Effects of Communities That Care on Handgun Carrying in Adolescence and Young Adulthood

Introduction: Firearms are a leading cause of injury and death among youth in the US, with handguns accounting for about 80% of firearm homicide and 90% of nonfatal firearm violence. Preventing the initiation of handgun carrying among adolescents and high-risk young adults could significantly reduce the risk of violence victimization and perpetration among them. Communities That Care (CTC) is a prevention planning and capacity building system for improving behavioral health problems among youth community-wide. It was tested in the Community Youth Development Study, a randomized trial involving 24 towns in 7 states. Intervention communities were trained in CTC and implemented evidence-based prevention programs for students in grades 6 through 9 aligned with local prevention priorities. This presentation reports on CTC effects on the cumulative initiation of handgun carrying in the past 12 months in a panel of 4,407 youth from grade 6 to age 23. Effects of CTC have been shown to differ by gender, so gender moderation was examined.

Methods: Panel participants reported on whether they had carried a handgun in the last 12 months at each of 7 data collection waves (retention = 88%). We analyzed CTC effects on the cumulative initiation of handgun carrying at each data collection (grades 6, 8, 10, 12, and ages 19, 21 and 23). We used generalized linear mixed models to account for nesting and included individual (e.g., gender, impulsiveness) and community (e.g., size) level covariates. We evaluated the pattern of significant intervention effects over time in the full sample using adjusted risk ratios (ARR) as an indication of effect size.

Results: Youth residing in communities which used CTC were significantly less likely to have initiated handgun carrying by the 8^th grade (ARR= 0.72, p= .031) compared to those in the control communities. This impact of the intervention on cumulative initiation was sustained through grades 10 (ARR= 0.71, p= .008) and 12 (ARR= 0.77, p= .024). Intervention effects approached significance (p=.08) through age 19 but were not significant by age 21. No evidence of gender moderation was detected.

Conclusions: CTC effects on reducing handgun carrying among adolescents are consistent with previous evidence of prevention effects on other health risk behaviors such as substance use and delinquency. However, the legalities and motivations for handgun carrying evolve as adolescents transition to young adults. Although handgun carrying increases the risk of injury and death among adults, the legal use of a handgun for self-defense, target shooting, or other reasons makes prevention efforts among young adults more complicated, and perhaps explains why intervention effects were not sustained beyond adolescence.