Rural-Urban Variation in the Association of Adolescent Violence and Handgun Carrying in the United States, 2002-2019

Strategies for recruiting adolescents in rural areas in firearm injury research

BACKGROUND

Participant recruitment is a central aspect of human sciences research. Barriers to participant recruitment can be categorised into participant, recruiter and institutional factors. Firearm injury research poses unique barriers to recruitment. This is especially true for rural adolescents, who are at high risk for firearm-related injury and death, and whose voice is often absent in firearms research. In particular, recruitment strategies targeting adolescents should align with developmental changes occurring during this life stage. Identifying strategies to address recruitment barriers tailored to firearm-related research can help future researchers engage rural adolescents in injury prevention efforts.

PURPOSE

The purpose of the current methodology paper is to outline barriers and provide strategies for recruiting rural adolescents in firearms research informed by the Youth Experiences in Rural Washington: Research on Firearm Safety project, a mixed-methods, community-based participatory research study of 13-18 year-olds residing in rural Washington.

STRATEGIES

Recruitment barriers and related strategies were organised by participant-related and recruiter-related/institutional-related factors. While carrying out the study, key considerations or strategies which addressed multiple participant and recruiter/institutional factors, emerged with potential to enhance firearm-related research with rural adolescents more broadly. Key considerations included logistics (ie, scheduling flexibility, adequate and aligned incentives), use of a community-based participatory research approach and accounting for developmental stage.

CONCLUSION

Reducing the burden of firearm injury and death for rural adolescents and developing effective interventions requires understanding and navigating recruitment barriers. Strategies used in the current project can guide future qualitative or mixed methods data collection informing firearm injury prevention.

Patterns in pro-gun beliefs and weapon carrying behaviors in rural White adolescent

Weapon carrying among White rural populations is understudied although evidence suggests that rural White boys have high rates of carriage. This study delineated patterns of weapon use and pro-gun beliefs using a latent class analysis on a sample of 32,916 White rural adolescents. Five groups were identified (i.e., Low Gun Risk, Naïve, Social Contagion, Independent, Unsupervised) using pro-gun beliefs, peer risk factors, and weapon carrying items. Multinomial logistic regression analyses revealed that identifying as male, age, housing instability, and victimization consistently differentiated group membership between different classes. These results suggest that rural White adolescents vary in their belief systems about guns and weapon carrying behavior and that this heterogeneity can be differentiated by lived experiences of these adolescents.

Violence and suicide risk behavior in a nationally representative sample of youth aged 12-17: What does it mean to be at-risk?

Suicide attempts and school violence, including gun violence, are now leading causes of death in youth 12-17. This study applied a latent class analytic approach to investigate how heterogenous subgroups of youth differed regarding patterns of violence engagement and suicide risk behavior and how geographic, demographic, and socioeconomic predictors related to subgroup membership. Data were drawn from the youth subsample of the 2021 National Survey on Drug Use and Health (N = 10,743). A suicide risk subgroup had low probabilities of violence engagement but high probabilities of suicide ideation and plan. A violence + suicide risk subgroup had high probabilities of violence engagement, suicide ideation, and suicide plan. A violence risk subgroup had high probabilities of violence engagement and carrying a handgun, but low probabilities of suicide ideation or plan. The largest subgroup had low probabilities across all class indicators. Demographic, geographic, and socioeconomic variables uniquely predicted subgroup membership.

The association of alcohol use and heavy drinking with subsequent handgun carrying among youth from rural areas

PURPOSE

Alcohol use and handgun carrying are more prevalent among youth in rural than urban areas and their association may be stronger among rural adolescents. Alcohol use may be modifiable with implications for reducing handgun carrying and firearm-related harm. We examined the association between lagged alcohol use and subsequent handgun carrying in rural areas and examined variation in the association by developmental stages, hypothesizing that it would be stronger among adolescents than youth adults.

METHODS

We used a longitudinal sample of 2,002 adolescents from ages 12 to 26 growing up in 12 rural communities in 7 states with surveys collected from 2004 to 2019. We estimated the association of lagged past-month alcohol use on handgun carrying in the subsequent 12 months using population-average generalized estimating equations with logistic regression on multiply imputed data.

FINDINGS

During adolescence (ages 12-18), those who drank heavily had 1.43 times the odds (95% CI = [1.01, 2.03]) of subsequent handgun carrying compared to those who did not drink alcohol, and those who consumed alcohol but did not drink heavily had 1.30 times the odds of subsequent handgun carrying compared to those who did not drink (95% CI = [0.98, 1.71]). During young adulthood (ages 19-26), associations of alcohol use (OR = 1.28; 95% CI = [0.94, 1.63]) and heavy drinking (OR = 1.38; 95% CI = [1.08, 1.68]) were similar to adolescence.

CONCLUSIONS

Alcohol use and subsequent handgun carrying were positively associated during adolescence and young adulthood among individuals who grew up in rural areas, similar to findings in urban areas. Reducing alcohol use may be an important strategy to prevent handgun carrying and firearm-related harm among young people in rural areas.