SAFER Study: Multilevel Risks and Resilience-Promotive Factors of Firearm Injury

Abstract

Firearm injury is a significant public health concern in the United States, driven in part by contextual and social stressors. Researchers, for instance, found syndemic effects of exposure to violence on multiple health outcomes. The adverse exposure may contribute to the development of mental distress symptoms, substance use, and behaviors that increase firearm injury risk through prolonged stress and unaddressed trauma. Yet, the consequences of exposure to violence have been shown to vary by individuals, with contextual factors such as access to mental healthcare accounting for some of this heterogeneity. While exposure to violence is a driver of substance use, mental distress, and firearm violence risk, these links have been primarily studied at the individual-level and it is necessary to investigate broader contextual and social factors, consistent with the socioecological model, to understand how and under what conditions exposure to violence leads to an increased risk for firearm injury.

Using the socioecological framework and Resilience Theory, we build on findings from the RF1 study (RF1NR020753-01) and extant findings in firearm research to understand the links between exposure to violence and firearm injury risk among Asian Americans, and the moderating effects of contextual stressors and promotive factors. We will examine both the individual and cumulative effects of the risks and promotive factors among participants using structural equation modeling, geospatial analyses, and cumulative indexes that are within the expertise of our research team. Findings will provide a solid basis to inform evidence-based interventions that prevent mental distress, substance use, and firearm injury risks.