Firearm Injury Prevention Programs
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67
68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84
85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101
102 103 104 105 106 107 108 109 110 111 112 113 114 115
In this chapter we review the research on the effectiveness of primary,
secondary, and tertiary programs for the prevention of firearms injury.
Special attention is given to efforts to prevent the use of firearms by
youth. The first section summarizes behavioral interventions targeted toward
reducing firearms injury. The second part considers what is known
about technological interventions aimed at preventing firearms injury. In
both cases, the existing research is very limited.
BEHAVIORAL INTERVENTIONS
In this section we review two aspects of behavioral interventions that
have been designed to prevent firearms injury: the structure and effectiveness
of the program plans in each case and the quality of the associated
outcomes research data.
The prevention of firearms violence has been addressed in a number of
ways, from legislative reform, to media campaigns, to educational interventions.
Educational interventions are typically employed in school settings,
with a focus on modifying the attitudes, knowledge, or behavior of individual
children. Other educational and media interventions have targeted
parents and older youth with messages designed to increase their knowledge
of the dangers of firearms as well as methods to ensure safe use and
storage. Most of these interventions are developed by well-meaning groups
or organizations whose concern for violence—or the potential of violence—
among the children leads them to be proactive. However, these programs
are rarely based on theoretical models or preliminary effectiveness data.
The implementation strategies lack structured evaluations and are not commonly
informed by an appreciation of the limitations of children’s developmental
stages.
Table 8-1 is a summary of the targeted populations, program design,
and evaluations of 11 selected interventions. This selection has been based
on the popularity of the program and whether the program has been peerevaluated
using randomized control groups. Most of these programs are
centered on educating children themselves about firearms and violence or
through programs involving parents or health care providers. Other comprehensive
programs, such as those listed by the Office of Juvenile Justice
and Delinquency Prevention (e.g., Boston Strategy to Prevent Youth Violence)
were not listed either because they incorporated suppression and
TABLE 8-1 Firearms Prevention Programs
Developer,
Sponsor Target
and/or Type of Age or
Program Publisher Program Grade
Eddie National “Just say no” Pre-K
Eagle Rifle to
Gun Association grade 6
Safety
Program
Steps to Brady Physician-directed Parents
Prevent Center to parent education
Firearm Prevent
Injury Gun
(STOP Violence
2)
prevention strategies for many types of violence, or they were designed
specifically to deter illegal gun possession and use.
Outcome Measures
The impact of most of these types of behavioral interventions is measured
in terms of changes in knowledge, attitudes, and behavior. Specific
outcomes may include knowledge of the danger of guns and attitudes toward
firearms and violence. Changes in behavior are detected by proximal
and distal outcome measures for the individuals targeted. For example, if
the program is designed to educate parents about firearms safety, a proximal
behavior goal would be related to how a gun is stored in the home
Description of Program Evaluation
Motivational program for Hardy et al. (1996) evaluated a
children in pre-K through grade similar program and in posttest
1, with easy-to-understand found no difference between
rhymes; activity books for children’s behavior toward
grades 2-6; 7-minute video, firearms in both treated and
reward stickers, parent letter, control groups.
instructor guides, in-service Of three programs evaluated
video. The message: If you (STAR and STOP, see below),
see a gun, stop, don’t touch it, Howard (2001) ranks the Eddie
leave the area, and tell an adult. Eagle program the best based on
educational material appropriate
for developmental level and
presentation appearance of printed
material.
Kit prepares health care Oatis et al. (1999) demonstrate in
providers to talk with a pre- and post-randomized trial
patients/clients and their that there was not a statistically
families about the dangers of significant drop in gun ownership
keeping a gun in the home. or improvement in gun storage
The fundamental goal is to after a practice-based intervention
assist the health care provider aimed to promote these behaviors.
in incorporating gun violence
prevention into routine injury
prevention counseling.
continued
TABLE 8-1 Continued
Developer,
Sponsor Target
and/or Type of Age or
Program Publisher Program Grade
Straight Talk Brady Center Skills-building Pre-K to
About Risks to Prevent grade 12
(STAR) Gun Violence
Safe San Jose Skills-building Juvenile
Alternatives Police offenders
and Violence Department ages 10-
Education (San Jose, 18
(SAVE) CA)
Options, Roy Farrell, Shock Grades 7
Choices, and M.D., and 8
Consequences Washington
(Cops and Physicians for
Docs) Social
Responsibility
In a Flash National Shock Middle
Emergency school
Medicine children
Association (ages
10-14)
FIREARM INJURY PREVENTION PROGRAMS 205
Description of Program Evaluation
Straight talk about risks of Using a randomized
firearm injury and death. prospective study design with
Age-appropriate lessons help 600 students, the Education
children identify trusted Development Center, Inc.
adults, deal with peer (LeBrun et al., 1999) found
pressure, and recognize risks STAR to be most effective for
related to gun handling. increasing gun safety
knowledge and attitudes for
children in grades 3-5 and only
moderately effective for older
children.
Hardy (2002b) in a
randomized control study (34
children ages 4 to 7) concludes
that STAR-like programs are
ineffective in deterring
children’s play with guns.
One-day, 6-hour violence Arredono et al. (1999)
awareness class for juvenile demonstrate in pretest and
offenders and their parents. posttest evaluations that
recidivism rates declined at 2-
year follow-up, but no