Pediatric Trauma Centers RE-AIM at Gun Safety (ACTFAST)

Pediatric Trauma Centers RE-AIM at Gun Safety - Adopting Comprehensive Training for FireArm Safety in Trauma Centers

Universal firearm injury and violence prevention counseling of parents and patients has been recommended by multiple national organizations for over a decade, yet clinicians rarely deliver this counseling. Barriers to its implementation must be addressed in order to effectively deliver firearm related injury prevention efforts. This study will implement a universal firearm injury prevention initiative within a national cohort of three pediatric trauma centers. The investigator's long-term goal is to demonstrate best practices for pediatric trauma center-based firearm injury prevention strategies that promote safe storage practices and reduce firearm related injury and death. This research will test the effectiveness of a comprehensive training strategy for improving the implementation of a universal firearm injury prevention effort, ACTFAST (Adopting Comprehensive Training for FireArm Safety in Trauma centers), to 1) increase the adoption, implementation and sustainability of a universal firearm injury prevention initiative within participating pediatric level 1 trauma centers; 2) increase firearm safety knowledge, attitudes and safe firearm storage practices among parents of pediatric trauma patients and youth patients treated within participating pediatric level 1 trauma centers, and 3) increase trauma center clinicians' firearm safety knowledge and confidence in delivering a firearm safety intervention.

Study Overview

• Status: Enrolling by invitation
• Conditions: Safety Issues; Firearm Injury
• Intervention / Treatment: Behavioral: Adopting Comprehensive Training for FireArm Safety in Trauma centers

• Study Type: Interventional
• Enrollment (Estimated): 1000
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

For parents/guardians of pediatric trauma patients:

Inclusion Criteria:

• live with an admitted pediatric trauma patient at a participating trauma center
• be fluent in English or Spanish

Exclusion Criteria:

- family members who do not live with the admitted pediatric trauma patient

For youth trauma patients:

Inclusion Criteria:

• Must be between the ages of 11-17 years
• admitted to a participating trauma inpatient service for an injury
• fluent in English or Spanish
• able to provide written assent and parent able to provide written consent

Exclusion Criteria:

• Youth who are prisoners or in police custody
• Youth who are admitted due to suicide attempt
• Youth with acute conditions that would preclude provision of informed consent (i.e., acute psychosis, altered mental status, cognitive impairment)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Standard Care; In the pre-implementation period, all trauma patients will receive standard routine care. Which may include some screening and counseling on gun safety.
Experimental: ACTFAST Intervention; During the implementation and maintenance periods, all trauma patients will receive study activities including firearm access screening, counseling on safe storage practices, and referral to safe storage and other community resources as appropriate.	Behavioral: Adopting Comprehensive Training for FireArm Safety in Trauma centers; Firearm access screening, brief firearm safe storage intervention, and referral to community and preventive health resources

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Implementation of Intervention	This outcome will be measured using chart review protocols examining rates of firearm access screening, documentation of firearm safety counseling, documentation of referral to community based resources and connection to medical homes as well as patient hospitalization characteristics including admission diagnosis, injury severity and patient demographic characteristics.	3 years
Parent firearm safety attitudes and behaviors	This outcome will be measured using parent survey and interview adapted from prior work by the study team.	3 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinician firearm safety knowledge and confidence	This outcome will be measured using clinician surveys derived from multiple sources developed through the prior work of members of the study team.	3 years
Adolescent patient firearm safety attitudes and behaviors	Measure firearm injury prevention knowledge, attitudes and safe firearm practices of adolescent trauma patients (11-17 years) within participating pediatric level 1 trauma centers. This outcome will be measured using patient survey and interview adapted from prior work by the study team.	3 years

Collaborators and Investigators

• Sponsor: Johns Hopkins University
• Collaborators: Yale University; Centers for Disease Control and Prevention; Rhode Island Hospital; University of Utah; Children's Hospitals and Clinics of Minnesota
• Investigators: Principal Investigator: Katherine Hoops, MD, PhD, Johns Hopkins School of Medicine

Study record dates

Study Major Dates

• Study Start (Actual): February 25, 2024
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): September 30, 2027

Study Registration Dates

• First Submitted: November 1, 2023
• First Submitted That Met QC Criteria: November 8, 2023
• First Posted (Actual): November 9, 2023

Study Record Updates

• Last Update Posted (Actual): March 16, 2026
• Last Update Submitted That Met QC Criteria: March 13, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Organization and Administration; Health Services Administration; Health Services; Health Care Facilities Workforce and Services; Hospital Administration; Health Facility Administration; Health Facilities; Emergency Medical Services; Hospital Departments; Emergency Service, Hospital; Trauma Centers
• Other Study ID Numbers: IRB00407213; CE003620 (Other Grant/Funding Number: Centers for Disease Control and Prevention)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: At the conclusion of the study, deidentified data will be made publicly available. Due to the sensitive nature of the topics being discussed, individual participant data will not be made available to other researchers outside of the study team.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No