PROJECT SUMMARY Firearm injury and mortality are a major public health concern for American youth age 1-19. Modifiable risk factors for youth firearm injury and death include unsafe storage of a firearm in the home, prior victimization/aggression, substance use, and depressive symptoms. Due to the fraught political landscape and lack of research funding, partnerships with firearm owners and firearm safety training programs to create and implement effective, non-policy-based preventive interventions for youth firearm injury are lacking. Bystander intervention (BI) is an intervention framework rooted in social psychological theories such as the Theory of Planned Behavior (TPB), with proven efficacy and effectiveness targeting both individual and community behavior change. “The Reframe” is a three-part, already-piloted intervention that uses the BI framework and TPB mechanisms to promote adult and youth community norms change about firearm safety, BI, and harm reduction techniques (e.g., safe storage, reducing access to lethal means, conflict resolution). Recognizing that BI is most rigorous when led by credible messengers, The Reframe uses instructional, peer-to-peer, and social-media strategies in conjunction with community organizations that are deeply connected to firearm safety efforts. Our community partner, the National 4-H Shooting Sports Program is a national leader and trusted messenger for firearm safety. In accordance with this RFA’s Research Objective Two, Funding Option B, we propose to conduct a Type I Hybrid Effectiveness-Implementation Trial to evaluate The Reframe’s effectiveness in changing firearm injury prevention norms, attitudes, intentions, and behaviors among a sample of fifty 4-H Shooting Sports Club communities (adults and youth). We propose to: (1) Conduct a series of key informant interviews with an advisory board of 20 key stakeholders (youth and adult 4-H Shooting Sports leaders representing a range of communities and 4-H experience) to ensure The Reframe addresses 4-H- specific issues of acceptability, feasibility, and appropriateness; (2a) Evaluate The Reframe’s effectiveness, compared to usual training, in changing individual- and community-level, proximal and distal behavioral outcomes related to firearm injury prevention at 0, 3, and 6 months; (2b) Examine barriers and facilitators to The Reframe intervention’s implementation using a mixed-methods (qualitative and quantitative) approach; (2c) Explore injury patterns among all 50 communities using population-level data. SIGNIFICANCE: This proposal will advance firearm injury prevention science by supporting a synergistic partnership between well- established firearm injury, suicide, and violence prevention researchers and the national 4-H Shooting Sports community. Consistent with CDC priorities, this proposal will build an evidence base for best practices for easy-to-implement individual- and community-level interventions that promote safe behaviors around youth firearm use and injury prevention.

PROJECT NARRATIVE Firearm injury and death are the second leading cause of death for American youth age 1-19, but few effective partnerships exist with firearm owners and firearm safety training programs. In this proposal, researchers will collaborate with the National 4-H Shooting Sports Program to evaluate effectiveness of The Reframe (a three- part bystander intervention program, based on the Theory of Planned Behavior) in reducing firearm injury risk among 4-H communities. This work has the potential to build an evidence base for best practices for individual- and community-level interventions that promote safe behaviors around firearm use and injury prevention, thereby saving lives; to meld best scientific practice with deep community-based expertise; and to create a model that can be scaled across 4-H’s network, which reaches nearly 6 million youth and their communities across the nation.