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BACKGROUND: Extreme Risk Protection Orders (ERPOs) are civil court orders that prohibit firearm purchase and possession when someone is behaving dangerously and is at risk of harming themselves and/or others. As of June 2024, ERPOs are available in 21 states and the District of Columbia to prevent firearm violence. This paper describes the design and protocol of a six-state study of ERPO use. METHODS: The six states included are California, Colorado, Connecticut, Florida, Maryland, and Washington. During the 3-year project period (2020-2023), ERPO case files were obtained through public records requests or through agreements with agencies with access to these data in each state. A team of over four dozen research assistants from seven institutions coded 6628 ERPO cases, abstracting 80 variables per case under domains related to respondent characteristics, events and behaviors leading to ERPO petitions, petitioner types, and court outcomes. Research assistants received didactic training through an online learning management system that included virtual training modules, quizzes, practice coding exercises, and two virtual synchronous sessions. A protocol for gaining strong interrater reliability was used. Research assistants also learned strategies for reducing the risk of experiencing secondary trauma through the coding process, identifying its occurrence, and obtaining help. DISCUSSION: Addressing firearm violence in the U.S. is a priority. Understanding ERPO use in these six states can inform implementation planning and ERPO uptake, including promising opportunities to enhance safety and prevent firearm-related injuries and deaths. By publishing this protocol, we offer detailed insight into the methods underlying the papers published from these data, and the process of managing data abstraction from ERPO case files across the multi-state and multi-institution teams involved. Such information may also inform future analyses of this data, and future replication efforts. REGISTRATION: This protocol is registered on Open Science Framework ( https://osf.io/kv4fc/ ).

ObjectiveTo describe the process of implementing a Youth Participatory Action Research (YPAR) project at a continuation high school (CHS) and share the results of a youth-designed research project that explores barriers to high school completion.Data sources and study settingYPAR was implemented across three cohorts at a CHS in the central coast of California from 2019 to 2022. Student survey respondents were enrolled CHS students between March and April 2021.Study designA modified YPAR curriculum integrating research methodology and social justice topics was used to guide student-led research that resulted in a cross-sectional survey.Data collectionField notes maintained by the first author documented the process of implementing YPAR including the curriculum, conversations, and research decisions and procedures. A student-designed survey disseminated to all enrolled students resulted in 76 (66%) participant responses. The survey included 18 close-ended questions and three narrative responses.Principal findingsThis study details how YPAR methodologies can be translated to a high school credit recovery program. For example, student cohorts were needed to maintain continuity over time. A student-designed survey revealed that 72% of student respondents reported taking care of family members and illuminated high rates of depression symptoms.ConclusionsThis study offers a detailed description of how we implemented YPAR at a credit recovery program and provides student-driven perspectives on educational reform and evaluation. This project addresses the implementation and challenges of using YPAR to engage youth in transformational resistance to rapidly study and improve CHS' policy and practice.

Introduction 159 I. Extreme Risk Protection Orders: A History and Overview 160 A. Responses from States and the Federal Government 162 B. The Rationale for ERPO Statutes 166 1. Recognizing [...], Extreme Risk Protection Orders (ERPOs) are civil court orders that temporarily prohibit gun purchase and possession by people who are behaving dangerously and at risk of committing imminent violence. As of September 2023, ERPOs are available in 21 states and the District of Columbia. This Article presents an overview of ERPO laws, the rationale behind their development, and a review and analysis that considers emerging constitutional challenges to these laws (under both the Second Amendment and due process protections) in the post-Bruen era. This Article notes that the presence of multiple constitutional challenges in many ERPO-related cases has confused judicial analysis and argues that, especially in light of Bruen 's novel text, history, and tradition test, courts should be especially careful to clarify how cumulative-rights arguments are impacting their analysis. An examination of Second Amendment court decisions concerning another type of civil protection order, Domestic Violence Protection Orders, informs the approach used to further consider ERPO rights deprivation claims and the constitutionally relevant distinctions among different civil dispossession proceedings. The Article further considers the state of ERPO law in the context of the evolving evidence documenting the uptake and impact of ERPOs on gun violence in the United States, including a review of scholarship that seeks to understand how ERPO statutes are being implemented and to determine whether the laws prevent interpersonal gun violence and suicide. Finally, this Article concludes with a commentary and set of recommendations to inform the practice and future scholarship of ERPO as a tool for preventing gun violence in the United States, in accord with constitutional protections in the post-Bruen age.

Limited research exists about factors that influence the sustainability of preventive school mental health interventions when research support ends. This study assessed barriers and facilitators to sustaining RAP (Relax, be Aware, do a Personal rating) Club, a trauma-informed universal mental health intervention, in urban schools following efficacy trial implementation. Between 2016 and 2018, 13 Baltimore City schools implemented RAP Club. We evaluated RAP Club sustainability using semi-structured interviews with administrators (n = 10) and school staff trained to deliver the intervention (n = 11), as well as review of intervention fidelity logs (n = 137) and notes from supervision calls (n = 10) with school staff and research team members who implemented the program. Although most school staff described RAP Club as acceptable and beneficial, none of the 13 schools sustained the intervention. Barriers to sustainability included low self-efficacy among school staff trained to deliver the intervention, school staff turnover, logistical challenges with space and time in the regular school calendar to deliver the program, insufficient funding to sustain the program outside of the research context, and limited planning and ongoing communication between school personnel and researchers about sustainability. Recommendations for increasing post-trial program sustainability include developing sustainability plans with schools during the pre-implementation phase, enhancing ongoing support for school staff during the implementation phase, and using academic-community partnerships to facilitate sustainability and intervention scale-up during the post-implementation phase. Increasing sustainability of beneficial school-based mental health programs has the potential to reduce mental health disparities and promote health equity.

This paper explores how Chesapeake-based watermen and seafood processors may experience occupational harm from microbial hazards like Vibrio spp. Fishing industry research primarily focuses on musculoskeletal injury, even though microbial hazards present risks to Total Worker Health® that clinicians should consider. This paper provides qualitative insights to address that gap. Commercial fishing is a dangerous profession with known hazards for musculoskeletal injuries, yet minimal examination of microbiological or attendant psychosocial hazards from water- and food-borne pathogens like Vibrio vulnificus and V. parahaemolyticus exists. Improving knowledge of Vibrio -related hazards addresses Total Worker Health® concerns for commercial fisheries workers. Methods: Following a grounded theory approach, we conducted semistructured interviews with watermen and related workers who fish and harvest shellfish in the Chesapeake Bay, USA, to investigate risk perceptions and understanding, and compliance with regulations intended to reduce worker and consumer illnesses and injuries from pathogen exposures. Results: Worker and consumer illnesses and injuries, and threat of fishery closures—with regulatory and organizational factors—influence this workforce. Conclusions: Our findings support interventions that promote monitoring, surveillance, and awareness of Vibrio- related risk among watermen, regulatory officials, medical professionals, and the public. [ABSTRACT FROM AUTHOR]

Many of the policies shown to benefit the public's health in research studies are never widely implemented. We conducted a qualitative and exploratory multiple-case study of three U.S. academic research-policy translation initiatives that resulted in the development, enactment and/or implementation of evidence-based policies to address public health issues: gun policy (Case 1); opioid policy (Case 2) and drug control policy (Case 3). We conducted semi-structured qualitative interviews with 25 key stakeholders involved in the three cases and analysed transcripts using a hybrid a priori and data-driven approach. Across cases, participants identified four key processes that should be included in research-policy translation initiatives: stakeholder engagement, consensus-building, long-term coalition engagement and use of effective knowledge brokers. Participants perceived differences in how the structure of and activities within each initiative facilitated these processes. For example, participants perceived the gun policy initiative, which included large-scale policy dissemination strategies such as state forums where research experts interacted with state policymakers and advocates, as more effective at long-term coalition engagement than the other two initiatives. Study results suggest concrete and actionable academic research-policy strategies that have the potential for widespread adoption by universities or other organizations.

Firearms increase the risk of lethality in violent intimate relationships. Policies that restrict access to firearms by respondents to civil domestic violence protective orders (DVROs) are associated with reductions in intimate partner homicide, yet there is scant literature about how such prohibitions are implemented. We document how four localities are implementing gun possession prohibitions that result from civil and criminal restraining orders and domestic violence misdemeanor convictions; and assess the findings in the context of Kingdon's agenda setting framework. We identified four jurisdictions where gun dispossession of prohibited domestic violence offenders was underway and collected data through in-depth interviews, site visits, and documents. We coded the data, identified explanatory themes, and compared the findings to Kingdon's framework. The four jurisdictions have policies ranging from no state laws restricting domestic violence offenders' access to guns to comprehensive state laws. We describe implementation initiatives to dispossess prohibited people of their guns in the four jurisdictions, two distinct implementation models through which gun dispossession occurs, and an expanded application of Kingdon's model. In each jurisdiction, we identified one or more individuals who championed implementation. Policies that prohibit domestic violence offenders from possessing guns are promising, and possible in diverse settings and jurisdictions. Here we provide insight into implementation efforts in four jurisdictions, emphasize the role of individuals in prioritizing implementation, and highlight the potential to realize these restrictions across states with different laws. Focusing on implementation is a much-needed paradigm shift that complements the traditional focus on passing domestic violence prevention laws., Author(s): Shannon Frattaroli [sup.1] , April M. Zeoli [sup.2] , Daniel W. Webster [sup.1] Author Affiliations: (1) grid.21107.35, 0000 0001 2171 9311, Center for Gun Violence Prevention and Policy, The [...]

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has demonstrated the need for epidemiologic models in public health decision-making. Modeling has been critical to planning outbreak responses since [...]

BackgroundPersons subject to domestic violence restraining orders (DVROs), known as respondents, are generally prohibited from possessing firearms. Efforts to enforce that prohibition have not been evaluated. The study objective was to determine whether associations exist between risk of incident arrest among DVRO respondents and 1) respondents' access to firearms, and 2) law enforcement recovery of firearms from respondents with access to them.MethodsThis was an observational study of 2,972 DVRO respondents in San Mateo County, California, 525 of whom were linked to firearms by standardized screening procedures. Enrollment occurred from May 2007 to June 2010 and follow-up through September 2010. Follow-up began when DVROs were served (or when issued if no date of service was available); median duration was 689 days. Principal exposures were access to firearms and, for subjects with access to firearms whose DVROs were served, contact by law enforcement personnel to recover those firearms. Main outcome measures were 1) incidence of arrest; 2) relative risk for arrest, adjusted for age, sex, prior criminal history, and duration of follow-up, assessed using logistic regression.ResultsRespondents linked to firearms were older than others and were more likely to have a history of prior arrest (49.7 % and 37.3 %, p

Extreme Risk Protection Orders (ERPOs) allow a court to restrict firearm access for individuals ("respondents") at imminent risk of harm to self/others. Little is known about ERPOs use for older adults, a population with higher rates of suicide and dementia. We abstracted ERPO cases through June 30, 2020, from California, Colorado, Connecticut, Florida, Maryland, and Washington. We restricted our analysis to petitions for older (≥65 years) respondents, stratified by documented cognitive impairment. Among 6,699 ERPO petitions, 672 (10.0%) were for older adults; 13.7% (n = 92) of these noted cognitive impairment. Most were white (75.7%) men (90.2%). Cognitively impaired (vs. non-impaired) respondents were older (mean age 78.2 vs 72.7 years) and more likely to have documented irrational/erratic behavior (30.4% vs 15.7%), but less likely to have documented suicidality (33.7% vs 55.0%). At the time of the petition, 56.2% of older adult respondents had documented firearm access (median accessible firearms = 3, range 1–160). Approximately 14% of ERPO petitions for older adults involved cognitive impairment; one-third of these noted suicide risk. Studies examining ERPO implementation across states may inform usage and awareness. ERPOs may reduce firearm access among older adults with cognitive impairment, suicidality, or risk of violence. [ABSTRACT FROM AUTHOR]

Author(s): Elise C. Omaki [sup.1] [sup.5] , Shannon Frattaroli [sup.1] , Wendy C. Shields [sup.1] , Eileen M. McDonald [sup.1] , Nicholas Rizzutti [sup.1] , Meri-K Appy [sup.2] , Denise [...], Objectives To demonstrate the feasibility of partnering fire department personnel and home visiting nurses to increase the number of low-income homes protected by smoke alarms. Methods During a regularly scheduled home visit, nurses at the Nurse-Family Partnership of Maricopa County (NFP) informed their clients about an opportunity to have smoke alarms installed in their homes for free. For interested families, nurses sent a referral to the Phoenix Fire Department (PFD), scheduled an appointment, and accompanied the PFD volunteers during the installation. During the appointment, PFD personnel installed alarms and provided safety education. Clients completed a follow-up survey 1-3 months after the installation visit. In-depth interviews were completed with key informants from NFP and PFD to solicit feedback on the program. Results Fifty-two smoke alarm installation visits were completed. Before the fire department arrived, 55% of homes had no working smoke alarm. Almost all (94%) homes received at least one new smoke alarm, and every home had at least one working smoke alarm at the end of the fire department visit. At follow-up, all homes maintained at least one working smoke alarm. Members from both organizations were enthusiastic about, and supportive of the project. NFP nurses appreciated the skill and knowledge of the firefighters; PFD representatives noted that the nurses' relationships with clients made it easier for them to gain access to families who are often described as "hard-to-reach". Conclusions Partnering home visiting nurses and fire departments can be successful to increase the number of vulnerable homes with smoke alarms.