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    Original Investigation
    June 4, 2021

    Public Awareness of and Personal Willingness to Use California's Extreme Risk Protection Order Law to Prevent Firearm-Related Harm

    Author Affiliations
    • 1University of California Firearm Violence Research Center and Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento
    JAMA Health Forum. 2021;2(6):e210975. doi:10.1001/jamahealthforum.2021.0975
    Key Points

    Questions  What does the public know about extreme risk protection orders (ERPOs) and are people willing to use these tools to prevent firearm-related harm, both in general and when a family member is at risk? If they are not willing, why not?

    Findings  In this state-representative cross-sectional survey study of 2870 adults in California, support for the appropriateness of and willingness to use an ERPO at least some of the time was high (>70%) across selected risk scenarios, particularly among firearm owners and nonowners who live with owners. Approximately two-thirds of respondents cited a lack of awareness of ERPOs as a reason why they were unwilling to use an EPRO, followed by a belief that the risk scenarios are private matters, and a distrust that the system will be fair.

    Meaning  These findings on public awareness and perceived appropriateness of ERPOs, willingness to use these tools to prevent firearm-related harm, and areas of focus to address barriers to EPRO uptake may be informative for EPRO implementation in California and other jurisdictions.


    Importance  Extreme risk protection order (ERPO) laws temporarily suspend firearm and ammunition access by individuals whom a judge has deemed to be at substantial risk of harming themselves or others. Despite widespread recent adoption of these laws, use of ERPOs has been limited. Barriers to ERPO uptake remain unclear.

    Objective  To assess public awareness and perceived appropriateness of and willingness to use ERPOs in various risk scenarios, and to identify reasons for being unwilling, overall and by firearm ownership status, to inform efforts to improve ERPO implementation.

    Design, Setting, and Participants  This was a cross-sectional study using data from the 2020 California Safety and Wellbeing Survey, a statewide internet survey on firearm ownership and exposure to violence and its consequences, conducted from July 14 to July 27, 2020. Adult respondents were recruited from the Ipsos KnowledgePanel using probability-based sampling methods. Responses were weighted to be representative of the adult population of California.

    Main Outcomes and Measures  Awareness and perceived appropriateness of gun violence restraining orders (GVROs; California’s official term for ERPOs), willingness to use a GVRO for a family member at risk of harm, and reasons for being not at all willing to use a GVRO in 1 or more risk scenarios, overall and by firearm ownership status.

    Results  Of the 5018 panel members invited, 2870 (57%) completed the survey. Of these respondents (mean [SD] age: 47.9 [16.9] years; 52.3% women; 41.9% White, 34.7% Latinx, 14.4% Asian, and 5.8% Black individuals), 65.6% (95% CI, 63.0%-68.1) had never heard of a GVRO or a red flag law. Firearm owners were significantly more likely (20.5%; 95% CI, 15.9%-26.0%) than nonowners who live with owners (6.1%; 95% CI, 3.7%-10.0%; P < .001) and nonowners (9.6%; 95% CI, 7.8%-11.6%; P < .001) to have heard of both a GVRO and a red flag law. After reading a brief description of California’s GVRO law, 72.9% (95% CI, 70.2%-75.4%) to 78.4% (95% CI, 75.9%-80.8%) of respondents, depending on the risk scenario, indicated that GVROs were in general at least sometimes appropriate, while 73.2% (95% CI, 70.5%-75.6%) to 83.6% (95% CI, 81.2%-85.8%) said they would be somewhat or very willing to use a GVRO for a family member at risk of harm. Firearm owners reported the highest levels of GVRO appropriateness in 4 of 5 risk scenarios (depending on the scenario, 80.0% [95% CI, 73.6%-85.1%] to 85.6% [95% CI, 79.9%-89.8%]). Nonowners who live with owners reported the highest levels of personal willingness to use a GVRO (depending on the scenario, 83.7% [95% CI, 74.7%-90.0%] to 94.7% [95% CI, 86.2%-98.1%]). The most frequently cited reasons for being unwilling to use a GVRO were not knowing enough about GVROs (44.9%; 95% CI, 39.7%-50.3%), believing the risk scenarios are personal or family matters (26.6%; 95% CI, 22.2%-31.6%), and distrust that the system will be fair (23.1%; 95% CI, 19.1%-27.6%).

    Conclusions and Relevance  In this cross-sectional survey study, public awareness of GVROs was low, but perceived appropriateness of and willingness to use these tools at least some of the time was high. Foci for efforts to address barriers to GVRO use in California were identified; similar challenges likely exist in other jurisdictions.