Journal of Behavioral Medicine

, Volume 42, Issue 4, pp 706–723 | Cite as

Risk and protective factors related to youth firearm violence: a scoping review and directions for future research

  • Carissa J. SchmidtEmail author
  • Laney Rupp
  • Jesenia M. Pizarro
  • Daniel B. Lee
  • Charles C. Branas
  • Marc A. Zimmerman


To conduct our scoping review of risk and protective factors for firearm violence among youth, we searched PubMed, Scopus, EMBASE, and Criminal Justice Abstracts for English-language research articles published between January 1985 and May 2018. We included studies of modifiable risk or protective factors associated with intentional (including suicide) or unintentional firearm victimization or perpetration with samples that included youth ≤ 17. Among the 28 included studies, 15 explored risk/protective factors for victimization, five focused on perpetration, five did not differentiate between victimization and perpetration, and five focused on suicide. Most studies examined individual-level risk factors. The few that explored factors beyond the individual were limited by methodological weaknesses and inconsistent findings. Protective factors for youth firearm outcomes were understudied. We need more research on youth firearm violence using longitudinal data and robust statistical methods. Future research is needed to understand the underlying mechanisms by which risk/protective factors influence firearm violence.


Children Adolescents Firearm violence Firearm suicide Risk factors 



We would like to thank Lynn Massey, Max Ozer-Staton, Melissa Goodman, and Mikala Cox for their support conducting this scoping review. We also extend our thanks to the University of Michigan Taubman Health Sciences Librarian Staff, including informationists, Kate Saylor, MLIS, who conducted the database searches for this scoping review, and Judith Smith, MS and Gupreet Rana, MLIS for additional consulting and advice on our search strategies.


This review was funded by NIH/NICHD 1R24HD087149-01A1. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies.

Compliance with ethical standards

Conflict of interest

Drs. Schmidt, Pizarro, Lee, Branas, Zimmerman, and Ms. Rupp declare that they have no conflicts of interest.

Human and animal rights and Informed consent

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 19–32.CrossRefGoogle Scholar
  2. Azrael, D., Hemenway, D., Miller, M., Barber, C. W., & Schackner, R. (2004). Youth suicide: Insights from 5 years of Arizona child fatality review team data. Suicide and Life-Threatening Behavior, 34, 36–43.CrossRefGoogle Scholar
  3. Brent, D. A., Perper, J. A., Moritz, G., Baugher, M., Schweers, J., & Roth, C. (1993). Firearms and adolescent suicide. A community case–control study. American Journal of Diseases of Children, 147, 1066–1071.CrossRefGoogle Scholar
  4. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by design and nature. Cambridge, MA: Harvard University Press.Google Scholar
  5. Carter, P. M., Cook, L. J., Macy, M. L., Zonfrillo, M. R., Stanley, R. M., Chamberlain, J. M., et al. (2017a). Individual and neighborhood characteristics of children seeking emergency department care for firearm injuries within the PECARN network. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 24(7), 803–813. CrossRefGoogle Scholar
  6. Carter, P. M., & Cunningham, R. M. (2016). Adequate funding for injury prevention research is the next critical step to reduce morbidity and mortality from firearm injuries. Academic Emergency Medicine, 23, 952–955. CrossRefGoogle Scholar
  7. Carter, P. M., Walton, M. A., Goldstick, J., Epstein-Ngo, Q. M., Zimmerman, M. A., Mercado, M. C., et al. (2017b). Violent firearm-related conflicts among high-risk youth: An event-level and daily calendar analysis. Preventive Medicine, 102, 112–119. CrossRefGoogle Scholar
  8. Carter, P. M., Walton, M. A., Roehler, D. R., Goldstick, J., Zimmerman, M. A., Blow, F. C., et al. (2015). Firearm violence among high-risk emergency department youth after an assault injury. Pediatrics, 135, 805–815. CrossRefGoogle Scholar
  9. Centers for Disease Control and Prevention. (2015). National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Accessed November 12, 2018.
  10. Choi, N. G., DiNitto, D. M., & Marti, C. N. (2017). Youth firearm suicide: Precipitating/risk factors and gun access. Children and Youth Services Review, 83, 9–16. CrossRefGoogle Scholar
  11. Cohn, D., Taylor, P., Lopez, M. H., Gallagher, C. A., Parker, K., & Maass, K. T. (2013). Gun homicide rate down 49% since 1993 peak: Public unaware. Washington, DC: Pew Research Center. Retrieved from June 8, 2019.
  12. Culyba, A. J., Miller, E., Ginsburg, K. R., Branas, C. C., Guo, W., Fein, J. A., et al. (2018). Adult connection in assault injury prevention among male youth in low-resource urban environments. Journal of Urban Health, 95, 361–371.CrossRefGoogle Scholar
  13. Cunningham, R. M., Walton, M. A., & Carter, P. M. (2018). The major causes of death in children and adolescents in the United States. New England Journal of Medicine, 379(25), 2468–2475.CrossRefGoogle Scholar
  14. Dahlberg, L. L., Ikeda, R. M., & Kresnow, M. J. (2004). Guns in the home and risk of a violent death in the home: Findings from a national study. American Journal of Epidemiology, 160, 929–936. CrossRefGoogle Scholar
  15. Dong, B., Branas, C. C., Richmond, T. S., Morrison, C. N., & Wiebe, D. J. (2017). Youth’s daily activities and situational triggers of gunshot assault in urban environments. Journal of Adolescent Health, 61, 779–785. CrossRefGoogle Scholar
  16. Erickson, P. G., Butters, J. E., Cousineau, M. M., Harrison, L., & Korf, D. (2006). Girls and weapons: An international study of the perpetration of violence. Journal of Urban Health, 83, 788–801. CrossRefGoogle Scholar
  17. Goldstick, J. E., Carter, P. M., Walton, M. A., Dahlberg, L. L., Sumner, S. A., Zimmerman, M. A., et al. (2017). Development of the SaFETy Score: A clinical screening tool for predicting future firearm violence risk. Annals of Internal Medicine, 166, 707–714. CrossRefGoogle Scholar
  18. Hawkins, J. D., Catalano, R. F., & Arthur, M. W. (2002). Promoting science-based prevention in communities. Addictive Behaviors, 27, 951–976. CrossRefGoogle Scholar
  19. Herrenkohl, T. I., Maguin, E., Hill, K. G., Hawkins, J. D., Abbott, R. D., & Catalano, R. F. (2000). Developmental risk factors for youth violence. Journal of Adolescent Health, 26, 176–186. CrossRefGoogle Scholar
  20. Hohl, B. C., Wiley, S., Wiebe, D. J., Culyba, A. J., Drake, R., & Branas, C. C. (2017). Association of drug and alcohol use with adolescent firearm homicide at individual, family, and neighborhood levels. JAMA Internal Medicine, 177, 317–324. CrossRefGoogle Scholar
  21. Huebner, B. M., Martin, K., Jr., Moule, R. K., Pyrooz, D., & Decker, S. H. (2016). Dangerous places: Gang members and neighborhood levels of gun assault. Justice Quarterly, 33, 836–862. CrossRefGoogle Scholar
  22. Kim, B. K. E., Gloppen, K. M., Rhew, I. C., Oesterle, S., & Hawkins, J. D. (2015). Effects of the communities that care prevention system on youth reports of protective factors. Prevention Science, 16, 652–662. CrossRefGoogle Scholar
  23. Kondo, M. C., South, E. C., Branas, C. C., Richmond, T. S., & Wiebe, D. J. (2017). The association between urban tree cover and gun assault: A case–control and case-crossover study. American Journal of Epidemiology, 186, 289–296. CrossRefGoogle Scholar
  24. Loeber, R., DeLamatre, M., Tita, G., Cohen, J., Stouthamer-Loeber, M., & Farrington, D. P. (1999). Gun injury and mortality: The delinquent backgrounds of juvenile victims. Violence and Victims, 14, 339–352.CrossRefGoogle Scholar
  25. Lösel, F., & Farrington, D. P. (2012). Direct protective and buffering protective factors in the development of youth violence. American Journal of Preventive Medicine, 43, S8–S23.CrossRefGoogle Scholar
  26. Madan, A., Beech, D. J., & Flint, L. (2001). Drugs, guns, and kids: The association between substance use and injury caused by interpersonal violence. Journal of Pediatric Surgery, 36, 440–442.CrossRefGoogle Scholar
  27. McGee, Z. T., Logan, K., Samuel, J., & Nunn, T. (2017). A multivariate analysis of gun violence among urban youth: The impact of direct victimization, indirect victimization, and victimization among peers. Cogent Social Sciences. Google Scholar
  28. Miller, M., Hemenway, D., & Azrael, D. (2007). State-level homicide victimization rates in the U.S. in relation to survey measures of household firearm ownership, 2001–2003. Social Science and Medicine, 64, 656–664.CrossRefGoogle Scholar
  29. Murnan, J., Dake, J. A., & Price, J. H. (2004). Association of selected risk factors with variation in child and adolescent firearm mortality by state. Journal of School Health, 74, 335–340.CrossRefGoogle Scholar
  30. Ouzzani, M., Hammady, H., Zbys, F., & Elmagarmid, A. (2016). Rayyan-a web and mobile app for systematic reviews (Version 5:210). Retrieved from
  31. Papachristos, A., Braga, A., Piza, E., & Grossman, L. (2015). The company you keep? The spillover effects of gang membership on individual gunshot victimization in a co-offending network. Criminology, 53, 624–649.CrossRefGoogle Scholar
  32. Papachristos, A. V., Braga, A. A., & Hureau, D. M. (2012). Social networks and the risk of gunshot injury. Journal of Urban Health, 89, 992–1003.CrossRefGoogle Scholar
  33. Paris, C. A., Edgerton, E. A., Sifuentes, M., Seidel, J. S., Lewis, R. J., & Gausche, M. (2002). Risk factors associated with non-fatal adolescent firearm injuries. Injury Prevention, 8, 147–150.CrossRefGoogle Scholar
  34. Pollard, J. A., Hawkins, J. D., & Arthur, M. W. (1999). Risk and protection: Are both necessary to understand diverse behavioral outcomes in adolescence? Social Work Research, 23, 145–158. CrossRefGoogle Scholar
  35. Resnick, M. D., Ireland, M., & Borowsky, I. (2004). Youth violence perpetration: What protects? What predicts? Findings from the National Longitudinal Study of Adolescent Health. Journal of Adolescent Health, 35, 424-e1.CrossRefGoogle Scholar
  36. Ruback, R. B., Shaffer, J. N., & Clark, V. A. (2011). Easy access to firearms: Juveniles’ risks for violent offending and violent victimization. Journal of Interpersonal Violence, 26, 2111–2138.CrossRefGoogle Scholar
  37. Shah, S., Hoffman, R. E., Wake, L., & Marine, W. M. (2000). Adolescent suicide and household access to firearms in Colorado: Results of a case–control study. Journal of Adolescent Health, 26, 157–163.CrossRefGoogle Scholar
  38. Spano, R., Freilich, J. D., & Bolland, J. (2008). Gang membership, gun carrying, and employment: Applying routine activities theory to explain violent victimization among inner city, minority youth living in extreme poverty. Justice Quarterly, 25, 381–410.CrossRefGoogle Scholar
  39. Stevens, M. M., Gaffney, C. A., Tosteson, T. D., Mott, L. A., Olson, A., Ahrens, M. B., et al. (2001). Children and guns in a well child cohort. Preventive Medicine, 32, 201–206. CrossRefGoogle Scholar
  40. Sumner, S. A., Maenner, M. J., Socias, C. M., Mercy, J. A., Silverman, P., Medinilla, S. P., et al. (2016). Sentinel events preceding youth firearm violence: An investigation of administrative data in Delaware. American Journal of Preventive Medicine, 51, 647–655. CrossRefGoogle Scholar
  41. Wilkinson, D. L., McBryde, M. S., Williams, B., Bloom, S., & Bell, K. (2009). Peers and gun use among urban adolescent males: An examination of social embeddedness. Journal of Contemporary Criminal Justice, 25, 20–44.CrossRefGoogle Scholar
  42. Zaza, S., Wright-De Agüero, L. K., Briss, P. A., Truman, B. I., Hopkins, D. P., Hennessy, M. H., et al. (2000). Data collection instrument and procedure for systematic reviews in the guide to community preventive services. American Journal of Preventive Medicine, 18, 44–74.CrossRefGoogle Scholar

Copyright information

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

Authors and Affiliations

  1. 1.Department of Health Behavior and Health EducationUniversity of Michigan School of Public HealthAnn ArborUSA
  2. 2.School of Criminology and Criminal JusticeArizona State UniversityPhoenixUSA
  3. 3.Department of EpidemiologyColumbia Mailman School of Public HealthNew YorkUSA

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