2017 - 2022, Complete

Building Research Capacity for Firearm Safety Among Children (FACTS)

Affiliated Project
“Firearm violence is one of the most critical challenges facing our society, and based on the latest federal data, this crisis is growing more and more intense. As a nation, we turn to scientific evidence to prevent injuries and deaths, and firearms should be no different.”

-Rebecca Cunningham, Vice President for Research


Among U.S. children, firearm-related fatalities are now the top leading cause of death. This project brought together a multidisciplinary team of researchers and community stakeholder groups (gun advocates, gun safety trainers, veterans, family groups) across the U.S. to inform and catalyze the science of childhood firearm injury prevention by addressing both the gaps in research and human resources. The overarching goal of the project was to build the capacity for pediatric firearm injury prevention. The project believes in applying the science of injury prevention used in other injury fields such as motor vehicle crash to the field of childhood firearm injuries; it does not seek to limit or reduce the number of firearms owned legally by U.S. adults. The results of the project led to a sustainable model that saw the growth of a national firearm injury prevention society and conference, pilot data that lead to a plethora of federally funded research, the funding of a T32 grant at the Institute for Firearm Injury Prevention to train future researchers interested in this field and a free online course focused on firearm injury prevention.


Among U.S. children, firearm-related fatalities are now the top leading cause of death and include the unintentional, accidental discharge of a firearm by a toddler with a playmate, the use of a firearm to self-inflict harm by a suicidal teen, and the escalation of bullying or dating violence to lethal means by an adolescent. Substantial disparities exist in firearm-related injuries, with African-American children disproportionally impacted by unintentional and assaultive firearm injury, and rural youth disproportionately dying of suicide by firearm. Childhood firearm injury rates have remained unchanged in the recent decades despite significant reductions in non-firearm fatal injuries due to an approach that includes improved epidemiologic data, behavior modifications, and technological solutions. In contrast, research funding and publications for firearm injury have lagged, leading to a current deficit of both established and developing researchers, as well as a lack of pilot work and literature needed to support large scale studies. A 2013 Institute of Medicine (IOM) report detailed the urgent need for novel and innovative research to address this deficit, however, was primarily focused on adult populations. This proposal builds on these IOM recommendations and utilizes multidisciplinary research expertise across the U.S., as well as stakeholder partner groups of gun owners, to catalyze the science of childhood firearm injury prevention with the overarching goal of reducing firearm injuries among children while also respecting gun ownership as an important part of the cultural fabric of US society.

The project specific aims are: Aim #1: Create a multidisciplinary team of researchers and stakeholder partners to define a pediatric-specific firearm injury research agenda for the five workgroups; Aim #2: Stimulate novel firearm prevention research by having workgroups conduct pilot studies that address key research questions identified in Aim 1, to provide preliminary data that informs large-scale studies; Aim #3: Improve access to and use of national firearm data and ease future secondary analyses by: 1) Establishing a web-based searchable data archive for childhood firearm injury that is enabled with variable-level searching and cross-study comparisons; and, 2) Enhancing and improving pediatric firearm injury data collection in existing pediatric datasets such as the PECARN core data project and the PECARN registry database; Aim #4: Build a cadre of national research scholars with multidisciplinary training and expertise that will serve as an emerging pipeline for future research.

Expected outcomes of this five-year grant will be to create six research resources: 1) consensus documents detailing the state of the science and key research questions for pediatric firearm injury prevention; 2) pilot data to support five large-scale research proposals; 3) a web-based data archive and searchable research repository on childhood firearm injury; 4) enhanced data collection opportunities on childhood firearm injuries through existing national networks (e.g., PECARN); 5) a cadre of new researchers (postdoctoral students) focused in this research area; and 6) a webinar series to inform researchers nationally in this topic area.

Learn more about the Firearm Safety Among Children and Teens Consortium (FACTS) here.

Project Team

Marc Zimmerman, PhD
Rebecca Cunningham, MD
Patrick Carter, MD
Peter Ehrlich, MD, MSc
Justin Heinze, PhD
Cheryl King, PhD
Maureen Walton, MPH, PhD
Mark Ilgen, PhD
April M. Zeoli, PhD, MPH
Jukka Savolainen, PhD, Co-Investigator
Lisa Prosser, PhD, Co-Investigator


National Institutes of Health


Ann and Robert H. Lurie Children’s Hospital

Arizona State University

Harvard University

Michigan State University

Rhode Island Hospital

University of Washington

Wayne State University