SaFETy Score as a Predictor of Gun Violence in Adolescent-young Adults Patients in a Primary Care Setting

Context: Firearm injury is the leading cause of death for individuals aged 12-24. Despite far-reaching impacts of gun violence, there is insufficient data available to inform prevention strategies. Screening adolescent patients and counseling those at high risk is one promising strategy that family physicians could implement in their clinics to prevent firearm exposure. However, few validated clinical tools are available to help physicians understand their patients’ risk. One new tool is the SaFETy questionnaire, a 4-item scoring system found to predict twenty-four month gun violence exposure in drug-using adolescents presenting to an urban emergency room. This tool has yet to be validated in a primary care setting.

Objective: Validation of the SaFETy questionnaire as a predictor of gun violence in a nonurban primary care setting.

Study Design and Analysis: Longitudinal quantitative study. Multivariate linear regression with gun violence exposure as the dependent variable and SaFETy score and other assessments/survey questions and demographics as independent variables.

Setting: primary care practices in eastern North Carolina

Population Studied: Patients (age 14-24) at four ## moderately-sized semi-urban and rural primary care clinics.

Intervention/Instrument: Baseline and six months post-enrollment surveys assessing patient demographics; SaFETy questionnaire; gun violence exposure, peer influence, and parent behavior measures; and community violence exposures.

Outcome Measures: SaFETy score and gun violence exposure

Results: The majority of the patients were female (69%), non-Hispanic or Latinx (73%), and had at least a high school diploma or GED (63%). 45% were white and 36% were Black or African-American. The majority of respondents had easy access to a gun (61%). Correlations between baseline and six months post baseline show association between the SaFETy score and a variety of different gun violence exposures including from friends, parents or guardians, and during various situations.

Conclusions: When used in a primary care setting, the SaFETy score is a useful tool in helping to predict the risk of gun violence exposure in an adolescent population.

Learning Objectives: Understand the relevance of the SaFETy questions in predicting gun violence & Understand the importance for primary care clinicians to predict gun violence risk

Research Category: Child and Adolescent Health

Study Design: Longitudinal quantitative study conducted over six month