Firearm injury is now the leading cause of death among U.S. children and adolescents. As its toll grows, researchers have focused on stopping violence in the moments before it happens. But new research led by the 天美影视传媒 suggests that interventions made earlier in young people鈥檚 lives may reduce the chances of it happening at all.听听

The study, , found that 鲍奥鈥檚 Communities That Care (CTC) prevention system reduced handgun carrying among adolescents growing up in rural areas. By the 12th grade, adolescents in CTC communities were 24% less likely to report carrying a handgun than those in communities without the program. Previous research has shown that handgun carrying is an important risk factor for听 firearm injury and harm.听听

鈥淭his provides yet another piece of evidence that science-based prevention systems such as CTC are worth further investments and scaling up, in different communities,鈥� said , UW professor of epidemiology and Interim Director of the UW’s . 鈥淔indings of this study suggest that community-based, science-based, upstream interventions focused on risk and protective factors early in life may play an important role in reducing firearm-related harm.鈥�听

The study surveyed more than 4,000 adolescents across 24 rural communities, 12 of which implemented a coordinated set of preventive interventions tailored to local priorities. Each year from 6th to 12th grade, researchers asked students about a wide range of behaviors, including whether they鈥檇 carried a handgun in the past year.听听

Adolescents in communities that implemented CTC were also 27% less likely to report carrying a handgun in a given grade than those in control communities.听听

Those findings, Rowhani-Rahbar said, merit deeper research into whether reduced handgun carrying in adolescence leads to a reduced risk of firearm-related violence throughout a person鈥檚 life. That鈥檚 especially true in rural areas, where the context around firearms may be different than in urban settings.听

Rowhani-Rahbar and his team have produced a of on among adolescents growing up in rural areas. A previous paper showed that about one-third of young males and 1 in 10 females in rural communities have carried a handgun, and that some rural youth began carrying handguns as early as sixth grade.听

鈥淭he overall burden of firearm mortality in rural areas is roughly the same as in urban areas, with differences seen in the manner in which it occurs at the population level,鈥� Rowhani-Rahbar said. 鈥淯nfortunately, rural communities continue to be under-researched and underserved.鈥澨�听

Data for this analysis came from an ongoing evaluation of CTC鈥檚 effectiveness over the past two decades.听听

Developed at the UW, CTC is an evidence-based prevention system that assists communities in using science-based solutions to foster the healthy development of young people. The 鲍奥鈥檚 Center for Communities That Care is currently helping to implement the system in 150 communities nationwide, in addition to 14 countries.听

The findings on handgun carrying stem from a long-term trial of CTC鈥檚 effectiveness. Including more than 4,000 adolescents, that trial has shown that CTC leads to long-term reductions in alcohol and drug use, antisocial behavior and violence beginning in adolescence, among other benefits.听听

Reducing gun-related risk was not an explicit goal of CTC. That it did anyway, UW social work professor Margaret Kuklinski said, points to the power of focusing on upstream risk factors to create wide-ranging change in the lives of young people 鈥� change that could last a lifetime.听听

鈥淏ehaviors in adolescence 鈥� both positive behaviors and behaviors we want young people to avoid 鈥� tend to share risk and protective factors,鈥� said , who is the UW Endowed Associate Professor of Prevention in Social Work and also director of the . 鈥淲hen CTC helps communities implement prevention approaches that, for example, strengthen commitment to school, increase positive activities for young people, reduce family conflict, or strengthen norms against alcohol and drug use, communities can expect to see a variety of positive behavior changes in young people. Now we know that those changes include reduced handgun carrying.鈥澨�听

Other authors are Sabrina Oesterle (Arizona State University), Emma Gause, Kimberly Dalve, Julia Schleimer (Department of Epidemiology, 天美影视传媒), Elizabeth Weybright (Washington State University), John Briney and David Hawkins (Social Development Research Group, School of Social Work, 天美影视传媒). This research was funded by the Centers for Disease Control and Prevention and the National Institutes of Health.听

For more information on this study, contact Ali Rowhani-Rahbar at rowhani@uw.edu.

The first of research led by the 天美影视传媒 into handgun carrying by young people growing up in rural areas has found six distinct patterns for when and how often these individuals carry a handgun.

The patterns, or 鈥渓ongitudinal trajectories,鈥� suggest that youths in rural areas differ in some ways from their urban counterparts when it comes to handgun carrying and provide information for programs designed to help prevent firearm violence and injury.

鈥淏ecause firearms in many rural areas are such an integral part of a robust gun culture, understanding how youth engage with firearms in those settings is incredibly important,鈥� said principal investigator and senior author听, a UW professor of epidemiology and the UW Bartley Dobb Professor for the Study and Prevention of Violence. 鈥淪trikingly, until now there has been almost no research into the longitudinal patterns of handgun carrying in rural areas.鈥�

In these communities, young people carry handguns at nearly twice the rate as in urban settings, the researchers point out. And urban youths and rural youths do not necessarily have the same cultural context, motivations and use of firearms.

鈥淎 key takeaway of our study is that about one in three youth in rural areas report carrying a handgun by age 26,鈥� said , lead author and acting assistant professor of pediatrics at the UW School of Medicine who holds a doctorate in economics. 鈥淪o, this is a prevalent behavior among these youth during adolescence and early adulthood. For those who carry, about half say they did so only one time, but another portion is carrying quite frequently, 40 times or more a year.鈥�

Funded by the Centers for Disease Control and Prevention, this study of handgun carrying among youth in rural areas is based on interviews with roughly 2,000 young people who started answering survey questionnaires in the sixth grade. Participants took repeated surveys over a roughly 15-year period, 2005 to 2019, as part of the 鲍奥鈥檚听. That larger study is designed to evaluate the university鈥檚听听program, which helps communities take a broad approach to preventing youth problem behaviors.

These study results are the first in a series of related UW studies that are funded by the CDC and part of a wider range of focusing on firearm violence and injury prevention. Investigators at the UW Social Development Research Group, Washington State University, Seattle Children鈥檚 Research Institute and Arizona State University collaborated on the current UW study.

The researchers identified these six patterns, which are based on 10 chronological waves of survey data (click on each image for a description):

The researchers add that in these patterns of carrying that emerged over the 10 nearly annual waves of surveys, some participants reported first carrying at an early age, as young as 12 years old. Consequently, they said, educating young adolescents about firearms, firearm violence, injury and conflict resolution may be suitable, especially if it connects to the firearm culture of that community.

鈥淐ertainly this behavior is very episodic, but adolescence is the age when other behaviors such as bullying and physical violence emerge,鈥� said Ellyson, who is also a principal investigator at Seattle Children鈥檚 Research Institute . 鈥淐arrying a handgun concurrently with bullying or physical violence may increase the risk, and those behaviors could escalate into more severe violence. More research is needed to measure the potential consequences and health risks of handgun carrying.鈥�

The study emphasizes that nearly all current interventions focused on handgun carrying are related to crime, which may not work for most youth in rural settings, where handgun carrying may occur with different motivations, circumstances and consequences.

鈥淏efore this study, we knew that there is a certain fraction of youth in rural areas who carry handguns,鈥� said Rowhani-Rahbar, co-director of the at the Harborview Injury Prevention & Research Center. 鈥淏ut with this study, we provided evidence that there are distinctive and different patterns of handgun carrying. The discovery of these patterns in rural areas is the first step toward prevention, because knowing when this behavior starts as well as its frequency and duration may provide important points of intervention for injury prevention.鈥�

In 2020, for the first time in nearly 30 years, the CDC听听$7.8 million in funding for more than a dozen national studies to understand and prevent firearm violence. The 鲍奥鈥檚 proposal to study handgun carrying among rural adolescents was awarded roughly $1.5 million. The current study is one of four areas of focus in the 鲍奥鈥檚 proposal and involved surveys from 12 communities across 7 states: Colorado, Illinois, Kansas, Maine, Oregon, Utah and Washington.

Next, the UW researchers will focus on improving understanding of the cultural context of handgun carrying among young people in rural areas. What are the reasons they pick up a handgun? What are the settings in which they do? What does 鈥渃arrying鈥� a handgun mean to them? After that, the researchers hope to examine what happened before a person carried and what happened after. What were the consequences? Finally, they hope to test the effectiveness of the Communities That Care prevention program.

鈥淭here is a very strong safety culture around the use of firearms in rural areas, and some of these young people are very well exposed to and trained in the safe use and handling of firearms, but some of them are not,鈥� said Rowhani-Rahbar. 鈥淭his type of research really sheds light on the fact that you have to think about context, you have to think about setting, you need to consider community-based factors that should drive and inform the prevention efforts that you design.鈥�

Co-authors are Emma Gause and Julia Schleimer, with the Firearm Injury and Policy Research Program, UW Harborview Injury Prevention and Research Center; Vivian Lyons, with the UW Harborview Injury Prevention and Research Center and the Department of Health Behavior and Health Education, University of Michigan; Schleimer, also Department of Epidemiology, UW School of Public Health; Margaret Kuklinski, John Briney and Kevin Haggerty, Social Development Research Group, UW School of Social Work; Sabrina Oesterle, Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University; and Elizabeth Weybright, Department of Human Development, Washington State University.

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For more information, contact Rowhani-Rahbar at rowhani@uw.edu.

Brian Donohue, public information editor at UW School of Medicine, contributed to this story.

Roughly one-third of young males and 1 in 10 females in rural communities have carried a handgun, reports a new 天美影视传媒 study. And, the study found, many of those rural kids started carrying as early as the sixth grade.

鈥淭his is one of the first longitudinal studies of rural adolescent handgun carrying across multiple states in the U.S.听It provides evidence that youth handgun carrying in these settings is not uncommon,鈥� said lead author , a UW associate professor of epidemiology and co-director of Firearm Injury & Policy Research Program at Harborview Injury Prevention & Research Center.

The study of rural communities across the country, in the Journal of Adolescent Health, also found the practice was associated with pro-handgun attitudes and with having friends who carry handguns.

Knowing that some kids as young as 12 report carrying a handgun indicates that firearm violence and injury-related prevention programs may need to be introduced early in a child鈥檚 life, researchers say.

鈥淵outh handgun carrying and firearm violence are often presented as an exclusively inner-city problem,鈥� said Dr. Rowhani-Rahbar, who is the Bartley Dobb Professor for the Study and Prevention of Violence in the UW School of Public Health. 鈥淗owever, that focus should not come at the cost of ignoring non-urban settings. Indeed, youth in some rural areas experience similar or even higher rates of handgun carrying and certain forms of interpersonal violence 鈥撯�� for example, being attacked or threatened with a weapon 鈥撯�� than their counterparts in urban areas.鈥�

Specifically, the researchers found:

• In sixth grade, 11.5% of males and 2.8% of females had carried a handgun within the past year.
• From the sixth grade to age 19, 33.7% of males and 9.6% of females reported carrying at least once during that time.
• Of those who carried, 34% of males and 29.3% of females had carried a handgun for the first time in the sixth grade. However, of those who carried, a majority of both sexes carried a handgun only once over the seven years.
• More kids who carried had friends who did the same. For instance, in the 10th grade, 63% of males who carried had a friend who carried. And of those young males who had not carried a handgun, only 6% had a friend who did. The same pattern was apparent for females.
• A far higher percentage of kids who carried also endorsed pro-handgun norms. For instance, they were much more likely to view taking a handgun to school or work as 鈥渘ot very wrong鈥� than their non-carrying peers.

The study of handgun carrying among rural youth is based on 2,002 kids who started answering survey questionnaires in the sixth grade when they lived in 12 rural communities in seven states. Participants took annual surveys over a seven-year period, 2005 to 2012, as part of the 鲍奥鈥檚 . That larger study is designed to evaluate the university鈥檚 program, which helps communities take a broad approach to preventing youth problem behaviors.

The 12 communities included in the new study had been randomly selected to not implement the Communities That Care prevention program, which has been found to reduce a variety of risky behaviors among youth, including carrying a handgun.

鈥淲e looked at handgun questions only in the control communities, those that did not receive the risk prevention program,鈥� Dr. Rowhani-Rahbar explained. 鈥淭his is because we did not want to measure the effect of the Communities That Care intervention in this study. We wanted to characterize the age at initiation, prevalence and patterns of handgun carrying in the absence of the intervention.鈥�

The dangers of young people鈥檚 exposure to guns are well-documented 鈥撯�� firearm injury is second only to vehicle crashes as a among U.S. kids, with 65% of those deaths resulting from a conflict with another young person. Carrying firearms adolescent bullying, physical fighting and assault. The researchers also point out that federal law prohibits people under age 18 from possessing a handgun.

This is just the first step toward studying health effects, Dr. Rowhani-Rahbar said. A lack of foundational information about youth handgun carrying in rural settings means studies of the causes and consequences of this behavior have also been missing. The team now plans to study these factors 鈥撯�� risk of violence or injury among rural youth who carry a handgun compared to those who do not, for instance 鈥撯�� in the near future.

The Communities That Care program and its youth development study are run by the UW School of Social Work鈥檚 .

Co-authors are Sabrina Oesterle, who is now at Arizona State University and worked on this study while with the Social Development Research Group in the UW School of Social Work; and , a research scientist with the Social Development Research Group. This research was funded by the National Institutes of Health.