Screening for firearm violence exposure in adolescents and young adults

INTRODUCTION: Firearm violence now accounts for more than 45,000 deaths annually in America, making it the leading cause of death in the pediatric population. Despite this, primary care clinicians (PCCs) lack screening tools to assess a patient's future risk of gun violence, hampering the ability to allocate resources that could prevent morbidity and mortality. 

METHODS: Longitudinal quantitative study designed to evaluate whether the Serious fighting, Friend weapon carrying, community Environment, and firearm Threats (SaFETy) score and other measures could predict gun violence exposure over 6 months in a nonurban primary care (PC) based adolescent-young adult population. 

RESULTS: Eighty-eight patients between the ages of 14 to 24 completed the baseline questionnaire and 62 completed the 6-month questionnaire. 45% of participants had a SaFETy score >0. Any score >0 indicates an increased risk of future firearm violence. A strong correlation was found between the SaFETy score and gun violence exposure, and Adverse Childhood Events (ACEs). 

CONCLUSIONS: This was among the first studies attempting to assess the viability of screening for firearm violence and other associated risk factors in a nonurban PC setting. Our findings suggest that adolescent and young adult PC patients are willing to disclose in a survey topics related to violence and firearms with their PCC. If validated in the PC setting, the SaFETy score could become a crucial tool for PCCs given the ease with which it can be implemented into a routine visit and the nonthreatening, and nonconfrontational question design. Tools such as the SaFETy score can provide PCPs with vital insight into their patients' past gun violence exposures and future violence risks.