[Skip to Navigation]
Special Communication
June 10, 2019

Prevention of Firearm Injuries Among Children and Adolescents: Consensus-Driven Research Agenda from the Firearm Safety Among Children and Teens (FACTS) Consortium

Author Affiliations
  • 1Department of Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor
  • 2Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island
  • 3Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor
  • 4School of Criminal Justice, Michigan State University, East Lansing
  • 5Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
  • 7Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 8Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 9Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
  • 10Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor
  • 11Children’s National Medical Center, The George Washington University, Washington, DC
  • 12Department of Health Policy and Management, T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts
  • 13Department of Emergency Medicine, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee
  • 14School of Criminology and Criminal Justice, Arizona State University, Phoenix
  • 15Child Health Evaluation and Research Center, Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor
  • 16Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor
  • 17Department of Epidemiology, School of Public Health, University of Washington, Seattle
  • 18Departments of Pediatrics, School of Medicine, University of Washington, Seattle
  • 19Harborview Injury Prevention and Research Center, University of Washington, Seattle
  • 20Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
  • 21Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora
  • 22Institute for Social Research, University of Michigan, Ann Arbor
JAMA Pediatr. 2019;173(8):780-789. doi:10.1001/jamapediatrics.2019.1494

Importance  Firearm injuries are the second leading cause of death among US children and adolescents. Because of the lack of resources allocated to firearm injury prevention during the past 25 years, research has lagged behind other areas of injury prevention. Identifying timely and important research questions regarding firearm injury prevention is a critical step for reducing pediatric mortality.

Objective  The Firearm Safety Among Children and Teens (FACTS) Consortium, a National Institute for Child Health and Human Development–funded group of scientists and stakeholders, was formed in 2017 to develop research resources for the field, including a pediatric-specific research agenda for firearm injury prevention to assist future researchers and funders, as well as to inform cross-disciplinary evidence-based research on this critical injury prevention topic.

Evidence Review  A nominal group technique process was used, including 4 key steps (idea generation, round-robin, clarification, and voting and consensus). During idea generation, stakeholders and workgroups generated initial research agenda topics after conducting scoping reviews of the literature to identify existing gaps in knowledge. Agenda topics were refined through 6 rounds of discussion and survey feedback (ie, round-robin, and clarification steps). Final voting (using a 5-point Likert scale) was conducted to achieve consensus (≥70% of consortium ranking items at 4 or 5 priority for inclusion) around key research priorities for the next 5 years of research in this field. Final agenda questions were reviewed by both the stakeholder group and an external panel of research experts not affiliated with the FACTS Consortium. Feedback was integrated and the final set of agenda items was ratified by the entire FACTS Consortium.

Findings  Overall, 26 priority agenda items with examples of specific research questions were identified across 5 major thematic areas, including epidemiology and risk and protective factors, primary prevention, secondary prevention and sequelae, cross-cutting prevention factors, policy, and data enhancement.

Conclusions and Relevance  These priority agenda items, when taken together, define a comprehensive pediatric-specific firearm injury prevention research agenda that will guide research resource allocation within this field during the next 5 years.

Add or change institution