# RFA-CE-23-006, The Confluence of State Bullying Policies and Firearm Policies in Reducing Youth Gun Carrying and Fatality

> **NIH ALLCDC R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $349,646

## Abstract

Our proposal is responsive to the Funding Option A of the current CDC RFA-CE-23-006. An average of some
15,000 teenagers 12 to 19 years old died annually in the United States. The 3 leading causes of death among
teenagers were unintentional injuries, homicide, and suicide. Among these fatal youth injuries, most homicides
were gun related (83%), and about half of suicides involved a gun (45%). The resulting injuries, medical cost,
and years of potential life lost are all part of significant public health burden of firearm violence to our society.
Research has consistently shown that youth gun violence is influenced by individual-level risk factors including
demographics including gender, race and ethnicity, mental health conditions, interpersonal relationships,
accessibility of lethal means, and experience of youth bullying. While the focus on individual-level risk factors is
valuable, little is known about the impact of broader youth-focused health policies in affecting youth gun
violence, including state bullying policies and firearm policies, and how they may interact in affect youth
violence especially involving guns. Consistent with the Prevention Paradox, the social ecological model
emphasizes that an individual is embedded within a social context; therefore, it is critical to understand how
social-contextual factors especially health policies influence youth firearm violence. The objective of our
proposal is to improve the evidence base for youth firearm prevention by conducting a comprehensive
multilevel evaluation with the use of propensity score matching and synthetic control methods to assess the
confluence of state-level bullying policies and firearm policies on reducing youth gun carrying and firearm-
related fatality from 1999 to 2021. Youth gun carrying data will be based on state-based Youth Risk Behavior
Survey data, and youth firearm fatality data will be based on vital statistics. Our aims include: Aim 1: evaluate
the impact of the overall state bullying policies environment and assess the relative effectiveness of specific
bullying policy component on youth gun carrying and firearm death; Aim 2: evaluate the impact of the overall
state firearm policies environment and assess the relative effectiveness of youth-oriented firearm policies on
youth gun carrying and firearm death; Aim 3: assess whether state bullying policies environment interacts with
state firearm policies environment in affecting youth gun-carrying and firearm death; Aim 4: explore potential
cross-level interactions between state-level policies and high risk target populations (e.g., depression; binge
drinking; suicidal attempt; racial/ethnic minority; gender minority group) in affecting youth gun carrying. Our in-
depth investigation on these already collected data will provide evidence on the relative effectiveness of policy
strategies in reducing youth firearm violence, and how these youth-specific policies have differential impact on
certain high-risk youth p...

## Key facts

- **NIH application ID:** 10900436
- **Project number:** 5R01CE003622-02
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Ziming Xuan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $349,646
- **Award type:** 5
- **Project period:** 2023-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10900436

## Citation

> US National Institutes of Health, RePORTER application 10900436, RFA-CE-23-006, The Confluence of State Bullying Policies and Firearm Policies in Reducing Youth Gun Carrying and Fatality (5R01CE003622-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10900436. Licensed CC0.

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