Journal of Behavioral Medicine

, Volume 42, Issue 4, pp 603–612 | Cite as

Characteristics and behavioral risk factors of firearm-exposed youth in an urban emergency department

  • Ruth AbayaEmail author
  • Tita Atte
  • Joanna Herres
  • Guy Diamond
  • Joel A. Fein


Assessing firearm access among adolescents with behavioral health risk factors is important for the primary prevention of suicide and interpersonal violence. We describe self-reported firearm access and the associated behavioral risk factors and demographic characteristics in a cross-sectional study conducted in the emergency department of an urban pediatric hospital from June 2013 to June 2014. A total of 2258 adolescents received a behavioral health survey to assess access to firearms inside and outside the home, mental health symptoms, and risk behaviors. One of 6 patients in our sample (15%) endorsed access to a firearm. Male gender, lifetime alcohol use, lifetime marijuana use, and lifetime other drug use were associated with access. Participants reporting access were more likely to report clinical levels of lifetime suicidality and depression. The odds of current suicidality were highest in those with 24-h access (OR 2.77 CI 1.73–4.46), compared to those who did not endorse access.


Firearm Adolescent health Suicide Emergency medicine Behavioral health 



A special thank you to Aimee Palumbo for her contributions to this work.


Funded by a Grant (No. H34MC04366) from the Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (Fein, PI). Funding for this paper was also provided by SAMHSA’s 5U79SM058386, 1U79SM060387, 1U79SM061750, Garrett Lee Smith Suicide Prevention Programs. We thank all the participating medical providers and patients who taught us so much about how to integrate MH services into a medical setting.

Compliance with ethical standards

Conflict of interest

The Behavioral Health Screening tool is owned by The Children’s Hospital of Philadelphia and licensed to Medical Decision Logic, Inc., a health science informatics and computer science engineering company. Drs. Diamond and Fein might 1 day receive a small royalty payment for their part in developing the tool. Dr. Abaya and the other coauthors do not report financial interests or potential conflicts of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric Emergency MedicineThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.College of Nursing and Health ProfessionsDrexel UniversityPhiladelphiaUSA
  3. 3.Department of PsychologyThe College of New JerseyEwingUSA
  4. 4.College of Nursing and Health ProfessionsDrexel UniversityPhiladelphiaUSA
  5. 5.Department of Pediatrics, Division of Emergency MedicineThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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