Laura Seewald

For U.S. teens, firearm access is a significant risk factor for fatal/non-fatal injury. To inform prevention efforts, we estimate prevalence of caregiver storage practices within a nationally representative sample and characterize factors associated with storing firearms unlocked and loaded (unsecure). A web-based survey (24 June 2020–22 July 2020) of caregivers (N = 2924) of teens (age: 14–18) was completed, with weighting used to generate nationally representative estimates; multivariable logistic regression was then used to identify factors associated with storing firearms unlocked and loaded. We identified that 44.1% of caregivers of teens personally own a firearm, with 31.1% regularly storing ≥ 1 firearm(s) unlocked and loaded. The primary motivation for firearm ownership was protection and a traditional firearm safe was the most commonly used storage device. Caregivers were more likely to store firearm(s) unlocked and loaded (vs. more secure storage methods) if they reported prior military service (AOR = 1.9) or conducted regular audits verifying location/storage (AOR = 1.6), and if their teen had received prior safety training (AOR = 2.4). While caregivers of teens may institute supplementary safety measures (e.g., audits; safety training), future research should examine the efficacy of such safety measures and their impact on teen firearm injury-related outcomes.

Background Adolescents and young adults with risk factors for opioid misuse and opioid use disorder are at elevated risk for overdose. We examined prior non-fatal overdose experiences among at-risk adolescents/young adults to inform prevention efforts. Methods Adolescents/young adults (ages 16–30) in two US emergency departments self-reporting past year opioid misuse or opioid use plus a misuse risk factor completed a baseline survey as part of an ongoing randomised controlled trial. We describe baseline factors associated with (a) overall non-fatal overdose experiences and (b) groups based on substance(s) used during the worst overdose experience. Results Among 771 participants (27.9% male), 40.7% reported a non-fatal overdose experience. Compared with those without a prior overdose experience, those with prior overdose experience(s) were less likely to be heterosexual, and more likely to report a prior suicide attempt and greater peer substance misuse. Regarding the worst overdose experience, substance(s) included: 36.6% alcohol only, 28.0% alcohol and cannabis, 22.6% alcohol with other substance(s) and 12.7% other substance(s) only (eg, opioids). Compared with the alcohol only group, the alcohol and cannabis group were younger and less likely to be heterosexual; the alcohol with other substance(s) group were older and had greater peer substance misuse; and the other substance(s) only group were more likely to be male, receive public assistance, screen positive for anxiety and less likely to be heterosexual. Conclusions Among at-risk adolescents/young adults, findings support the need for tailored overdose prevention efforts based on substance(s) used, with consideration of sexuality, mental health and peer substance use. Trial registration number NCT04550715.

Statement of Purpose Firearms are the leading cause of death for high-school aged youth, with firearm access the most significant risk factor for adolescent firearm injury. Parental rules regarding teen firearm access have not been previously characterized. We estimate prevalence of firearm safety/access rules among parents of high-school age teens and parental correlates of maintaining teen firearm safety/access rules. Methods/Approach Data was from a cross-sectional web-based survey (6/24/2020–7/22/2020) conducted among parents (n=2,924) of high-school age teens (age:14–18). Weights were applied to generate nationally representative estimates. Bivariate comparisons were examined. Results Among U.S. parents of high-school teens, 84.5% (95%CI=82.1–85.7) maintain rules with their teen regarding firearm access/safety. For example, most do not allow their teen to access firearms (40.0%) or allow only supervised access (27.0%). Few families (2.6%) allow unsupervised firearm access, with firearm-owning families allowing for more unsupervised access (3.1% vs 1.3%; p=.21). The prevalence of rules governing teen firearm access differed by household firearm ownership, with firearm-owning families more likely to maintain rules than non-firearm owning families (94.8% vs 72.1%; pSignificance Firearm owning families have different rules than non-firearm owning families, including greater unsupervised firearm access and greater teen firearm safety training. Future research should examine optimal interventions for limiting unsupervised teen access to firearms, as well as whether more restrictive parental rules are efficacious decreasing teen access and injury risk.

PURPOSE We undertook a study to determine the prevalence and associations of technology-facilitated abuse (TFA)—insults, harassment, coercion, or threats carried out using digital tools such as smartphones and computers—among a US nationally representative sample of young men. METHODS Analyses were based on 1,079 men aged 18 to 35 years who completed questionnaires during August and September of 2014 and reported ever having been in a romantic relationship. We used validated measures to assess demographics, health service use, mental health and substance use, and TFA delivered to and received from partners in the past year. We calculated survey-weighted descriptive statistics and conducted multinomial logistic regression analysis. RESULTS Overall, 4.1% of men reported delivering TFA only, 8.0% receiving TFA only, and 25.6% both delivering and receiving TFA. Men were more likely to report only delivering TFA if they identified as Hispanic (adjusted odds ratio [AOR] = 2.72; 95% CI, 1.13 to 6.57), used marijuana (AOR = 1.31; 95% CI, 1.02 to 1.68), and used prescription opioids for nonmedical reasons (AOR 2.86; 95% CI, 1.48 to 5.54). Men were more likely to report only receiving TFA if they identified as Hispanic (AOR = 2.55; 95% CI, 1.01 to 6.43) and used prescription opioids for nonmedical reasons (AOR = 2.43; 95% CI, 1.34 to 4.39), whereas a primary care connection appeared protective (AOR = 0.43; 95% CI, 0.22 to 0.86). Men were more likely to report both delivering and receiving TFA if they identified as non-Hispanic Black (AOR = 2.83; 95% CI, 1.44 to 5.58), owned a smartphone (AOR = 1.80; 95% CI, 1.05 to 3.09), had ever had mental health care visits (AOR = 1.86; 95% CI, 1.16 to 2.98), misused alcohol (AOR = 1.10; 95% CI, 1.04 to 1.17), and used prescription opioids for nonmedical reasons (AOR = 1.79; 95% CI, 1.04 to 3.08). CONCLUSIONS We found that TFA was prevalent among young men, with 1 in 25 reporting delivery only, 1 in 12 reporting receipt only, and 1 in 4 reporting both. Primary care physicians can consider assessing TFA among male patients and developing interventions to mitigate this behavior. VISUAL ABSTRACT