OUR RESEARCH

Recruiting for Study

Are you a Military Health System (MHS) clinician?

If so, we invite you to take part in a research study that will take place virtually and involve your completing questionnaires and reviewing and providing feedback on SECuRe intervention materials (30-45 minutes). One month later, we will contact you to complete a single follow-up web-based questionnaire (10-15 minutes).

If eligible, we are offering a $50 electronic gift card after you have completed all study procedures.

Participation is voluntary and confidential.

If interested, please sign up through the link below.

study link

AUTO: Advancing Understanding of Transportation Options

Deciding when to “hang up the car keys” is one of the most emotional and difficult decisions older adults face, especially in the context of age-associated cognitive impairment, such as Alzheimer’s disease. Yet, it is also one that almost every individual, and their families, must wrestle with. This study evaluates the use of a web-based decision aid to help older adults and their loved ones make decisions about driving that are informed and in-line with personal values. The AUTO study aims to understand which types of older adults benefit most from the decision aid, along with when the decision aid should be used, to optimize real-world use. The results of this study may be particularly important for individuals with cognitive impairment, which complicates driving decisions and has been linked to both driving risk and the need for eventual driving cessation. This study is funded by the National Institute on Aging and has enrolled 300 older drivers in three states, with a two-year follow-up period. Dr. Betz is the PI.

Firearm Suicide Prevention

P2P - Pause To Protect

The voluntary, temporary storage of personally owned firearms by trusted safekeepers, such as firearm ranges/retailers, is a recommended strategy to prevent firearm-related harms, including suicide. Despite high rates of firearm suicide among military service members, no resources exist to connect service members with firearm ranges/retailers near military installations as a site to securely store personally owned firearm. In this program evaluation, we will expand on our prior work through the creation of a network of civilian firearm ranges/retailers in the community surrounding Buckley Space Force Base (our partner in prior work). We will subsequently expand this approach to additional military installations in the United States (US). To that end, the Pause to Protect project will be multi-faceted and include: developing an education and technical support materials and a firearm storage map, develop a partner network of civilian ranges/retailers near Buckley Space Force Base, and near up to three additional military installations in the United States, that will provide education, outreach, and firearm secure storage options to the local military community (Service Members, family, and civilian employees), and transition partner network maintenance for long-term sustainability.

SECuRe - Securing the Environment, Connecting to Reduce Risk

Suicide is the second leading cause of the death in the U.S. military, and over 16 Veterans die by suicide each day. The military suicide rate is higher than the general population, with 10-year record deaths in 2018 in active duty Marines, Soldiers, and Special Operations Forces.

SECuRe is a multi-faceted intervention that (1) trains clinicians in delivering firearm safety counseling via an online course developed in partnership with the American Medical Association; (2) provides patients with the web-based Lock to Live (L2L) firearm and medication storage decision-making tool; and (3) helps connect clinicians to community firearm storage locations via partnerships with local firearm retailers or ranges. The SECuRe study aims to adapt and pilot this important, evidence-based intervention for use within the Military Health System given the unique firearm-related protocols, norms, and expectations of this high-risk population. Long term, the adapted SECuRe intervention may help to reduce firearm suicide among service members via clinician-patient counseling and safer firearm storage. This study is an interdisciplinary collaboration with Lackland Air Force Base and the CU SOM Firearm Injury Prevention Initiative and is funded by the Air Force Research Laboratory. Dr. Betz is the PI.

PROtECT: Promoting Responsible Ownership and Elevating Community Togetherness

Violence involving firearms—including suicide—threatens overall force readiness and can undermine the successful execution of the Department of Defense National Defense Strategy. Existing interventions for preventing firearm-related violence offer promise but have not yet been tailored to or tested in Active Duty populations. The PROtECT project seeks to address this by facilitating the development and implementation of relevant and effective interventions to prevent suicide and other violence in military populations, with a particular focus on voluntary reductions in firearm access during at-risk periods as a way to decrease the risk of death.

Using Community Based Participatory Research, focus groups and interviews, this study will adapt a pre-existing lethal means counseling intervention, Project Safe Guard (PSG), for universal delivery among Active Duty service members. Community input and feedback will guide the adaptation efforts and explore how the intervention can address a range of violent or harmful firearm behaviors and utilize “real-world” delivery by military personnel. The adapted intervention will then be tested for effectiveness through a randomized controlled trial conducted with Airmen and Guardians at Buckley Space Force Base.

This study is a collaboration with Buckley Space Force Base, Rutgers University, and The Ohio State University. It is funded by the Medical Technology Enterprise Consortium (MTEC). Dr. Betz is the PI.

Decision Making Among Older Adults: "Firearm Retirement"

Cars and guns: both are often linked to perceptions of youth, independence, and strength, but can also pose injury risks for older adults with declining physical or cognitive capacity. Decisions about “driving retirement” can be difficult for older adults, their family members, and their providers. While resources exist that address driving retirement and assist individuals in making decisions about when and how to stop driving, few/no such resources exist for "firearm retirement".

Through focus groups and interviews with older adults, family members, firearms instructors, healthcare providers, and more, we hope to learn more about the decisions that take place when people begin to think about removing firearms from the home as they age. By better understanding the ways in which people think about and use firearms as they grow older, we hope to create resources and other support tools to help families plan for what to do about firearms in the home in the future. This study is funded by the National Institute on Aging. Dr. Betz is the PI. Recruitment has concluded for this study and analysis is underway.

Online Storage Maps to Facilitate Voluntary Firearm Storage: Mixed Methods Evaluation

Suicide accounts for the majority of firearm deaths in the United States. Temporary firearm storage away from home, thereby reducing firearm access for those at risk, is an effective suicide prevention strategy. This study builds off of newly developed public-facing, online state maps in Colorado and Washington that display firearm ranges, retailers, and law enforcement agencies willing to consider temporary, voluntary firearm storage.

This study will address key issues about the temporary storage maps including the views of storage providers and of storage users, and the best methods for program growth and dissemination. Over a two-year period, our study uses mixed methods (qualitative + quantitative) to examine the perspectives about statewide voluntary firearm storage maps, including participation, usage, and preferred dissemination. Through this work we will also develop an implementation toolkit for other states, providing the scientific foundation for rapid, broad dissemination of firearm storage maps and offers the potential to have a significant impact in firearm suicide prevention efforts. This study is a collaboration with University of Washington and is funded by the National Institute of Mental Health. Dr. Betz is the PI. Recruitment has concluded for this study and analysis is underway.

Firearm Access in dementia

Safety in Dementia

Behavioral changes that come with Alzheimer’s Disease and related dementias (ADRD) can increase the injury risk from in-home firearms. The "Safety in Dementia" (SiD) online decision aid helps informal caregivers to clarify their values and preferences, and commit to implementing their preferred options.

In this three year study, we will recruit informal (unpaid) caregivers of community-dwelling adults with ADRD who have firearm access (n=500) to test the efficacy of SiD on firearm safety decision quality and behaviors. This study is funded by the National Institute on Aging. Dr. Betz is the PI. Recruitment has concluded for this study and analysis is underway.

COMPLETED STUDIES

ED-AID: Assisting in Informing Decisions in Emergency Departments

ED-AID is a study funded by the National Institutes of Health (National Institute of Mental Health, R34MH11353) that aims to develop and test a web-based decision aid to help adults with suicide risk choose firearm storage options.

The "Lock to Live" decision aid is available for public use.

The SAFETY Study

The SAFETY Study is a collaboration between Northeastern University, the Colorado School of Public Health, and the Harvard T.H. Chan School of Public Health. The project aims to understand parent responses to safety counseling in the emergency department (ED). Ultimately, our goal is to help prevent youth suicide by strengthening counseling for parents of adolescents who visit the ED for a mental health emergency. Enrollment is ongoing at multiple hospitals in Colorado. Dr. Betz is a Co-Investigator.

Our group is developing educational and decision-support tools for family members concerned about firearm access in the context of dementia. If you are interested, please contact us at marian.betz@cuanschutz.edu.

Advance Firearm Directive - a worksheet for individuals to use with families and friends to make plans for future firearm transfers, should safety become a concern.
(Adapted from www.thehartford.com/sites/thehartford/files/at-the-crossroads-2012.pdf)