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Firearm - Prevention Strategies

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Anatomy of Gun Violence: Contextualized Curriculum to Train Surgical Residents in Both Technical and Non-Technical Skills in the Management of Gun Violence.
Onufer EJ, Andrade E, Cullinan DR, Kramer J, Leonard J, Stewart M, Vallar K, Wise PE, Klingensmith ME, Punch LJ.
J Am Coll Surg. 2020 Dec;231(6):628-637.

Rationale for inclusion:  Novel firearm-related injury curriculum for surgical trainees.

CAVEAT: Single-center survey

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Circumstances surrounding gun violence with youths in an urban setting.
Borg BA, Krouse CB, McLeod JS, Shanti CM, Donoghue L.
J Pediatr Surg . 2020 Jul;55(7):1234-1237.

Rationale for inclusion: Identification of high-risk zones for drive-by shootings may allow for system-focused interventions and collaboration with law enforcement and community partners. Further stratification of data by zip code, age and circumstances surrounding firearm-related injury offers an opportunity for targeted injury prevention programs.

CAVEAT: Retrospective review

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Identifying participants for inclusion in hospital-based violence intervention: An analysis of 18 years of urban firearm recidivism.
Bonne S, Tufariello A, Coles Z, Hohl B, Ostermann M, Boxer P, Slogan-Power E, Gusmano M, Glass NE, Kunac A, Livingston D.
J Trauma Acute Care Surg. 2020 Jul;89(1):68-73.

Rationale for inclusion: Report of one institutions experience of recidivism and evaluation of characteristics of patients who may benefit from early hospital based violence intervention.

CAVEAT: One center/region experience

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Dusk to Dawn: Evaluating the effect of a hospital-based youth violence prevention program on youths' perception of risk.
Snyder KB, Farrens A, Raposo-Hadley A, Tibbits M, Burt J, Bauman ZM, Evans CH.
J Trauma Acute Care Surg. 2020 Jul;89(1):140-144.

Rationale for inclusion: Example of a hospital-based violence intervention program using a social cognitive approach to addressing youth  perceptions of violence and violent injury to mitigate risk of injury.

CAVEAT: Single-center experience

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Proceedings from the Medical Summit on Firearm Injury Prevention: A Public Health Approach to Reduce Death and Disability in the US.
Bulger EM, Kuhls DA, Campbell BT, Bonne S, Cunningham RM, Betz M, Dicker R, Ranney ML, Barsotti C, Hargarten S, Sakran JV, Rivara FP, James T, Lamis D, Timmerman G, Rogers SO, Choucair B, Stewart RM.
J Am Coll Surg. 2019 Oct;229(4):415-430.e12.

Rationale for Inclusion: Comprehensive summary of public health approach to firearm-related injury prevention

CAVEAT: Consensus statement

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American Association for the Surgery of Trauma Prevention Committee topical update: Impact of community violence exposure, intimate partner violence, hospital-based violence intervention, building community coalitions and injury prevention program evaluation.
Rosenblatt MS, Joseph KT, Dechert T, Duncan TK, Joseph DK, Stewart RM, Cooper ZR.
J Trauma Acute Care Surg. 2019 Aug;87(2):456-462.

Rationale for inclusion: National guideline about interpersonal violence and injury prevention.

CAVEAT: Evidence-based opinion piece of recommendations

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Recommendations from the American College of Surgeons Committee on Trauma’s Firearm Strategy Team (FAST) Workgroup: Chicago Consensus I
CL Talley, BT Campbell, DH Jenkins, SL Barnes, RA Sidwell, G Timmerman, RI Gross, M Coburn, JA Bailey, A Eastman, J Ficke, E Kuncir, RW Letton, BJ Eastridge, AE Liepert, A Wilson, D Robinette, JW Davis, C Shalgian, H Michaels, MC Weissler, DA Kuhls, EM Bulger, RM Stewart
J Am Coll Surg. 2019 Feb;228(2):198-206.

Rationale for Inclusion: First consensus statement from the ACS COT FAST Working Group to address a public health approach to firearm-injury prevention.

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Eastern Association for the Surgery of Trauma Firearm Injury Prevention Statement
J Trauma Acute Care Surg. 2019 Jan;86(1):168-170.

Rationale for Inclusion: EAST consensus statement of firearm injury prevention.

CAVEAT: Consensus statement

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Changes in US mass shooting deaths associated with the 1994-2004 federal assault weapons ban: Analysis of open-source data.
DiMaggio C, Avraham J, Berry C, Bukur M, Feldman J, Klein M, Shah N, Tandon M, Frangos S.
J Trauma Acute Care Surg. 2019 Jan;86(1):11-19.

Rationale for inclusion: The authors found that between 1981 and 2017 mass shootings accounted for an increasing proportion of all firearm related homicides; however, the rate of increase slowed during the AWB period and increased in the post-ban period. The calculated risk ratio for the association of the federal ban period with mass-shooting fatalities as a proportion of all firearm-related homicides was 0.29, indicating that mass shooting fatalities were 70% less likely to occur during the federal ban period. 

CAVEAT: Database study

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Variability of child access prevention laws and pediatric firearm injuries
EC Hamilton, CC Miller III, CS Cox Jr, KP Lally, MT Austin
J Trauma Acute Care Surg. 2018 Apr;84(4):613-619.

Rationale for Inclusion: National perspective on firearm access and pediatric injuries. Implementation of strong child access prevention laws by each state, which require safe storage of firearms, has the potential to significantly reduce pediatric firearm injuries.

CAVEAT: Database

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Reducing Suicides Through Partnerships Between Health Professionals and Gun Owner Groups—Beyond Docs vs Glocks
C Barber, E Frank, R Demicco 
JAMA Intern Med. 2017 Jan 1;177(1):5-6.

Rationale for Inclusion: Emphasizes importance of engaging firearm owners and health professionals in approaching suicide prevention.

CAVEAT: Brief review of key issues

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Association Between Gun Law Reforms and Intentional Firearm Deaths in Australia, 1979-2013.
Chapman S, Alpers P, Jones M.
JAMA. 2016 Jul 19;316(3):291-9.

Rationale for inclusion: Observational study using Australian government statistics on deaths caused by firearms (1979-2013) and compared changes in intentional firearm death rates before and after gun legislation reforms in 1996.  After gun law reforms, firearm deaths decreased and there were no mass killings with firearms.

CAVEAT: Australia only

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Guns in the home and risk of a violent death in the home: findings from a national study.
Dahlberg LL, Ikeda RM, Kresnow MJ.
Am J Epidemiol. 2004 Nov 15;160(10):929-36.

Rationale for inclusion: Demonstrated that in homes where a firearm of any kind or in any number is present, there is almost a 2 fold increased risk of dying a violent death of all causes - homicide or suicide - by firearm than in homes without a firearm.

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Seeing is believing: what do boys do when they find a real gun?
Jackman GA, Farah MM, Kellermann AL, Simon HK.
Pediatrics. 2001 Jun;107(6):1247-50.

Rationale for inclusion: Demonstrated that boys placed in a room with a firearm routinely find, play with, and attempt to fire the firearm, regardless of parental guidance on the issue of firearm handling or perceived interest or knowledge of firearm handling by the parents.

CAVEAT: Small sample size

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Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act.
Ludwig J, Cook PJ.
JAMA. 2000 Aug 2;284(5):585-91.

Rationale for inclusion: Compared firearm homicide and suicide rates between states after implementation of background checks and a waiting period. 

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State gun safe storage laws and child mortality due to firearms.
Cummings P, Grossman DC, Rivara FP, Koepsell TD.
JAMA. 1997 Oct 1;278(13):1084-6.

Rationale for inclusion: Demonstrated a 23% reduction of child deaths due to firearm in states with laws that hold gun owners responsible for storing firearms in a manner that makes them inaccessible to children.

CAVEAT: Retrospective

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Gun ownership as a risk factor for homicide in the home.
Kellermann AL, Rivara FP, Rushforth NB, Banton JG, Reay DT, Francisco JT, Locci AB, Prodzinski J, Hackman BB, Somes G.
N Engl J Med. 1993 Oct 7;329(15):1084-91.

Rationale for inclusion: Case control study demonstrating 3x increased risk of homicide in homes with firearms.

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Suicide in the home in relation to gun ownership.
Kellermann AL, Rivara FP, Somes G, Reay DT, Francisco J, Banton JG, Prodzinski J, Fligner C, Hackman BB.
N Engl J Med. 1992 Aug 13;327(7):467-72.

Rationale for inclusion: Case-control study demonstrating 5x increased risk of suicide in homes with firearms.

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The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study.
Brent DA, Perper JA, Allman CJ, Moritz GM, Wartella ME, Zelenak JP.
JAMA. 1991 Dec 4;266(21):2989-95.

Rationale for inclusion: Demonstrated increased risk of suicide in homes of adolescents in which there is a firearm.

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Handgun regulations, crime, assaults, and homicide: A tale of two cities
JH Sloan, AL Kellermann, DT Reay, JA Ferris, T Koepsell, FP Rivara, C Rice, L Gray, J LoGerfo
N Engl J Med. 1988 Nov 10;319(19):1256-62.

Rationale for Inclusion: One of first papers to describe relationship between firearm restrictions and homicide.

CAVEAT: Retrospective, examining Seattle vs Vancouver

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

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