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

ACTFAST: Urban and Rural Trauma Centers RE-AIM at Firearm Injury Prevention

The goal of this interventional study is to evaluate the implementation and effectiveness of a comprehensive a universal firearm injury prevention program, ACTFAST (Adopting Comprehensive Training for FireArm Safety in Trauma centers), in level 1 trauma centers. The main aims of the study are:

1. (Primary Aim 1) Increase the adoption, implementation, and maintenance of a universal firearm injury prevention intervention at three participating trauma centers in the mid-Atlantic states;
2. (Primary Aim 2) Assess firearm injury prevention knowledge, attitudes, and safe storage practices among trauma patients treated within participating trauma centers.

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): 1776
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins Hospital
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins Bayview Medical Center
  • Pennsylvania
    • York, Pennsylvania, United States, 17402
      • WellSpan Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Electronic Medical Record (EMR) Participants:

Inclusion Criteria:

• trauma patients admitted to adult trauma inpatient services at participating institutions

Exclusion Criteria:

• none

Patient participants

Inclusion Criteria:

• at least 18 years of age;
• admitted to a participating trauma service for an injury;
• fluent in English or Spanish;
• able to provide informed consent.

Exclusion Criteria:

• prisoner or in police custody;
• admitted due to suicide attempt
• any acute conditions that would preclude provision of informed consent or assent (i.e., acute psychosis, altered mental status, cognitive impairment).

Staff participants

Inclusion Criteria:

• trauma service physician, physician assistant, nurse practitioner, nurse or social worker at participating pediatric trauma center

Exclusion Criteria:

• none

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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
No Intervention: No Intervention: Standard Care; All trauma patients will receive standard routine care which may include some screening and counseling on gun safety.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of admitted injured patients receiving each element of the ACTFAST Program	ACTFAST components will be collected through retrospective data abstraction of each site's electronic medical record to determine if admitted injured patients received the Screening, Brief Intervention and Referral to Treatment (SBIRT) program components during the different phases of the study.	48 weeks
Percentage of admitted injured patients receiving elements of the ACTFAST Program	Among those eligible, compared to pre-implementation, there will be a difference in patients receiving each element of the ACTFAST program as measured by participant survey responses gathered during the participant's admission and 2-weeks post-discharge from survey data derived from multiple sources developed through the prior work of members of the study team.	Admission, 2 weeks post discharge
Patient firearm safety attitudes and behaviors as assessed by survey	This outcome will be measured using the patient survey data adapted from prior work by the study team.	48 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinician firearm safety knowledge and confidence as assessed by survey	This outcome will be measured using clinician survey data derived from multiple sources developed through the prior work of members of the study team.	48 weeks

Collaborators and Investigators

• Sponsor: Johns Hopkins University
• Collaborators: National Institute on Minority Health and Health Disparities (NIMHD); Rhode Island Hospital; WellSpan Health
• Investigators: Principal Investigator: Katherine Hoops, MD, MPH, Johns Hopkins University

Study record dates

Study Major Dates

• Study Start (Actual): October 30, 2024
• Primary Completion (Estimated): March 1, 2028
• Study Completion (Estimated): April 30, 2028

Study Registration Dates

• First Submitted: February 27, 2024
• First Submitted That Met QC Criteria: March 4, 2024
• First Posted (Actual): March 8, 2024

Study Record Updates

• Last Update Posted (Actual): March 9, 2026
• Last Update Submitted That Met QC Criteria: March 6, 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: IRB00433605; R01MD019173 (U.S. NIH Grant/Contract)

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