# RFA-CE-22-004, Optimizing Firearm Suicide Prevention in Healthcare

> **NIH ALLCDC R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2024 · $649,993

## Abstract

Suicide accounts for 60% of U.S. firearm deaths, with even higher rates in Alaska, Colorado, and
Washington. Firearms are the most common method of suicide in the U.S., and firearm access is linked
to increased suicide risk. Most people who die by suicide see a health care provider in the year prior to
death, thus clinical providers have important opportunities to intervene with patients at risk for firearm
suicide. Though firearm access is relevant to patients’ health and safety, routine questions about firearm
access are uncommon and there is a dearth of evidence available to guide implementation of promising
clinical practices for firearm suicide prevention, including firearm access assessment and provider-
initiated dialogue about limiting access. Our team has begun to address this evidence gap in a series of
innovative studies focused on firearm access assessment. Specifically, we established that adult
primary care and mental health patients will answer standardized questions about firearms, and
highlighted how limiting screening questions to patients receiving mental health care misses many at risk
patients. We also elicited patient and clinician concerns about firearm access assessment and described
how concerns about privacy, autonomy, and ownership rights may be addressed by their suggestions.
 This study will build on these findings and address the critical need for patient-centered strategies to
identify and engage patients at high-risk of firearm suicide through Objective One of CDC’s RFA-CE-
22-004: Research to inform the development of innovative and promising firearm injury/mortality
prevention strategies. Human Centered Design and Community Based Participatory Research
approaches will support Option B for new data collection activities and the implementation of
prevention activities. We will employ the Discover, Design and Build, and Test framework to inform
implementation strategies in three healthcare systems serving ~1.3 million people in communities with
high rates of firearm ownership and suicide. We will:
 1 (DISCOVER): Elicit patient, clinician, and leader perspectives on clinical practices for identifying
 and engaging individuals at risk of firearm suicide, and to identify opportunities for practice
 improvement via retrospective chart review and descriptive analyses of medical records.
 2 (DESIGN/BUILD): Partner with clinical and quality improvement staff and leadership to design
 intervention strategies to support evidence-based clinical practices for firearm suicide prevention.
 3 (TEST): Pilot test clinical intervention strategies in three healthcare systems to demonstrate
 feasibility, acceptability, and usability; and to measure reach.
Our work will lay a strong foundation for future dissemination of patient-centered firearm suicide
prevention practices and evaluations of effectiveness.

## Key facts

- **NIH application ID:** 10827485
- **Project number:** 5R01CE003460-03
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Julie Elissa Angerhofer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $649,993
- **Award type:** 5
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10827485

## Citation

> US National Institutes of Health, RePORTER application 10827485, RFA-CE-22-004, Optimizing Firearm Suicide Prevention in Healthcare (5R01CE003460-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10827485. Licensed CC0.

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