Firearm Injury, Safety Issues
Conditions
Brief summary
The goal of this interventional study is to evaluate the implementation and effectiveness of a comprehensive a universal firearm injury prevention program, ACTFAST (Adopting Comprehensive Training for FireArm Safety in Trauma centers), in level 1 trauma centers. The main aims of the study are: 1. (Primary Aim 1) Increase the adoption, implementation, and maintenance of a universal firearm injury prevention intervention at three participating trauma centers in the mid-Atlantic states; 2. (Primary Aim 2) Assess firearm injury prevention knowledge, attitudes, and safe storage practices among trauma patients treated within participating trauma centers.
Interventions
Firearm access screening, brief firearm safe storage intervention, and referral to community and preventive health resources
Sponsors
Johns Hopkins University
National Institute on Minority Health and Health Disparities (NIMHD)
Rhode Island Hospital
WellSpan Health
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
OTHER
Masking
NONE
Intervention model description
The trial uses a unidirectional crossover stepped wedge design with a sequential roll-out of the intervention, ACTFAST, RE-AIM implementation framework, over several discrete time points or "steps." Each of the three trauma centers will be randomly assigned to one step that will determine when they crossover from control to implementation. Data are collected over multiple wedges, each 4-6 months in length. During the first wedge, none of the participating trauma centers will receive ACTFAST. During the second wedge, the first trauma center completes the Adoption and Implementation period. Over the third wedge, the first center shifts to the Maintenance period, the second trauma center enters the Adoption and Implementation period, and the remaining cohort stays in the control condition. This pattern continues until all trauma centers have progressed from control condition through the active implementation period.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Electronic Medical Record (EMR) Participants: Inclusion Criteria: * trauma patients admitted to adult trauma inpatient services at participating institutions
Exclusion criteria
* none Patient participants Inclusion Criteria: * at least 18 years of age; * admitted to a participating trauma service for an injury; * fluent in English or Spanish; * able to provide informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of admitted injured patients receiving each element of the ACTFAST Program | 48 weeks | ACTFAST components will be collected through retrospective data abstraction of each site's electronic medical record to determine if admitted injured patients received the Screening, Brief Intervention and Referral to Treatment (SBIRT) program components during the different phases of the study. |
| Percentage of admitted injured patients receiving elements of the ACTFAST Program | Admission, 2 weeks post discharge | Among those eligible, compared to pre-implementation, there will be a difference in patients receiving each element of the ACTFAST program as measured by participant survey responses gathered during the participant's admission and 2-weeks post-discharge from survey data derived from multiple sources developed through the prior work of members of the study team. |
| Patient firearm safety attitudes and behaviors as assessed by survey | 48 weeks | This outcome will be measured using the patient survey data adapted from prior work by the study team. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinician firearm safety knowledge and confidence as assessed by survey | 48 weeks | This outcome will be measured using clinician survey data derived from multiple sources developed through the prior work of members of the study team. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORKatherine Hoops, MD, MPH
Johns Hopkins University
Outcome results
None listed