SPONSORED RESEARCH: Scaling out S.A.F.E. Firearm across Two Health Systems as a Universal Suicide Prevention Strategy (SCALE ASPIRE)
February 10, 2025
Read a Q&A Below
In January, Rinad Beidas, PhD and team at Northwestern University Feinberg School of Medicine, Henry Ford Health, and Kaiser Permanente Colorado received an R01 grant (R01MH138333) from the National Institute of Mental Health titled, “Scaling out S.A.F.E. Firearm across Two Health Systems as a Universal Suicide Prevention Strategy (SCALE ASPIRE).” Patrick Janulis, PhD, associate professor of Medical Social Sciences, serves as a co-investigator, and external co-investigators include Brian Ahmedani, PhD of Henry Ford Health in Michigan, Jennifer Boggs, PhD, MSW and Arne Beck, PhD of Kaiser Permanente Colorado.
What are the aims of the project?
Over the past few years, Beidas and collaborators tested how best to implement S.A.F.E. Firearm, a universal evidence-based suicide prevention intervention that includes a brief harm reduction focused conversation around secure storage and the offer of a free cable lock. Their original ASPIRE trial was the largest study of its kind, enacted across more than 47,000 well-child visits in 30 pediatric clinics in Michigan and Colorado. While almost no pediatricians reported delivering the components of the program before the study began, 22% did so when prompted with an electronic health record alert (“nudge”) implemented as part of the study and 49% did so when they were prompted with the nudge and received logistical support from trained facilitators. Implementing the S.A.F.E. Firearm program was effective, cost-efficient, and well-supported by clinical staff.
Based on the success of the initial trial, partners in other service lines, including adult primary care and women’s health, were interested in the opportunity to expand the program to adults across their health systems. In this new trial, the investigative team seeks to assess the effectiveness of the S.A.F.E. Firearm program in adult primary care and women’s health at nearly 50 clinics across Henry Ford Health and Kaiser Permanente Colorado. First, in partnership with clinicians, clinic leaders, and patients, the investigative team will adapt S.A.F.E. Firearm for the broader adult population, co-designing updates to clinician- and patient-facing materials and the process of running the program. Adapted materials will then be incorporated into the most effective arm of the original trial (which featured the electronic nudge, clinician training, and logistical support through facilitation) and tested to determine the adapted program’s ability to reach patients and its effectiveness at encouraging secure firearm storage behavior. Finally, as the study concludes, the team will interview patients and clinical staff to understand the mechanisms behind study results. In addition to helping health systems learn strategies to widely scale interventions, the study aims to recognize effective strategies for secure firearm storage.
What are your next steps?
Along with a sister study led by Beidas which will explore how to expand the S.A.F.E. Firearm program to community health care centers in Illinois, the team is beginning to prepare for the adaptation process and evaluate ways to make the program most salient for adults in the primary care setting. Investigators at Henry Ford Health and Kaiser Permanente Colorado are meeting with primary care and women’s health leaders within their health systems to start planning for SAFE Firearm adaptation.
What do you hope will come out of this funded research?
Suicide is a leading cause of death for people in the United States. In promoting a universal approach in which clinicians talk to everyone, regardless of perceived risk level, about secure firearm storage, the goal is to save lives. Investigators seek to build off the accomplishments of the original ASPIRE trial and expand the reach of S.A.F.E. Firearm, demonstrating that it can be successfully implemented in both pediatric and adult primary care settings. Ultimately, the team aims to scale the program across the country, increasing secure firearm storage and decreasing firearm injury and mortality nationwide.