2:30pm - 3:30pm (CDT) | 3216.0 - Guardians 4 health: Feasibility of youth recruitment for a 4-h shooting sports firearm injury prevention training

Session: Firearm Violence Poster Session

Program: Injury Control and Emergency Health Services

Authors:

Guangyu Tong, PhD

Megan Ranney, MD, MPH, FACEP

Abstract

Background

Firearm injury is the leading cause of death for American youth. Few firearm injury prevention (FIP) interventions exist that are co-designed with communities with high rates of firearm ownership. Given the excellent firearm safety record within 4-H Shooting Sports (4HSS) and the influence these youth have in their communities, we are conducting a CDC-funded Type 1 hybrid effectiveness-implementation randomized controlled trial of a bystander FIP intervention for youth in 4HSS, in collaboration with 4-H leadership. Here we describe recruitment and baseline demographic data for this study.

Methods

We recruited a national sample of 4HSS clubs to Guardians for Health (G4H), a bystander FIP intervention, from September 2022-February 2024. After club/instructor enrollment, clubs were block randomized, with randomization stratified based on self-reported rurality of the club as well as the presence or absence of a state Child Access Prevention (CAP) law. After randomization, club leaders shared a 10-minute video with families of youth ages 12-18 emphasizing the non-policy-based nature of the study; some leaders also arranged presentations by national 4HSS leadership. Parents were then invited to enroll eligible youth and themselves online via RedCap over an 8-week period; youth received a link to assent. Baseline demographics were obtained and analyzed descriptively. Intervention delivery and data collection ends in September 2024.

Results

Of 86 potential sites, 61 site instructors enrolled and were randomized, and 50 contributed baseline data (24 control, 26 intervention). Sites were from 27 states: 16% Northeast, 20% Midwest, 24% South, 40% West; 52% rural, and 52% with a state CAP law; no differences were observed in region, rurality, or state laws between groups. Instructors for these 50 sites reported a mean age 49.42 [SD 11.28], 34% male, 96% White, 2% Hispanic, 96% gun owners, 8% veterans, 58% volunteers (vs 4-H employees). Amongst the 50 sites, we received contact information for 368 families, of whom 430 youth and 310 parents enrolled in the study, and 422 youth and 301 parents completed demographic surveys. (We will provide CONSORT diagrams for site clusters and parent/youth enrollees at the presentation.) Of enrolled participants, the mean youth age was 14.35 [SD 1.82], and youth participants were 55% male, 83% White, 5.7% Hispanic. Mean parent age was 45.18 [SD 6.83], and parental participants were 36% male, 90% White, 3.2% Hispanic, 87% gun owners, 5% veterans. The treatment group had a higher proportion of younger children (ages 12-14) than the control group (62% vs. 48%, p=0.007) and a higher percentage of households with firearms (90% vs. 83%, p=0.068).

Conclusions

Enrollment of 4HSS sites and families in a national RCT of bystander FIP training is feasible, with successful recruitment of our target sample size from a geographically and politically varied sample of states. Instructor, parent, and youth demographics roughly mirrored those reported to us by 4-H, with ~17% non-White, ~6% Hispanic, and ~90% household gun ownership - a group less commonly included in FIP research. Future analyses will examine intervention acceptability and outcomes.