of outcome and their interactions with randomized assignment will be added to the models as a series of supportive analyses. All analyses will be performed based on the intent-to-treat principle. The amount and nature of missing data for collected study variables will be characterized and no method of imputation will be used for missing data for primary analyses. All tests will be two-sided and tested at a 0.05 nominal significance level. Standard diagnostic plots will be used to assess model fit and transformations of variables may be considered in order to meet statistical assumptions. With the proposed sample size, mean differences of 0.6 standard deviations are detectable at 80% power. Group-specific means and proportions will be estimated with an associated confidence interval width of 0.55 standard deviations and 28 percentage points, respectively. Hypotheses: Aim 2: The SAFR intervention will improve social workers' knowledge of gun violence, attitudes about social workers' need to intervene with all clients, and behaviors regarding discussing guns and gun violence risks with clients compared to pre-test and the control group. We also hypothesize that the SAFR intervention will be feasible and acceptable.

Interventions

BEHAVIORALSocial Workers Addressing Firearm Risk

Educational intervention for social workers.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Intervention model description

RCT

Eligibility

Sex/Gender

ALL

Age

18 Years to 100 Years

Healthy volunteers

Yes

Inclusion criteria

* Practicing social worker * In New York * Age 18 or older * English proficiency

Exclusion criteria

* Not meeting above criteria

Design outcomes

Primary

Measure	Time frame	Description
Change in Knowledge About Gun Violence	Baseline, 1 month later, and 3 months later	Assessed with the Knowledge about gun violence measure (novel). Theoretical minimum/maximum = 0.0/5.0. High scores indicate more knowledge about firearm safety.
Change in Attitudes About Firearms Safety Counseling	Baseline, 1 month later, and 3 months later	Assessed with the Attitudes about firearms safety counseling (novel). Theoretical minimum/maximum = 0/5.00. High scores indicate greater inclination towards discussing firearm safety with clients.
Change in Confidence About Firearms Safety Counseling	Baseline, 1 month later, and 3 months later	Assessed with the Confidence about firearms safety counseling (novel). Theoretical minimum/maximum = 0/5.00. High scores indicate greater confidence about discussing firearm safety with clients.
Change in Behaviors With Clients	Baseline, 1 month later, and 3 months later	Assessed with the Behaviors with Clients measure (novel). Theoretical minimum/maximum = 0/5.00. High scores indicate more interventions about firearm safety with clients. This scale asked questions like, I talk to my clients about firearm access, with answers ranging from Strongly disagree to strongly agree.
Change in Behaviors With Clients in Last Month	Baseline, 1 month later, and 3 months later	Assessed with the Behaviors with Clients in last month measure (novel). Theoretical minimum/maximum = 0/2.00. Higher scores indicate more interventions about firearm safety with clients. This scale asked questions like, In the last month, I have provided clients with information about firearm safety... with answers specified as none of the time, some of the time, and all of the time.

Countries

United States

Participant flow

Participants by arm

Arm	Count
Social Workers Addressing Firearm Risk The Social workers Addressing Firearm Risk (SAFR) intervention is fully-online intervention that contains four modules. Each module includes interviews with experts, didactic content, handouts, and brief quizzes to check learning (required by New York State for continuing education credit). Social Workers Addressing Firearm Risk: Educational intervention for social workers.	63
Control Wait list control. Will receive access to SAFR intervention at conclusion of the study.	48
Total	111

Withdrawals & dropouts

Period	Reason	FG000	FG001
Overall Study	Lost to Follow-up	21	17

Baseline characteristics

Characteristic	Control	Total	Social Workers Addressing Firearm Risk
Age, Categorical <=18 years	0 Participants	0 Participants	0 Participants
Age, Categorical >=65 years	1 Participants	4 Participants	3 Participants
Age, Categorical Between 18 and 65 years	47 Participants	107 Participants	60 Participants
Age, Continuous	39.7 years STANDARD_DEVIATION 11.2	40.0 years STANDARD_DEVIATION 11	40.2 years STANDARD_DEVIATION 10.9
Race (NIH/OMB) American Indian or Alaska Native	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Asian	1 Participants	3 Participants	2 Participants
Race (NIH/OMB) Black or African American	3 Participants	12 Participants	9 Participants
Race (NIH/OMB) More than one race	3 Participants	3 Participants	0 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Unknown or Not Reported	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) White	41 Participants	93 Participants	52 Participants
Region of Enrollment United States	48 participants	111 participants	63 participants
Sex: Female, Male Female	14 Participants	31 Participants	17 Participants
Sex: Female, Male Male	34 Participants	80 Participants	46 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk
deaths Total, all-cause mortality	0 / 63	0 / 48
other Total, other adverse events	0 / 63	0 / 48
serious Total, serious adverse events	0 / 63	0 / 48

Outcome results

Primary

Change in Attitudes About Firearms Safety Counseling

Assessed with the Attitudes about firearms safety counseling (novel). Theoretical minimum/maximum = 0/5.00. High scores indicate greater inclination towards discussing firearm safety with clients.