A Longitudinal Mixed Methods Study of Psychosocial and Behavioral Health After Non-Fatal Firearm Injuries Among High-Risk Youth

ABSTRACT I am an Assistant Professor at the School of Nursing at the University of Texas Medical Branch (UTMB) in Galveston, Texas. The purpose of this resubmitted K23 Mentored Patient-Oriented Research Career Development proposal is to provide me with the knowledge, analytical skills, and experience necessary to

become a successful investigator. This K23 award will graciously provide the necessary support to accomplish my 5-year career goals: (1) to learn more complex, multivariate statistical methods, such as latent class analysis and regressions utilizing longitudinal data; (2) to strengthen my proficiency in mixed-methods analysis;

(3) to develop content knowledge about the sociocultural context of Black male youth who are most at risk for recurrent firearm injury; and (4) to obtain the necessary career development skills (i.e., writing, dissemination, and networking) to become a federally funded independent investigator who informs healthcare practice with

evidence. To achieve these goals, I have assembled a mentoring and advisory team of high-caliber researchers, led by Dr. Jeff Temple (primary mentor), Vice Dean of Research and Scholarship and Director of the Center for Violence Prevention at UTMB, and Dr. Shannon Juengst (co-mentor), Clinical Investigator at

TIRR Memorial Hermann and an expert in patient outcomes research, rehabilitation, latent class analysis, and instrumentation. The psychosocial and behavioral health outcomes of non-fatal firearm injuries are understudied. During the K23 period, I will accomplish the following aims: (1) identify the psychosocial and behavioral health sequela

of interpersonal firearm injury, including the associated risk for repeat victimization across 1-year, and (2) identify latent classes of participants who cluster around similar responses and thus share similar risk of repeat victimization and firearm propensity (access, ownership, carriage, attitudes). I hypothesize that (1a)

participants with higher levels of psychological distress, lower mental cognition, and more engagement in risky behaviors will have a heightened risk of recurrent firearm victimization. I further hypothesize that this risk is mitigated by the protective effects of adult social support, economic mobility (e.g., aspirations for work and

school), and safe environments. Second (2a), I hypothesize that at least 3 subgroups of participants exist, exhibiting low-, middle, and high-risk for repeat victimization and firearm propensity. Addressing these aims will have a tremendous impact on understanding the burden of non-fatal firearm injuries among individuals who are transitioning into young adulthood and developing life trajectories. Findings

will also inform healthcare strategies (e.g., screening for associated psychosocial and behavioral risk factors) and form the basis for larger research and implementation studies to build and evaluate effective hospital- based violence intervention programs.