2020 - 2024, Active

Family Safety Net: Developing an upstream suicide prevention approach to encourage safe firearm storage in rural and remote Alaskan homes

Affiliated Project

Learn more about the project “Developing a universal safe firearm storage intervention for rural Alaska Native Communities” presented by Ferhana Begum at the Firearm Safety Among Children and Teens (FACTS) symposium, September 23, 2020.

Rural and Alaska Native (AN) communities are disproportionately affected by youth suicide, and 60% of the Alaskan suicide fatalities are due to firearms. In rural Alaska Native communities, virtually all homes have multiple guns for traditional subsistence activities, which increases suicide risk significantly. The intervention utilizes existing tribal primary care settings and integrates Alaska Native preference for family involvement by engaging adult family members in a simple, effective suicide prevention strategy–reducing youth access to firearms at home–which has the potential to save lives.


Suicide is a major and rising public health problem in the United States. In Alaska, suicide rates are consistently triple the national rate and fully 60% of the suicide fatalities are due to firearms. In rural Alaska Native (AN) communities, virtually all homes have multiple guns, which increases suicide risk significantly. In the AN study region, youth suicide rates are 18 times that of other American teens. This context presents an important opportunity to enhance safety and prevent suicide deaths by restricting access to firearms in the people’s homes. Restricting `lethal means’ for suicide prevention is one of the most effective strategies to date. Key challenges are widespread uptake, particularly within high-risk and hard-to-reach populations.

The proposed research will inform the development of the Family Safety Net (FSN), a public health approach that builds on the collectivist, family-centric orientation of AN people by universally engaging adult family members of youth in increasing their home safety. Our central hypothesis is that by supporting adult family members in locking and unloading all household firearms, we can reduce a key environmental risk factor that contributes to youth suicide in rural AN communities. Using a community-based participatory approach, the study will integrate important culturally-specific considerations to support, encourage, and assess safe firearm storage practices relevant to AN families. The formative research will result in a feasible and acceptable FSN intervention that will undergo preliminary efficacy testing.

The project aims are to: (1) Characterize AN household firearm storage practices to inform intervention development; (2) Iteratively develop and focus test the Family Safety Net (FSN) intervention; and (3) Conduct a pilot randomized control trial (n=70, 35/group) to assess feasibility, acceptability, and fidelity of the Family Safety Net (FSN) intervention, as well as examine preliminary efficacy at increasing safe storage practices and expected mechanisms of change based on our theoretical model. The proposed research is significant because effective safe storage interventions are needed to address: 1) elevated rates of U.S. adolescent firearm suicides; and 2) disparities in AN youth suicide rates. Key innovations include: 1) an upstream focus on universal youth suicide prevention and family safe storage practices in a firearm-owning population; 2) addressing collectivist cultural norms, as compared to individualistic norms, which can be an important for other populations; and 3) a focus on tailoring intervention content to address the role of the family member, both gun owners and others, in controlling firearm access. This formative research sets the stage for a larger fully powered randomized trial to evaluate FSN efficacy to increase safe household firearm storage of people who have multiple firearms, and whose youth are at extremely high risk for suicide.

Learn more about the Family Safety Net here.

Project Team

Lisa Wexler, PhD
Patrick Carter, MD
Jason Goldstick, PhD
Cheryl King, PhD
Ken Resnicow, PhD
Courtney Bagge, Co-Investigator


National Institutes of Health


Maniilaq Association


Learn more about Dr. Lisa Wexler’s suicide prevention work developed in partnership with Alaska Native and American Indian communities: The ‘S’ Word: A Podcast about Suicide Prevention: Preventing Suicide and Promoting Culture among Alaska Natives and American Indians.

Dr. Wexler and team has presented on the innovative findings of their work on Family Safety Net (FSN) project. See below:

  • Wexler, L., Porter, K., Leys, Megan, Apala-Flaherty and Moto. Building on Family Strengths to Increase Firearm Safety at Home: Lessons Learned from a Pilot Study of an Innovative Approach to Lethal Means Reduction. International Association of Suicide Research, Barcelona, Spain, October 16, 2023
  • Wexler, L., Porter, K., Leys, Megan, Apala-Flaherty and Moto, R. “Are you worried that someone from your household is at risk of suicide?” Screening to reduce quick access to firearms in rural and remote Alaska Native homes. 2023 National Research Conference for the Prevention of Firearm-Related Harms. Chicago, IL, November 2, 2023.

Additionally, Family Safety Net Intern Avery Moje (Summer 2022), presented a poster from her work with the FSN team at the 2023 National Research Conference for the Prevention of Firearm-Related Harms and won a prize for health equity. Her poster was called: Alaska Native Adult and Youth Perspectives of Youth Firearm Access.

Dr. Wexler also participated in a working session on Gun Violence Prevention: The Role of Social Work, hosted by Crown Family School of Social Work, Policy and Practice, University of Chicago; NYU Siler School of Social Work; and the University of Buffalo on November 3-4, 2023.