GVRC FY'23 Progress Report by NJ Gun Violence Research Center at Rutgers University

NJGVRC

@NJGVRC

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INTRODUCTION This progress report aims to summarize GVRC research, publications, active externally funded grants, research projects funded by the GVRC, community outreach projects and partnerships, and communications conducted by the New Jersey Gun Violence Research Center (GVRC) during FY23. The GVRC's mission is to conduct and fund cutting-edge scientific research on gun violence prevention and serve as a voice to make scientific information available to all communities impacted by gun violence. Our plan is to focus on all aspects of gun violence, specifically firearm suicide and interpersonal gun violence. The GVRC is committed to combating racial disparities that leave marginalized communities shouldering a disproportionate burden of interpersonal gun violence, and we plan to partner with groups like our service and community members heavily impacted by gun violence.

The NJGVRC works in collaboration with and is supported by the New Jersey Office of the Secretary of Higher Education (OSHE).

A year's overview

MESSAGE FROM OUR LEADERSHIP

The New Jersey Gun Violence Research Center (GVRC) aims to address all forms of gun violence and to do so in a manner that has a tangible impact on the communities we serve. Our primary mission has two aims: (1) To conduct and fund cutting edge research on all forms of gun violence and (2) to disseminate the science of gun violence prevention broadly so as to empower communities to make data-driven policy and program demands that meet their local needs. Given the historical underfunding of gun violence research, far too few scientists have devoted their careers to this field. The GVRC believes that a vital component to addressing that issue is the training of young scholars in gun violence prevention science, thereby setting the field on the path to feature increasing numbers of young scientists leveraging their skills to develop, test, and disseminate possibilities for preventing gun violence. To this end, the GVRC currently employs five doctoral students from a range of disciplines. We also feature three postdoctoral fellows. Each of these young scholars has been a key member of our team, contributing to our research and dissemination efforts and bringing invaluable energy to the center. The GVRC also emphasizes the importance of speaking to and working with individuals from all political perspectives

Michael Anestis, PhD

and from a diverse range of communities. There are plenty of firearm-related issues that people disagree on vociferously, but there are also many on which we agree. We feel it is essential to ensure that we are not conducting our work in an echo chamber, missing or even alienating the communities we most need to reach. To that end, we have developed partnerships and collaborations with an enormous range of individuals with the capability to influence various aspects of gun violence prevention, and we will strive to further increase that range. This past year, the GVRC expanded not only in size, but in our productivity. As noted throughout our Progress Report, we published a substantial number of peer reviewed manuscripts, secured externally funded grants, further developed the New Jersey Safe Firearm Storage Map, engaged regularly with the popular media to ensure datadriven perspectives are voiced where people can hear them, and held several high-profile events. In May, we not only hosted our second annual virtual GVRC Research Day, which showcases our own work as well as that of all the researchers we funded, but we also hosted the first annual in-person GVRC Summit, a meeting of scientists, elected officials, and other stakeholders during which we discussed specific tangible steps we can take to address various aspects of gun violence in New Jersey. We are excited to build upon this momentum in FY24 and to further advance our efforts to reduce the burden of gun violence both within and beyond New Jersey.

GVRC Executive Director, Michael Anestis, Ph.D.

GVRC Assistant Director, R. Thurman Barnes, JD, MDiv

R.Thurman Barnes, JD, MDiv

WELCOME Daniel Semenza, PhD Director of Interpersonal Violence Research

Dr. Semenza is the Director of Interpersonal Violence Research at the New Jersey Gun Violence Research Center. He is an Assistant Professor in the Department of Sociology, Anthropology, and Criminal Justice at Rutgers – Camden with a secondary appointment in the Department of Urban-Global Health in the School of Public Health at Rutgers. He has been with the GVRC since starting the position in July 2022. In this role, Dr. Semenza is responsible for leading and collaborating on research projects, pursuing grant opportunities, working with community partners, and mentoring doctoral and postdoctoral affiliates with the GVRC on research related to interpersonal gun violence, such as community violence, mass shootings, and domestic violence. Dr. Semenza conducts ongoing research on primary and secondary firearm markets as well as the health-related consequences of gun violence exposure. He is currently a primary or collaborating investigator on numerous grants from the Bureau of Justice Assistance, the South Jersey Institute for Population Health, and the National Science Foundation’s Law & Science Program. He is working alongside community partners, including Acenda Integrated Health, Life Worth Living, and Cure Violence Global, to implement and evaluate a community violence intervention (CVI) program in three rural counties in South Jersey. He is also working alongside local community partner Cure4Camden to assess the healthcare needs and barriers for Black men who have been injured by a firearm in South Jersey.

GVRC

Director of Interpersonal Research, Daniel Semenza, PhD

TABLE OF 6-18

6-18

19-43

44-47

48-59

Research GVRC research papers that were published in national accredited publications.

Funded Research Projects Active and ongoing GVRC research projects.

Externally Funded Projects Active and multi-year GVRC research projects.

GVRC In The News An outline of all the GVRC interviews, podcasts, social media, conferences, events, and more.

60-74 Events, Social Media, and Analytics A list of events, conferences, social media and website activity

The NJGVRC works in collaboration with and is supported by the New Jersey Office of the Secretary of Higher Education (OSHE).

RESEARCH

July 2022 Firearm type and number: Examining differences among firearm owning suicide decedents Michael D. Anestis, PhD, Allison E. Bond, MA. https://www.tandfonline.com/doi/abs/10.1080/13811118.2021.1885536

Objective: To determine the type of firearm used, owner of the firearm, storage habits, and location of injury among suicide decedents who used a firearm in their suicide death, and to examine differences among sexes, races, and age groups.

September 2022 Injury characteristics and circumstances of firearm trauma: Assessing suicide survivors and decedents Aleksandr T. Karnick MA, MPH, Allison E. Bond MA, Elinore J. Kaufman MD, MSHP, Michael D. Anestis PhD, Daniel W. Capron PhD https://onlinelibrary.wiley.com/doi/10.1111/sltb.12916

Objective: Despite representing fewer than 5% of suicide attempts, firearms account for over half of deaths. Yet there is little clinical information regarding firearm attempts, particularly survivors. We assessed clinical factors differentiating firearm suicide survivors from decedents, firearm attempters from other methods, and firearm attempters from similarly injured trauma patients.

September 2022 2022 report on firearms in New Jersey Michael D. Anestis, PhD, Daniel Semenza, PhD https://gunviolenceresearchcenter.rutgers.edu/2022-report-on-firearms-in-new-jersey/

Objective: To provide an accurate description of firearm access in New Jersey. Specifically, we wanted to know how many New Jerseyans live in homes where firearms are typically kept, how many firearms they own, why they own those firearms, how the firearms are stored, and how often they carry their firearms outside their homes. This survey was statewide in collaboration with the GVRC and Eagleton Center for Public Interest Polling at Rutgers.

October 2022 Evaluation of safe firearm storage messaging in a sample of firearm-owning US military service members Michael D. Anestis, PhD, Craig J. Bryan, PsyD, Daniel W. Capron, PhD, AnnaBelle O. Bryan, MS https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2797192

Objective: To examine whether US military service members endorse greater openness to safe firearm storage depending on the content of the visual message they are randomly assigned to view.

November 2022 Demographic differences in the type of firearm and location of bodily injury in firearm suicide decedents Allison E Bond, MA, Aleksandr T Karnick, PhD, Shelby L Bandel , MA, Daniel W Capron, PhD, Michael D Anestis, PhD https://pubmed.ncbi.nlm.nih.gov/36382498/

Objective: This study describes the type of firearm used and the location of bodily injury among demographic subgroups of suicide decedents. A series of five logistic regression analyses examining the age of the decedent, type of firearm, location of wound site, loaded vs. unloaded firearms, and locked vs. unlocked storage, using predictors including gender, race, who owns the firearm and age were performed.

December 2022 Firearm suicide prevention in the US military: Recommendations from a national summit Marian E Betz, PhD, Ian H Stanley, PhD, Michael D Anestis, PhD, Craig J Bryan, PsyD, ABPP, Jessica Buck-Atkinson, PhD, Neil Carey, PhD, Marjan GhahramanlouHolloway, PhD, Brooke Heintz Morrissey, PhD, Kathryn Holloway, PhD, Claire Houtsma, PhD, Rachel Kennedy, PhD, Christopher M Paine, PhD, Rajeev Ramchand, PhD, Joseph Simonetti, PhD, Adam Walsh, PhD, Erin Wright-Kell, PhD https://academic.oup.com/milmed/advance-article-abstract/doi/10.1093/milmed/usac371/6874501?redirectedFrom=fulltext&login=true

Objective: The US DoD has identified firearm suicide prevention as a key operational priority. One vital approach to addressing firearm suicides is through promoting lethal means safety, which involves the voluntary use of secure storage for personally owned firearms and/or temporarily moving firearms out of the home during risk periods.

December 2022 How combinations of state firearm laws link to low firearm suicide and homicide rates: A configurational analysis John A. Rich, PhD, Edward J. Miech, PhD, Daniel C. Semenza, PhD, Theodore J. Corbin, PhD. https://doi.org/10.1016/j.ypmed.2022.107262

Objective: We evaluated ten state firearm laws using configurational comparative methods (CCMs) designed to uncover how multiple factors are linked to a given outcome. We applied coincidence analysis, a novel CCM, to ten firearm laws in US states in 2016, to assess how different combinations of firearm laws distinguished states with low firearm homicide or suicide rates from those states with higher rates. The suicide analysis included all 50 US states; the homicide analysis involved the 47 US states with homicide rates reported by the Centers for Disease Control and Prevention (CDC) in 2016.

December 2022 Lethal means safety counseling among firearm-owning US National Guard personnel: Hyperarousal symptoms as a moderator of treatment outcomes Michael D Anestis , Craig J Bryan , Daniel W Capron, AnnaBelle O Bryan https://pubmed.ncbi.nlm.nih.gov/33351652/

Objective: To examine whether lethal means counseling and provision of cable locks prompt safe firearm storage relative to control among firearm-owning members of the Mississippi National Guard.

January 2023 Differences in firearm storage practices among United States military service members who have and have not disclosed suicidal thoughts or attended behavioral health sessions Michael D Anestis, PhD, Allison E Bond, PhD, Daniel W Capron, PhD, AnnaBelle O Bryan, PhD, Craig J Bryan, PsyD. https://doi.org/10.1111/sltb.12940

Objective: Two-thirds of military suicides are by firearm, and unsafe storage increases the risk of suicide. Understanding who is at risk for suicide, their interactions with behavioral healthcare, and their firearm storage habits have implications for suicide prevention.

January 2023 Conformity to masculine role norms, firearm storage behaviors, and openness to means safety among two samples of firearm owners Samantha E. Daruwala, Shelby L. Bandel, Michael D. Anestis https://www.sciencedirect.com/science/article/abs/pii/S0022395623000110

Objective: Understanding the sociocultural characteristics that are associated with US firearm owners' current storage practices and openness to means safety can inform suicide prevention initiatives.

January 2023 Urban housing affordability, economic disadvantage and racial disparities in gun violence: A neighborhood analysis in four US cities Richard Stansfield, Daniel Semenza https://academic.oup.com/bjc/article-abstract/63/1/59/6511710

Objective: This study seeks to examine how urban affordability, and related issues of eviction and joblessness, are associated with gun violence in the United States. After discussing the theoretical importance of studying housing affordability, we provide a preliminary examination of how urban affordability moderates the relationship between other markers of economic disadvantage and gun violence.

March 2023 Firearm owners' preferences for locking devices: Results of a national survey Marian E. Betz, MD, MPH, Ian H. Stanley, PhD, Jessica Buck-Atkinson, MPH, Rachel Johnson, MS, Craig J. Bryan, PsyD, Justin C. Baker, PhD, AnnaBelle O. Bryan, MS, Kyleanne Hunter, PhD, Michael D. Anestis, PhD https://www.acpjournals.org/doi/full/10.7326/M22-3113

Objective: To describe preferences about personal firearm locking devices among firearm-owning adults living in the United States.

March 2023 Interactions at the point of firearm purchase and subsequent use of locking devices Shelby L. Bandel, Allison E. Bond, Michael D. Anestis https://link.springer.com/article/10.1186/s40621-023-00421-0

Objective: Examined the extent to which firearms retailers notifying purchasers at the point of sale about the included cable locks was associated with subsequent locking device use in two large samples and three subsamples. Exploratory analyses then examined demographic factors associated with frequency of seller notification of locks.

March 2023 Assessment of firearm storage practices in the US, 2022 Michael D. Anestis, PhD, Jayna Moceri-Brooks, PhD, Rachel L. Johnson, PhD, Craig J. Bryan, PsyD, ABPP, Ian H. Stanley, PhD, Jessica T. Buck-Atkinson,PhD, Justin C. Baker, PhD, ABPP, Marian E. Betz, MD, MPH https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2801915

Objective: In this survey study with a weighted sample of 2152 adults, the results indicated that gun safes were the most frequently used device by the respondents. Believing locks are unnecessary, and concerns about access speed were the most frequent obstacles; concern about child access was the most common reason for considering locking unlocked firearms.

March 2023 Firearm access and suicide rates: An unambiguously robust association Michael D. Anestis, PhD https://www.tandfonline.com/doi/abs/10.1080/13811118.2023.2192753

Objective: In this commentary, I aim to contextualize the findings within the broader literature and to provide clarity for readers aiming to navigate the findings of the two studies. Ultimately, I conclude that the results of Lane more accurately represent the nature of the relationship and align with the extant literature on the topic.

March 2023 Addressing mental health needs of secondary homicide survivors through a social determinants of health framework Lauren A. Magee, Daniel Semenza, Sami Gharbi, Sarah E. Wiehe https://journals.sagepub.com/doi/abs/10.1177/10887679231163099

Objective: Drawing on a social determinants of health framework, death records, and Medicaid data were linked at the individual and family level to examine mental health outcomes among secondary homicide survivors in the 12 months following a homicide of a loved one.

April 2023 Determining who healthcare providers screen for firearm access in the United States Allison E. Bond, Jayna Moceri-Brooks, Taylor R. Rodriguez, Daniel Semenza, Michael D. Anestis https://www.sciencedirect.com/science/article/abs/pii/S0091743523000567

Objective: The representative sample included 3510 residents from five US states who reported whether they have been asked about their access to firearms by a healthcare provider. The findings demonstrate that most participants have never been asked by a provider about firearm access.

April 2023 Defensive behaviors during COVID-19 and the 2020–2021 firearm purchasing surge: A latent class analysis Michael D. Anestis, Allison E. Bond, Shelby L. Bandel, Marian E. Betz, Craig J. Bryan https://guilfordjournals.com/doi/abs/10.1521/jscp.2023.42.2.160

Objective: This study examined the extent to which political beliefs and public health behaviors cluster together and define distinct groups of individuals and whether those groups differ on firearm purchasing behaviors.

April 2023 Licensed firearm dealers, legal compliance, and local homicide: A case study Richard Stansfield, Daniel Semenza, Jie Xu, Elizabeth Griffiths https://onlinelibrary.wiley.com/doi/full/10.1111/1745-9133.12621

Objective: This study uses a combination of tract-level and street network-level analyses to examine: (1) the overall association between federally licensed firearm dealers (FFLs) and homicides, (2) the relationship between dealers with serious violations (such as selling to prohibited buyers or failing to record sales) and homicide, and (3) whether the dealer– homicide association is moderated by community disadvantage.

May 2023 Examining characteristics and experiences of Black firearm owners Allison E. Bond, Jasmin R. Brooks, Taylor R. Rodriguez, Shelby L. Bandel, Michael D. Anestis https://onlinelibrary.wiley.com/doi/abs/10.1002/jclp.23532

Objective: The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk.

June 2023 Identity, experience, and threat: Assessing key correlates of firearm ownership and related behaviors in a representative sample of five US States Daniel C. Semenza, Lauren A. Magee, Michael D. Anestis, and Shani A. L. Buggs https://www.sciencedirect.com/science/article/pii/S2211335523001602

Objective: The purpose of this study was to examine psychosocial, experiential, and demographic correlates of firearm ownership, carrying, and storage methods. We used a representative survey of 3,510 people living in five US states (Colorado, Minnesota, Mississippi, New Jersey, and Texas) conducted in 2022.

June 2023 Revisiting the relationship between concealed carry licenses and firearm homicide in the United States: A reciprocal county-level analysis Richard Stansfield, PhD, Daniel Semenza, PhD, Ian Silver, PhD doi: 10.1007/s11524-023-00759-2

Objective: This study investigates the reciprocal county-level relationship between the number of concealed carry weapon (CCW) licenses issued and homicides between 2010 and 2019 in a sample of eleven states.

June 2023 Understanding risk and implementing data-driven solutions for firearm suicide Michael D. Anestis, Allison E. Bond, Shelby L. Bandel https://journals.sagepub.com/doi/10.1177/00027162231173321

Objective: In the US, research has shown, time and again, that access to firearms increases the risk for suicide death, particularly when firearms are not stored safely. Means safety, therefore, could be a powerful tool in reducing suicide deaths in America, where firearms are highly lethal, widely available, and frequently used within a specific geographic area.

RESEARCH PROJECTS

Principal Investigator: Tyrell Connor, PhD, Associate Professor, State University of New York

Co-Principal Investigator: Ryan LeCount, PhD, Associate Professor, Hamline University

Black Americans and Firearms: A National Mixed-Methods Exploration of the Attitudes of Legal Black Gun Owners

Recent conversations and debates about gun violence prevention policy are at the forefront of the national political discourse. An overwhelming majority of the narratives that support the Second Amendment have come from the perspectives of White males in this country. The attitudes of Black legal firearm owners have been neglected within the dominant discourse surrounding firearms. Additionally, firearm scholarship has also contributed to the exclusion of Black voices on matters of gun policy and debates. This mixed-methodological study aims to close this gap by centering the experiences and opinions of Black men and women legal gun owners. Building on Monica Bell’s concept of Legal Estrangement, our work seeks to sort out how Black New Jerseyans make sense of their relationship to law enforcement in a time when racial disparities in policing have been made powerfully salient. We are especially interested in understanding how patterns of legal firearm ownership might be uniquely related to alienation from racist policing and attitudes about policing efficacy. We hope to reorient and deepen the existing research, public conversation, and policy debate by including the perspectives and experiences of a diverse group of Black peoplemany of whom may well care deeply about crime and gun violence, racism, police brutality, and racial disparities in the criminal justice system- and who also, for a diverse range of reasons, are advocates of gun rights as well. We have partnered with the National African American Gun Association (NAAGA) to conduct this study. This partnership will assist with data collection by sharing solicitations for participation and engagement with their members around the country.

Principal Investigator: Kerri M. Raissian, PhD, Associate Professor of Public Policy, University of Connecticut

Co-Principal Investigator: Jennifer Dineen, PhD, Associate Professor in Residence of Public Policy, University of Connecticut

Gun Talk: Identifying the Facilitators and Barriers to Physician and Care Provide -Initiated Conversations Regarding Securing Firearms

This study will fill a significant gap in understanding why child and child related healthcare providers initiate conversations about secure storage and/or Extreme Risk Protective Orders (ERPOs). Given that firearm injury risk can vary across the life course, we seek to discover ways to involve healthcare providers (hereafter “provider(s)”) across a number of primary care physician (PCP) settings, which will include obstetricians and gynecologists (Ob/Gyn, who provide treatment in the prenatal phase to both fetus and mother as well as maternal postnatal care), pediatricians (who provide treatment throughout childhood), and general practitioners (who provide treatment to both children’s caregivers and directly to children as they mature). Despite physicians’ unique role and the impact of firearms on health outcomes –such as trauma, injury, and death - physician-initiated firearm safety counseling rates are low. There is a paucity of rigorous study around the facilitators and barriers of these lifesaving conversations. Given the potential impact of secure storage conversations, they should be established as routine care. However, before that can occur, we must understand (1) why they are or are not currently integrated into the office visit schedule, and (2) what changes could be made to make secure storage conversations part of a children’s healthcare provider’s standard anticipatory guidance protocols.

Principal Investigator: Evan Kleiman, PhD, Assistant Professor, Department of Psychology- NB/SAS

Co-Principal Investigator: Shireen Rizvi, PhD, ABPP, Professor, Department of Clinical Psychology – NB/GSAPP

Understanding Suicide and Gun Violence in New Jersey through partnerships between Rutgers and the Office of the Chief State Medical Examiner

New Jersey is a unique state for many reasons, not the least of which being its relatively low suicide rate compared to the rest of the country. Over the past decade, not only has New Jersey had one of the lowest suicide rate each year, the rate of suicides due to firearms has been particularly low and relatively stable compared to other states that have had a steady increase over this time. Interestingly, to our knowledge, there has been no systematic attempt to better understand why the suicide rate is low in NJ, especially the suicide rate due to firearms. Better understanding suicide deaths, especially those via firearm, in NJ may help identify ways to reduce the suicide rate more broadly. Importantly, while it is certainly positive that New Jersey’s suicide rate is among the lowest in the nation, this is simply a relative statistic. Indeed, the annual rate of 2.0 deaths by suicide due to firearm per 100,000 people means someone dies by suicide via firearm every other day in NJ. Accordingly, the purpose of this study is to better characterize suicides in New Jersey by laying the groundwork for a long-term collaboration with the New Jersey Office of the Chief State Medical Examiner (OCSME). This collaboration is notable as it will build on our newly-formed relationship with the OCSME, which represents a unique and previously undeveloped partnership. This study establishes a formal relationship between our group, the Rutgers Suicide Prevention and Research Center (Rutgers SPARC), and the NJ OCSME. This study also involves SPARC and NJ OCSME working together on a scientific evaluation of suicide deaths in New Jersey. Additionally, as part of this study, individuals from Rutgers SPARC and the NJ OCSME will be trained in the conduct of psychological autopsies, a well-validated research and clinical method that allows unparalleled insight into the psychosocial factors surrounding death by suicide.

Principal Investigator: Kerri M. Raissian, PhD, Associate Professor of Public Policy, University of Connecticut

Co-Principal Investigator: Jennifer Dineen, PhD, Associate Professor in Residence of Public Policy, University of Connecticut

Does the Messenger Matter? A Survey Experiment to Understand Citizen Support for Secure Storage Policy in America

In the debate over how to best address the public health crisis of gun violence in America, we often hear policy makers calling for “common sense gun laws” in their effort to promote restrictive gun policies such as universal background checks, Emergency Risk Protection Orders, and Child Access Protection legislation. However, the idea of “common sense” in policy rational may be problematic because common sense may not be all that common. If common sense is what we perceive as good judgement or sound decision making it can vary from person to person, because perception of what is good or sound is informed by our own knowledge and experiences. In the case of gun policy, what is common sense to a gun owner may not be common sense to a non-owner and vice versa. This study will improve our understanding of “if” and “how” presenting gun policy from a known trusted messenger; a permissive gun advocacy group such as the NRA; a government agency like the CDC; or as “common sense” impacts a person’s support for a policy. We will also seek to understand whether or not the effect varies by issue salience (e.g., in this case, how important gun access or gun control is to the focal person). Gun policy is often contentious and politicized. Therefore, better understanding how a particular messenger affects message receptivity can help improve the quality and the effectiveness of conversations related to this gun policy. Such information will be useful as America considers and adopts future gun legislation – especially given the incremental nature of the policy process.

Principal Investigator: Julianne E. Cary, MA Co-Principal Investigator: Michael LeDuc, MA, Doctoral student Faculty Sponsor: Sean M. Mitchell, PhD,Texas Tech University

Examining the link between gun storage practices and attitudes, masculine gender norms, threat sensitivity, and suicide ideation among U.S. uniformed law enforcement officers

This novel study will identify current gun storage practices and attitudes among currently employed U.S. uniformed law enforcement officers (ULEO), test the relations between suicide ideation and gun storage practices and attitudes, and test moderators of these relations. It will utilize a cross-sectional, online-based survey design. The rationale is that identifying current gun attitudes, gun storage practices, and suicide ideation among ULEO is the first step in promoting safe storage practices and suicide prevention in this population. This project aligns with the vision of the New Jersey GVRC by identifying the nature of gun attitudes, storage practices, and suicide ideation risk factors among a population at risk for self-directed gun violence. This study’s expected outcomes are to identify 1) gun storage practices, gun attitudes, and suicide ideation experiences, 2) the relation between these variables, and 3) key moderators in a national sample of U.S. ULEO (N =300). Findings will provide strong preliminary data for a larger study, examining the most effective ways to promote safe storage practices among ULEO and inform ULEO gun safety messaging, including ULEO in NJ. This work will also inform life-saving suicide prevention for U.S. and NJ ULEO.

Principal Investigator: Christina Rosie Bauder, PhD, MPH, LPC, Postdoctoral scholar in the Department of Psychiatry and Behavioral Health at The Ohio State University College of Medicine Co-Investigator: Craig J Bryan, PsyD, ABPP, clinical psychologist and the Stress, Trauma, and Resilience (STAR) Professor of Psychiatry and Behavioral Health at The Ohio State University College of Medicine

Exploring experiences, attitudes, and practices of firearms among women gun owners in New Jersey and Ohio

Firearms account for more than half of U.S. suicide deaths and nearly two-thirds of all firearmrelated deaths. Though men are more likely to use a firearm more than other lethal means, guns account for approximately a third of suicide deaths for women and are the leading method of suicide among female veterans. There is increased recognition that firearms are associated with increased suicide risk, as they are fatal in nine out of ten suicide attempts. However, firearms means safety counseling and safe storage practices are strongly associated with reduced suicide risk. Additionally, there is an association between suicide deaths using a firearm in states with less restrictive gun laws and policies; approximately four times as many women died by suicide using a firearm in Ohio than in New Jersey between 2010 and 20201. The overall goal of this proposal is to explore the experiences, attitudes, and practices of female gun owners in New Jersey and Ohio– two states with more restrictive and less restrictive gun laws, respectively – in order to inform firearm-specific suicide prevention practices and to reduce the number of lives lost to gun violence. The primary objective of this project is to determine if there are specific features of the experiences, attitudes, and practices of women gun owners in both states that influence safe storage practices. The secondary objective is to explore possible associations among the experiences, attitudes, and practices of women gun owners based on state residency and corresponding firearm laws and policies. By focusing on these objectives, this project will likely confirm previous research on the diverse perspectives of stakeholders and expand upon potential key influences on gun use and safe storage practices from state firearm laws in New Jersey and Ohio, respectively.

Principal Investigator: Joanne Kim, Clinical Psychology, MS, Doctoral student

Faculty Sponsor: Edward Selby, PhD, Director of the Emotion and Psychopathology Lab at Rutgers University

Disclosure of gun access and suicidal thoughts and behaviors: An investigation of facilitators and barriers

Suicide risk assessment requires obtaining accurate information – and thus, accurate disclosure – about an individual’s history of suicidal thoughts and behaviors (STB) to inform risk categorization and appropriate intervention selection. However, research shows that accurate STB disclosure is challenged by barriers such as fear of involuntary hospitalization or other adverse consequences, perceived public stigma of suicide (i.e., beliefs that society or others hold negative judgments or stereotypes regarding suicide) and self-stigma (i.e., negative judgments or stereotypes one holds about their own experiences with suicide). Studies have found that participants also reported facilitators that increased honesty in responses to probing about suicidal thoughts. Some preliminary findings indicate that desire for support, trust in health care providers, and opportunity to access mental health treatment facilitate accurate STB disclosure. Therefore, even if barriers are not eliminated, enhancing facilitators may increase accurate disclosure and bolster suicide prevention efforts. There remain several gaps in the STB disclosure literature that this study hopes to address. Few studies have focused specifically on STB disclosure to a medical provider or mental health professional, who likely present increased opportunity to access appropriate treatment resources. Further, it is not well understood if accurate STB disclosure is more or less likely among those who may be at higher current risk for suicide, which may have implications for suicide risk assessment tools and procedures. Factors that influence firearm access disclosure have been even less studied. Some studies provide conflicting evidence showing that White respondents, older individuals, and those with more progun attitudes are more comfortable disclosing gun ownership, while others found no racial group difference and that older individuals and those with pro-gun attitudes are less likely to respond. This highlights the need to understand the barriers and facilitators to disclosing firearm access, and to explore whether firearm access disclosure may be more feasible than STB disclosure to facilitate lethal means counseling even without accurate STB disclosure.

Principal Investigator: Devon Ziminski, Senior Research Project Administrator, PhD Student, Rutgers University School of Social Work Faculty Sponsor: Dr. Caroline Harmon-Darrow, PhD, Assistant Professor, Rutgers University School of Social Work Kiersten Henson, Research Project Coordinator Senator Walter Rand Institute for Public Affairs at Rutgers Camden

Perceptions of Violence and Safety in Three Southern New Jersey Counties

The specific aims of this proposed research are to understand perceptions of community violence and firearm violence, explore notions of safety, and examine the similarities and differences among various individuals and organizations operating in violence prevention spaces among a diverse population of communities that live in urban and rural communities in Southern New Jersey. This explorative approach will rely on primary data collection to understand what violence prevention/safety promoting programs, practices, and policies are in place by local and state institutions and community efforts; what the spectrum of these efforts can inform us about what builds individual and community perceptions of safety; and what programmatic elements may be overlooked or essential to violence prevention efforts in local communities. Community safety goals, and the mechanisms with which to achieve them, are at times simultaneously in unison and at odds - this research aims to highlight the spectrum of how the causes, contributing factors, and solutions to violence broadly, and firearm violence specifically, vary among people and organizations, and how the mechanisms of the processes for asset-focused community safety can contribute to future research, policy, and practice. The intended population for this research study will center around three Southern New Jersey cities that experience both higher rates of violence than other municipalities in their counties, and traditionally have been underrepresented in funding and violence prevention initiatives. This target population represents localities in New Jersey that capture populations from “nonmajor cities” (populations under 75,000) but that represent diverse residents and unique components of communities that straddle urban/rural dynamics, an area that currently remains under researched in the nuances of how violence affects these communities, and how firearm violence proliferates in these communities. This proposed project also provides focus on three counties Southern New Jersey (in the coastal area, the greater Philadelphia region, and the Southernmost part of the state), where a dearth of resources and research exists in comparison to the Central and North regions of the state.

Principal Investigator: Jared R. Dmello, PhD, Assistant Professor of Criminal Justice & Criminology, Sam Houston State University, Research Associate, Rutgers University School of Criminal Justice

Behind the Trigger: Investigating the Typologies of Gang-Involved Individuals charged with Firearm-Related Offenses in New Jersey

This project builds on research efforts led by the PI to investigate longitudinal gang violence in New Jersey. His work funded by the National Institute of Justice seeks to investigate the networked diffusion of firearm violence within the gang conflict landscape, with a primary focus on the connections (i.e., the edges) of violence between actors. However, greater research is needed to investigate the typologies of the individuals who are involved in the violence (i.e., the actors). Thus, this study seeks to fill this void to investigate the typologies of offenders charged with gang-related firearms offenses. Within the preliminary sample of 40 individuals, we already observe representation from a variety of gangs. While the majority of the sample are captured by the Blood and Crip gang families, other entities, are also present. For example, the Latin Kings have a strong representation in the sample, which is not terribly unexpected given their long-standing presence in the northeast. The team was a bit surprised to see some neo-Nazi groups, such as the Atlantic City Skinheads, captured within the sample, evidence of the racially diverse set of illicit gang-involved actors engaging in firearm violence within the State.

We also ran an analysis looking at the motivations and commitments driving gang involvement. In terms of motivations, the primary driver identified within the sample was for criminal incentive (62.5%), which was a bit surprising, given that gang violence in the northeast is usually associated with the economic benefits of drug trafficking. The majority of the sample (55%) also perceived grievances for a collective group and/or injustice, while 62.5% exhibited lack of understanding, empathy, and/or tolerance to individuals outside their group. This preliminary finding indicates that while gang members identify as an attack on the collective, most also don’t connect with the experiences of other groups, suggesting a lack of familiarity with diverse worldviews.

Principal Investigator: Jeffrey Tabares, PhD, Research Scientist, The Ohio State University

Cortisol Reactivity Stress & Firearms (CROSSFIRE)

The Trier Social Stress Test (TSST) can safely simulate the onset of psychosocial stress via activation of the Hypothalamic-Pituitary-Adrenal (HPA) Axis. The TSST has identified differences in stress response by demographical features such as age or biological sex and may have utility in identifying differences between firearm owners (FOs) and those who do not own firearms (DNOs). Given what we know about rates of firearm suicide, psychosocial stressors commonly preceding suicide, and rapid fluctuations in suicide risk, a critical need emerges to identify quantitative differences in stress response via cortisol between FOs and DNOs. In the absence of this information, our ability to leverage how FOs experience stress activation during times of psychosocial crisis into agile interventions will remain limited; meanwhile, increasing rates of firearm-related death proceed without limit. The overall objective for this study is to fill a knowledge gap: identify differences in psychosocial stress response between FOs and DNOs. The rationale for this study is that FOs and DNOs will produce detectable, differential stress response patterns with measurable difference during simulated psychosocial stress via TSST. This study proposes to identify differences in stress response between FOs and DNOs from salivary cortisol collected during the TSST. This proposed study will include seven measurements spanning pre- to post-TSST and salivary cortisol comparisons between FOs and DNOs will take place for each of these measures. By the conclusion of this proposed study, the expected outcome will identify differences in stress response between FOs and DNOs.

Principal Investigator: Samantha E. Daruwala, PhD, Suicide and Trauma Reduction Initiative (STRIVE) Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical

Examining Firearm Owners’ Preferences for Peer-Delivered Lethal Means Counseling

Lethal means counseling (LMC), which involves a discussion of limiting access to specific methods for suicide, has been shown to be effective in promoting secure firearm storage practices in a recent randomized controlled trial. LMC can be delivered by providers in clinical settings (e.g., mental health, emergency departments, primary care) to individuals deemed at increased risk for suicide. However, such a prevention approach may critically miss individuals who do not seek care and/or do not disclose their suicidal thoughts to providers. Indeed, recent research found that suicide decedents who died by firearm were less likely to seek mental health and substance use treatment and had a higher likelihood of dying on their first attempt. Additionally, firearm owners tend to rate physicians or medical professionals as the least preferable messengers who could teach firearm owners about safe storage practices for suicide prevention. Therefore, LMC cannot only be delivered by providers and/or after a suicidal crisis has occurred. A community-based primary prevention approach, such as peer-delivered LMC (PDLMC), is critically needed. While community-based interventions to improve firearm storage practices exist, there is limited research examining PDLMC to firearm owners. To inform the development of PDLMC, it is essential to understand the factors associated with firearm owners’ preferences for receiving this intervention for firearm suicide prevention. Prior research suggests a source’s perceived similarity by an audience (i.e., homophily) can increase the credibility and likeability of the source. Perceived similarity to the source has also been shown to reduce resistance to the source’s message. It may be that firearm owners are more open to receiving LMC when it is delivered by a peer who is more similar to themselves in terms of demographic (e.g., gender, race, sociopolitical beliefs) and firearm-related (e.g., firearm owner, reason for ownership, experience with firearms) characteristics. Furthermore, differences in preferences may exist based on the regional differences in firearm ownership, gun culture, and firearm laws. The long-term goal of this research is to inform the development and implementation of PDLMC. In line with this goal, the primary objective of this study is to examine firearm owners’ openness to receiving PDLMC based on characteristics of the peer. For exploratory purposes, this study will also examine if openness to receive PDLMC based on peer-specific characteristics differs based on participants’ self-reported gender and state of residence. This preliminary investigation can inform who may be best suited to serve as a peer in delivering LMC in order to expand its reach and promote secure firearm storage practices before a suicidal crisis occurs.

Principal Investigator: Cornelia Griggs, MD, Massachusetts General Hospital; Gretchen Felopulos, PhD, Massachusetts General Hospital; Robin Cogan MEd, RN, NCSN, FNASN, FAAN, Rutgers University New Brunswick

Piloting a Gun Violence Prevention Training Curriculum for School Nurses and Counselors in New Jersey and Massachusetts

In 2019, the Massachusetts General Center for Gun Violence Prevention (CGVP) was launched with a mission focusing on clinical care and education, research, and community engagement. It shared the belief of many others that gun violence is an urgent and devastating public health threat. Healthcare workers serve as key disseminators of safety information to the community. Early data showed that most providers reported having no prior exposure to gun violence prevention education. This preliminary data demonstrated that knowledge about available resources, awareness about relevant laws, and comfort in discussing access to guns and gun safety increased dramatically among our trainees and study participants post-training. Amid the national crisis around school shootings, there is increasing demand for partnerships with gun violence prevention programs and schools. Therefore, expanding this curriculum to schools is a logical next step. In partnership with Robin Cogan, Rutgers faculty, and the New Jersey Director for the National Association of School Nurses representing the New Jersey State School Nurses Association, this pilot program adapts and distributes the current gun violence prevention curriculum for school nurses and counselors in New Jersey and Massachusetts. There is no existing curriculum for school nurses to develop comfort around gun violence prevention efforts with within the classroom and, by extension in student’s homes. This represents a significant gap in the national approach to gun violence among school aged youth and families. School nurses are essential to maintaining a safe, supportive environment for students. As such, school nurses may be uniquely poised to identify at-risk students and as such should be educated on how to ask about gun presence, gun safety, and the conditions when “red flag” measures should be considered.

Principal Investigator: Ian H. Stanley, PhD, 1Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Center for COMBAT Research, Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus and Angela Wright, MD, 1Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus

Identifying Optimal Messengers to Prevent Firearm-Related Suicide: Delivery of Lethal Means Safety Counseling by Emergency Medical Services (EMS) Personnel

In a study of 6,200 US residents, Anestis et al. found that individuals in first responder roles – in particular, law enforcement, current military personnel, and military veterans – were rated as the most credible sources to discuss secure firearm storage for suicide prevention. One analog first responder group – emergency medical services (EMS) personnel – might also be optimally positioned to discuss secure firearm storage, especially with at-risk individuals. EMS personnel encompass both emergency medical technicians (EMTs) and paramedics. These individuals are frequently the first on the scene for mental health crises, including suicide-related crises, which typically occur in someone’s home. These in-the-home touchpoints might provide an opportunity for EMS personnel to broach the subject of secure firearm storage, either with the patient themselves or with other inhabitants (e.g., loved ones, roommates, caregivers). Such a discussion could provide immediate increases in creating a secure home environment, especially in the context of an individual with potentially active suicide risk that may or may not necessitate hospitalization. However, to our knowledge, there are currently no programs in place to train EMS personnel in lethal means safety interventions. The provision of lethal means safety interventions by EMS personnel is consistent with a community paramedicine framework, wherein EMS personnel deliver interventions outside of their typical emergency response and transport roles. This study addresses an unmet need to identify a novel, opportune group of messengers – EMS personnel – for secure firearm storage interventions. The findings from this proposal will provide foundational work for future large-scale federal grant funding focused on EMS personnel as messengers of secure firearm storage.

Principal Investigator: Jennifer Paruk, MPH, School of Criminal Justice, Michigan State University Karen Holt, PhD, Faculty Advisor, School of Criminal Justice, Michigan State University

Family Member and Intimate Partner Efforts to Reduce Firearm Access for Those at Risk of Harming Themselves or Others

Family members and intimate partners are uniquely positioned to prevent an at-risk person from firearm access, as family members and intimate partners might notice warning signs or be victims of the of individual’s violence. Additionally, family members and intimate partners often know where and how firearms in their home are, giving them the opportunity to intervene and prevent future harm. However, besides research on DVROs and ERPOs, there is no research on how and when family members and intimate partners act to prevent their loved one from firearm access. One place to study these efforts to reduce firearm access is when law enforcement officers are called to the scene. Law enforcement officers are consistently seen as credible messengers around firearm safe storage, are often willing to temporarily store firearms when someone in the home is at-risk of harming themselves, and depending on the incident and state law, can seize firearms or take them for safekeeping. By identifying when and how family members and intimate partners reduce firearm access, we can then evaluate these efforts for safety and efficacy in decreasing firearm injury, and study and address legal obstacles to reducing firearm access. This dissertation will use police incident reports to explore family members’ and intimate partners’ efforts to reduce firearm access when their adult loved one is at risk of harming themselves or others. The objectives of this dissertation are two-fold: (1) identify and characterize family and intimate partners’ efforts to reduce firearm access, and (2) identify what demographic and incident-level factors are important in predicting these efforts.

Principal Investigator: John Shjarback, PhD, Associate Professor, Department of Law and Justice Studies, Rowan University

A Spatial Examination of Gun Violence in New Jersey

While gun violence in New Jersey is relatively lower than most states in the country, an average of 254 people die from gun homicides with another 543 wounded by gun assaults every year. Interpersonal gun violence is not evenly distributed throughout space or among race/ethnicity, gender, and age demographics. Instead, it affects certain municipalities and young Black and Hispanic men disproportionately. Eight cities – Atlantic City, Camden, East Orange, Irvington, Newark, Jersey City, Trenton, and Paterson – accounted for approximately 61% of the 1,100 firearm homicide deaths in the state from 2016 through the end 2020. Black and Hispanic New Jerseyans represent 76.7% and 15%, respectively, of those killed by firearm homicides over that same five-year period; 87.8% of those killed are men and 70.2% are between the ages of 15 and 34. Despite these broad descriptive statistics, less is known about where – specifically – transactional gun violence is occurring throughout the state, and which features of those places contribute to shootings. Previous analyses on the topic that have used cities/municipalities as the unit of analysis may suffer from the “ecological fallacy”, which suggests there is more opportunity to conceal variation across geographic spaces that is less visible at larger levels of aggregation. Cities/municipalities have a substantial mix of different neighborhoods with vastly different economic characteristics as well as population demographics within their overall spatial boundaries. Therefore, the degree to which gun violence is concentrated within and across neighborhoods in the state is less clear. There is no central publicly available dataset that identifies gun violence in New Jersey across smaller, more micro units of analysis. As such, the purpose of this study is 1) to construct a dataset to identify, map, and spatially explore transactional gun violence in the more than 2,000 census tracts within cities/municipalities in New Jersey, 2) to merge those measures of gun violence in census tracts with other data sources in order to better contextualize the neighborhoods in which gun violence is occurring, and 3) to empirically examine which census tract characteristics (e.g., economic disadvantage, population density) are associated with transactional gun violence.

Principal Investigator: Kwan-Lamar Blount-Hill, PhD, JD, Arizona State University

Understanding the Credibility of Credible Messengers in Violence Prevention Work

The use of “credible messengers” to deliver violence reduction programs has spread rapidly since the Chicago CeaseFire (now Cure Violence) program began in 1999. Since then, Cure Violence (CV) has become a national and international model for violence prevention. New York City’s Young Men’s Initiative and Crisis Management System use credible messengers as the preferred staff for much of their programming; Washington, D.C. has a thriving credible messenger initiative; and, in New Jersey, credible messengers are being used in a novel application of the CV model in rural counties. This study is designed to contribute to further understanding the antecedents, correlates, and outcomes of credibility and deepening the conceptualization of a “credible messenger”. Specifically, this study conducts a qualitative case study of a CV program Blount-Hill & Szkola, “Credibility of Credible Messengers” operating in the Northeastern region of the United States. The site is ideal for the study of credibility, as it fits the basic profile common of CV programs across the country: It operates in a “high violence,” “low income” community composed predominantly of people of color and is staffed primarily with people of color previously involved in violence-prone networks and/or criminal legal processes.

Principal Investigator: Meaghan E. Brown, PhD, University of South Florida

From Guns to Intimate Partner Violence: The Impact of Power and Control

Despite the widespread ownership of firearms, guns can pose a threat of harm within the home, particularly homes with incidences of intimate partner violence. A gun in the home increases the risk for both accidental and intentional death. Further, guns pose a risk for not only gun violence but non-gun related violence in the home, including intimate partner violence (IPV). That is, the mere presence of a gun may escalate arguments and increase the fear of victimization among individuals in the home. In the context of IPV, gun possession has been found to increase the risk that abusers will threaten use of a firearm toward a partner, relative to abusers who do not own guns. Despite relatively low rates of such gun threats and of intimate partner homicide in the US, the availability of a gun in the hands of abusers remains a credible threat for current as well as escalating violence, even if a gun is not used in the perpetration of IPV. In this regard, the further examination of the possible psychological factors that can potentially explain how and when gun ownership relates to IPV or escalating violence (besides the obvious link that guns can cause more serious harm through threats and injuries) is warranted. Based on limited literature on the potential role of feelings of control in gun ownership and IPV, we propose that the desire for power associated with gun ownership can explain when gun possession is related to severity of IPV. Indeed, the need for control and respect is a common theme in perpetrators of IPV, particularly in men who perpetrate more serious and repeated acts of IPV. Given the lack of data on the topic, the current study seeks to examine the nature of the relationship between gun ownership and IPV in a community sample of Floridian men. There is also a dire need to obtain more data on gun ownership and its correlates to enhance the research literature. There is no federal database of gun owner characteristics currently in the US, and prior to the development of some national gun studies, researchers often had to estimate gun ownership based upon gun-related suicides using state level data. Thus, one of the other aims of this study is to create an open database, with a large sample of Floridian gun owners and nonowners, to enable further psychological research on gun ownership that is available publicly to researchers.

Principal Investigator: Kristen D. Krause, PhD, MPH, 1Deputy Director, Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Instructor, Department of Urban-Global Public Health, Rutgers School of Public Health Christopher B. Stults, PhD, Director, Sexual and Gender Minority Health Lab, Assistant Professor, Department of Psychology, Baruch College, City University of New York

Gun-Related Interpersonal Violence Among Sexual and Gender Minority People in New Jersey

The overarching goal of this study is to collect pilot data on the role of guns in occurrences of interpersonal violence (IPV) among sexual and gender minority (SGM) people living in New Jersey. This mixed methods study will consist of two phases. The first phase is a qualitative study exploring the experiences of gun-related IPV among a sample of (N= 30) SGM adults living in New Jersey. The aim of his phase of the study is to describe the intersection of gun access, possession, and violence with IPV. The qualitative data collected in this phase of the study will inform the second phase of the study, a quantitative study of (N =250) SGM adults in New Jersey. The primary aim of the second phase of the study is to assess the extent to which gun access, possession, and/or violence victimization/perpetration is explained by (a) sociodemographic factors and (b) history of IPV victimization and/or perpetration among SGM individuals.

Preliminary results have been illuminating thus far. Specifically, participants have described several different forms of gun-related IPV, including being threatened by a former romantic partner, having a current romantic partner fire a weapon in their presence as a form of intimidation, and concerns for friends with mental health problems who were known to have access to or possess firearms. These initial interviews have informed a preliminary codebook that will be used to code the qualitative data at the completion of phase one of the study. The data has also been used to inform a draft of the quantitative survey to be launched at the completion of phase one of the study.

Principal Investigator: Pamela Valera, PhD, MSW, NCTTP Assistant Professor Rutgers School of Public Health

Establishing the Northern New Jersey Correctional Officer Mental Health, Suicide and Gun Violence Task Force – An Exploratory Study

Workplace hazards such as exposure to violence and infectious diseases [e.g., hepatitis, COVID19] and experiencing assaults are major concerns of correctional officers (COs). Between 1999 to 2008, 113 work-related fatalities were documented amongst COs. Assaults, violent acts, and transportation-related accidents comprised 80% of the total incidents. The assaults and violent acts were caused by homicide (62%), followed by self-inflicted gunshot wounds (38%). The burden of working within corrections has a lasting effect on many COs. Furthermore, they are more likely to experience post-traumatic stress disorder than military veterans. There is a critical need to understand the risk factors for suicide and gun violence and explore the types of mental health care services available to COs. Our long-term goal is to reduce suicide caused by gun violence in COs. The central hypothesis of this study is that exposure to stressful conditions among COs may lead to suicidal behaviors (e.g., self-inflicted gunshot wounds) and poor mental health outcomes. To our knowledge, there are currently no systems to evaluate the barriers and facilitators to promoting mental health and wellness interventions in jails and prisons for COs, which presents a missed opportunity in reducing suicide. The overall objective of this project is to identify barriers and facilitators toward delivering mental health and wellness for COs in jails and prisons using a collaborative stakeholder and mixed-methods approach.

Principal Investigator: Vanessa LoBue, PhD, Professor at the School of Psychology, Rutgers University-Newark

The Effect of Gun Violence on Threat Processing

The rapid detection and identification of threat is critical for survival. A large body of research suggests that attentional biases—defined as rapid or prolonged attention—for a variety of threatening stimuli are normative and early developing. However, recent work suggests that both biological and environmental factors may also play a role in shaping attention biases over the lifespan, and can lead to maladaptive pathways of emotional processing, such as risk for clinical anxiety. Importantly, like most research in psychology, the vast majority of work on attention biases and their relation to socioemotional functioning has focused on one specific population—namely, middle class, Caucasian adults. This is profoundly problematic, as there is evidence that individuals who live in more diverse and mixed socioeconomic environments experience a greater number of environmental threats—including higher rates of crime, delinquency, and most importantly, gun violence—and a greater incidence of mental health problems than middle to high income adults. In an ongoing longitudinal investigation of attention biases to various threats across environments that vary widely in demographics, we found that adults living in Newark, NJ reported significantly higher levels of community violence when compared to adults from communities in other states. However, it is unclear what type of community violence adults in the local Newark community most often experience, and how exposure to specific types of violence—namely gun violence—is affecting their emotional reactivity to threat and general wellbeing. This is a significant issue, as experience with specific types of environmental threats (e.g., physical violence) affects individuals’ threat responses. This study takes the first step of asking whether exposure to gun violence in a sample from the Newark community is related to behavioral responding to threatening stimuli. We will take a novel, multi-method approach that includes behavioral and neural (i.e., fMRI) measures to a) assess differential responses to stimuli that vary in valence (negative, neutral) and type of threat (general, guns); and to b) characterize the mechanisms underlying the processing of gun-related threats and how they are influenced by exposure to violence.

Principal Investigator: Alejandro Gimenez Santana, PhD, NPSC Director (Rutgers-Newark SCJ)

Empowering community organizations to become co-producers of public safety: Developing a gun violence crime reduction strategy in the city of Newark

This study seeks to develop a Data-Informed Community Engagement (DICE) strategy to mitigate the risk of gun violence in the city of Newark. Gun violence incidents have increased by 17% between 2020 and 2021, with an increase of over 25% in shootings (hit and no hit). The spike in gun violence has disproportionately affected the South and West Ward of Newark. Currently, the Newark Public Safety Collaborative (NPSC) is partnering with organizations like the Newark Community Street Team (NCST), Brick City Peace Collective (BCPC), and the Office of Violence Prevention and Trauma Recover (OVPTR), among other community organizations serving these geographic areas. This study aims to develop one or more DICE strategies to identify places that attract and/or generate these criminal behaviors, engage community-based organizations (CBOs) in a collaborative effort to unveil the risk narratives explaining why these locations are disproportionately affected by gun violence, and provide community organizations with data and analytics to assist their efforts in reducing the risk of gun violence in their communities. The Newark Public Safety Collaborative (NPSC), through its strategic partnership with the Newark Police Division (NPD) and other community-based organizations (CBOs), will collect and analyze secondary data for gun violence incidents within the geographic boundaries of the city of Newark. The NPD COMSTAT unit, Newark’s law enforcement crime analysis unit, will provide NPSC analysts with real-time access to incident-level crime data for most violent crime incidents, including domestic violence and interpersonal violence (IPV) incident reports. The NPSC will then review, geocode, analyze gun violence data, and develop a DICE strategy with its community partners.

Principal Investigator: Elizabeth Griffiths, PhD, Associate Professor, School of Criminal Justice, Rutgers Newark

“Ghost gun stores” and the concentration of shootings: An investigation of the causal effect of gun store locations on gun violence

Recent political attention to gun violence in the United States has stimulated commonsensical policy adoption, yet these policies have been developed largely in the absence of empirical data. One of the major foci of President’s Biden’s comprehensive strategy to address gun violence via executive order and the Bipartisan Safer Communities Act relate to the activities and regulation of firearms dealers, in particular. While existing scholarly work has attended to secondary gun markets, gun trafficking, and the production and use of ghost guns, which hinder ownership information and tracing, recent research shows that the risk of gun violence is elevated by licit gun dealers and in the vicinity of licensed firearm dealers, particularly in disadvantaged neighborhoods. One central concern of all studies on the attractive or repellent effects of physical features of place on violence relates to causality. That is, violence is not evenly distributed in space and thus any relationship between the presence of certain kinds of physical features (e.g., bars, liquor stores, ATMs, laundromats, bus stops, gun stores, etc.) and the clustering of violence may be correlational and spurious, rather than causal. Consider bus stops and laundromats, which tend to be more heavily concentrated in communities with few socioeconomic resources; in this case, any identified relationship between the presence of these establishments and violence may be a function of relative disadvantage. To estimate the causal effects of gun stores on the locations of gun violence, this study takes a novel approach. Rather than comparing gun violence pre- and post the opening of a gun store, or using propensity matching to compare how a physical feature of place affects the distribution of violence in otherwise similar neighborhoods, this project investigates the effects of the “footprints” of former federally-licensed gun stores (or what I call “ghost gun stores”) vis-à-vis existing gun stores on the incidence and locations of firearm violence.

Principal Investigator: Ping-Hsin Chen, PhD, Associate Professor, Department of Family Medicine Rutgers – New Jersey Medical School

SAVE VOICE: Safety against Violence for Employees through Violence Outreach Intervention and Community Education for local health workers

Gun violence is a major public health concern in the U.S. and its related health issues have increased in the COVID-19 era. Since 2019, we received funds to explore risk factors for gun violence, develop collaborative learning and educational video sessions, and implement the Violence Outreach Intervention and Community Education (VOICE) Program in New Jersey. Recently, we received feedback from University Hospital (UH) and New Jersey Medical School (NJMS) that there is an urgent need for healthcare staff to receive training in gun violence prevention and intervention. The Association of American Medical Colleges recently reported that threats against healthcare workers are rising. Hospital safety directors reported that violence against healthcare workers increased during the COVID-19 pandemic in 2020. A recent national survey of more than 2,000 nurses indicated that almost half (48%) reported an increase in workplace violence. We are seeking funding to pilot test a hybrid VOICE Program in the UH and NJMS community. The proposed program will benefit our medical community members who are at risk for violence at workplace, including gun violence. It will also help healthcare workers to better provide violence prevention and intervention for their clients based on the Train-theTrainer principle. These steps are necessary to create a culture of support around violence in the health care setting. This study aims to create a VOICE Program website to increase accessibility for the local medical community and make its content enduring and to tailor and implement a hybrid VOICE Program for UH and NJMS staff.

Principal Investigator: Arlana Henry, PhD, Faculty Advisor, Professor, School of Criminal Justice at Rutgers Newark

The impact of proximity to health care on the lethality of gun violence

While fatal firearm related violence is an ongoing concern, nonfatal firearm related violence is just as, if not more concerning. Research has found that most individuals who are injured by gun violence survive and that cases of nonfatal injury are twice as prevalent as deaths from firearms. According to the John Hopkins Center for Gun Violence (formally the Educational Fund to Stop Gun Violence (Ed Fund), there are approximately 77,497 emergency department visits for gunshot wounds annually. Black men, specifically, have the highest rates of firearm-related hospitalization and firearm mortality. Research has found that victim survival from firearm-related injuries is often contingent on the speed and quality of care provided, and that victims who are shot farther from trauma centers have an increased likelihood of death. Another study assessing the mortality rates in following serious injury in Chicago found that geographic disparities in access to trauma care exist even within urban trauma systems. This study seeks to contribute to this area of research by assessing the factors that contribute to lethality of gun violence and whether access to healthcare contributes to survival in the state of New Jersey. Specifically, it seeks to examine the individual and structural factors that may impact firearm injury survival and treatment. The aims of my study are to (1) explore whether proximity to a hospital and access to healthcare contributes to firearm injury mortality, and (2) whether there are any existing disparities in access to trauma care (i.e., the types of treatment and care received after firearm injury). This study is important given that researchers have found evidence if the existence of “trauma deserts” in urban cities and there is scarce existing research on the effect of distance to hospitals on firearm injury mortality in New Jersey. Nonfatal incidents of gun violence is concerning given the related trauma and its adverse effects on the physical and mental health and well-being of not only individuals but communities at large. Furthermore, assessing nonfatal firearm injury is necessary for the development effective strategies for firearm-related violence, prevention, and treatment. It is imperative to go beyond studying firearm deaths when developing and evaluating injury prevention initiatives.

The Lived Experiences of Illicit Firearm Owners

Community Street team (NCST) to conduct a Community Based Participatory Research (CBPR) study focused on examining the lived experiences of individuals who own and have access to illicit firearms. The community academic research partnership facilitated capacity building aimed at enhancing the knowledge and skills of community members to successfully engage in research. Two NCST staff members received Collaborative Institutional Training Initiative (CITI) training and participated in interviewing participants and analyzed the data. Community members joined our team to discuss the research findings at the annual NJGVRC Research Day. Click here to access the recording with the findings. Part of the findings informed our understanding of the need to promote secure storage practices among those who have access to and own illicit firearms. With this in mind, one of our next steps includes distributing biometric locks to community organizations for broad dissemination across New Jersey with the aim of minimizing unintentional deaths and firearm injury. This collaboration will yield a peer-review publication co-authored by the members of the Newark Community Street Team with the goal of co-creating written scholarship.

Community Perceptions of Gun Violence

Approximately 80% of all homicides occur in five New Jersey cities: Newark, Trenton, Camden, Jersey City, and Atlantic City. In order for the GVRC to address the needs of these communities and to ensure that we are funding research capable of doing so, we need to hear from local community members who have been impacted by gun violence. To address this need, we are conducting focus groups in five cities across New Jersey- Newark, Trenton, Camden, Jersey City, and Patterson to better understand what aspects of gun violence are important to community members. More specifically, we seek to: 1) understand how communities experience gun violence; 2) capture perceptions of gun violence; 3) document how communities have been touched by gun violence; and 4) identify concerns and solutions for addressing gun violence. We will leverage this information in our annual RFPs, thereby ensuring that individuals who apply for research funding from the GVRC are shaping their proposals around ideas put forth by the community. The first phase of data collection will begin in Camden during the end of Summer 2023 in partnership with Superior Arts Institute. As part of this collaboration, Superior Arts will utilize an artistic outlet to disseminate the research findings to Camden residents.

GVRC

The values, beliefs, and meaning of firearms and firearm ownership among current and former Post9/11 era service members.

This qualitative study involves interviewing current and former service members to understand the values, beliefs, and meaning of firearms and firearm ownership and if/how their military experiences informs firearm ownership and storage behaviors.

Attempted Intimate Partner Homicide

Research suggests that Black women are killed at a rate of 4.4 per 100 000 people compared to White women who are killed at a rate of 1.5 per 100 000 thereby placing Black women at greater risk (Petrosky, 2017). While research shows women’s risk of being killed by a partner with firearm has been high for decades (Kellermann & Mercy,1992), more research is needed to understand the nonfatal use of firearms in intimate partner violence (IPV) relationships where victims have been almost killed by the abuser specifically those women from historically disadvantaged groups. In order to better understand the non-fatal use of firearms among racial and ethnic minority groups, evidence can come from the lived experiences of African American and Black Caribbean immigrant women who have been abused by an intimate partner in a manner that involved a firearm.

An examination of the impact that firearm ad campaigns have on firearm owners and non-firearm owners

GVRC Doctoral Student Fourth Year SEDL Doctoral Student at Rutgers University

Amount Awarded: $8,540 The purpose of this project is to examine the influence of firearms ad campaigns on both firearm and non-firearm owners. Participants are being recruited via Qualtrics and will be randomized to view a video ad campaign from End Family Fire or The National Rifle Association. Participants will then rate their emotional state and openness to secure firearm storage. Data collection is ongoing.

Who do you listen to?: Examining credible sources to discuss firearm safety for suicide prevention

GVRC Doctoral Student Fourth Year SEDL Doctoral Student at Rutgers University

Amount Awarded: $21,840 This project aims to determine if the credible source who discusses secure firearm storage has an impact at openness to secure storage and actual engagement in secure storage.

An examination of mental healthcare providers’ screening practices and perceptions of firearm safety discussions to reduce firearm-related injury

Discussing firearm safety is recommended in healthcare settings, yet most providers do not ask patients whether they have access to firearms, even when risk for suicide/violence is high. This study aims to extend this literature by examining mental healthcare providers screening practices for firearm access. Data collection is ongoing and 71% complete. Preliminary data will be presented at the 2023 National Firearm Injury Prevention Conference in Chicago, IL. These preliminary data offer promising findings that many mental healthcare providers screen for firearm access at least some of the time. However, most providers do not screen all clients, and many believe that certain clients do not need to be screened. Given the difficulties in accurately assessing risk, there are likely many individuals presenting to mental healthcare who have firearms in/around their home that are not detected.

EXTERNALLY FUNDED

Expanding a Multi-Level, Longitudinal Database to Assess Ecological Risk Factors and Racial Disparities in Community Gun Violence in One Hundred U.S. Cities

This grant will support building out an ecological database on gun violence exposure, community health, and risk factors for violence in more than 15,000 neighborhoods across the US.

Piloting a Culturally Congruent Survey to Study Trauma, Violence Exposure, and Health among Black Men in Camden, NJ

This grant supports a pilot study of the healthcare needs and barriers to access for violently injured Black men living in Camden county.

Acenda CVIPI Multi-County Coalition

This grant supports the development and implementation of a community violence intervention (CVI) program in three rural counties in South Jersey.

New Jersey Safe Firearm Storage Map

This grant is active and has created a free online tool to connect New Jersey firearm owners with local firearm retailers willing to temporarily store their personally owned firearms. This legal path for temporary away-from-home firearm storage offers a straightforward method to reduce the risk of suicide, unintentional shootings, and firearm theft.

Augmenting Suicide Prevention Interventions for Service Members (ASPIS)

In this active grant, a suicide research center located at the Ohio State University Wexner Medical Center leads a team of researchers on projects examining interventions to prevent suicide among service members. The GVRC will held lead one such project, leveraging Project Safe Guard, a lethal means counseling intervention first tested by the GVRC (Anestis et al., 2021; American Journal of Public Health).

Protective Environments: Military Community Engagement to Prevent Firearm-Related Violence

In this multi-year grant, a team of researchers including the GVRC, is utilizing community based participatory research methods to adapt Project Safe Guard, a lethal means counseling intervention first tested by the GVRC (Anestis et al., 2021; American Journal of Public Health).

Protective Environments: Military Community Engagement to Prevent Firearm-Related Violence

In this grant, a team of researchers including the GVRC will engage in three tasks to better understand the firearm storage preferences of service members. The first task is a systematic review of the research literature to examine extant data on preferences for specific storage approaches (e.g. cable locks, gun safes). The second task is a survey of a nationally representative sample that will directly assess not only storage preferences, but also obstacles to using specific approaches and situations in which preferences may change (e.g. cost reductions).

Project Safe Guard: Training and Evaluation

This grant will leverage Project Safe Guard, a lethal means counseling intervention first tested by the GVRC (Anestis et al., 2021; American Journal of Public Health), adapting it to meet the needs of the National Guard and conducting training sessions with nominated Guardsmen across two states currently exhibiting elevated firearm suicide concerns (states TBD). These trainings will occur over the course of 15 months and will include evaluations aimed at determining the extent to which the intervention is used in subsequent months, whether trainees encounter obstacles in utilizing it, and whether the treatment is deemed acceptable by those who receive it

Michael Anestis runs New Jersey's nonpartisan Gun Violence Research Center talks about the large mass public shootings and how they represent about one percent of gun violence nationwide. Dr. Daniel Semenza, director of Interpersonal Research, talks about how every shooting has this vast ripple effect that affects so many more people and tears apart families and communities. Reducing gun violence should be the number one priority for our country. Anything less, we are failing our children. Click here for more information

Professor Mike Anestis, who heads up the New Jersey Gun Violence Research Center at the Rutgers School of Public Health, said that many people survive suicide attempts using other methods. "Intentional overdose? Only 2% to 3% of the folks who attempt suicide using an overdose die," said Anestis. "Almost 95% of folks who use a firearm do. They don't get a second chance." According to Anestis, guns are the main cause of suicide deaths: "More than half of all suicide deaths in any given year are caused by self-inflicted gunshot wounds. So, that's somewhere in the vicinity of 25,000 firearm suicide deaths in the U.S. every single year." Click here for more information

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Michael Anestis, Ph.D., executive director of the New Jersey Gun Violence Research Center at Rutgers University, joins Steve Adubato to examine gun violence in the U.S. and the legislation he believes would help combat it.

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Daniel Semenza, Ph.D., director of interpersonal research, at the Gun Violence Research Center at Rutgers University, joins Steve for a compelling conversation about the prevalence of gun violence, concealed carry laws and the communities that are disproportionately impacted.

This study focused on 719 active-duty, reserve, and National Guard firearm owners and found that, of nearly 39% who said they had experienced suicidal thoughts in the previous year, those who said they sought mental health treatment were more likely to report storing their firearms safely.

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R. Thurman Barnes, the assistant director of Rutgers University’s New Jersey Gun Violence Research Center and faculty at the Rutgers School of Public Health said, “In a country like ours, we have a lot of guns.” He added, “And when you have as many guns as we have which we have more guns than people, you’re going to have more gun violence in all of its forms.” Click here for more information

They're called "survivor cities" — places where residents may not yet have been personally touched by gun violence, but the threat continually remains that they might, said Daniel Semenza, GVRC director of interpersonal research and assistant professor at Rutgers University-Camden. Semenza, is applying that term to cities like Philadelphia and several of its neighbors to the east in the Garden State. Click here for more information

The New Jersey Gun Violence Research Center study published in JAMA Network Open was featured in Forbes. Researchers surveyed 2,000 firearm owners about how they stored their weapons. Nearly 50% of respondents who didn’t lock their firearms said locks are unnecessary, while more than 44% of respondents said that locks would prevent quick access in an emergency.

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Service members are more likely to store firearms safely when the message on safe storage is delivered by military law enforcement, according to a Rutgers study. “These findings line up with what we have been finding consistently across prior work relying on self-report surveys: that law enforcement – or security forces in the case of the military – is seen as a particularly compelling voice on this issue,” said Michael Anestis, lead author of the study and executive director of the New Jersey Gun Violence Research Center at Rutgers and an associate professor at the Rutgers School of Public Health. “It might be that law enforcement is viewed as having more experience with and knowledge about firearms and that they are not viewed pushing a political agenda on this issue. Regardless of the reason, their voices may be key in getting service members to adopt safe firearm storage practices with their personally owned firearms.”

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Researchers used data from the National Violent Death Reporting System to examine the deaths of more than 117,000 people who killed themselves with guns between 2003 and 2018. "These results highlight that more often than not, unsecured handguns are the driving force in firearm suicide in America," said senior author Michael Anestis, executive director of the New Jersey Gun Violence Research Center at Rutgers University. Click here for more information

Researchers, led by Michael Anestis at Rutgers University's School of Public Health, sought to figure out the answer to that question and which campaigns would be most effective as the VA and military continue to push for the expansion of gun safety initiatives and outreach.

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The message is important, according to a 2018 Rand Corp. study, because suicide often doesn't involve extensive planning, and anything that can cause a delay can save lives. "Suicide attempts are impulsive acts that may never be repeated if the first attempt fails," the study found. "Because those who impulsively attempt suicide with a gun rarely get a chance to reconsider the decision, it is reasonable to suspect that when guns are less available, fewer suicide attempts will result in fatality."

Rutgers University’s Gun Violence Research Center has created a searchable online map that shows safe gun storage locations like firearm retailers, community businesses, and even police departments for people during a crisis.

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Brian Lehrer and his team interview with Michael Anestis, associate professor at the Rutgers School of Public Health and the executive director of the New Jersey Gun Violence Research Center, talks about the recent report that looked into who owns firearms in New Jersey, how many they own, and why they say they own a gun. Click here for more information

“The words we use in discussing these issues matter, so we need to be thoughtful in how we frame solutions and work toward a shared goal of preventing injury and death,” said Michael Anestis, associate professor in urbanglobal public health at the Rutgers School of Public Health and executive director of the New Jersey Gun Violence Research Center. New Jerseyans as a whole are more split, however, when it comes to weighing the importance of protecting the rights of Americans to own guns versus controlling gun ownership. While nearly half (46 percent) say controlling gun ownership is more important, three in 10 (30 percent) side with the former, and one in five say they are both equally important (21 percent). Click here for more information

Gun violence researchers from the GVRC, discuss how effective new federal gun legislation is and NJ Acting Attorney General Platkin talks about the state's new firearm safety package.

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Michael Anestis, executive director of the New Jersey Gun Violence Research Center, discusses the psychology of mass shooters after the Highland Park parade shooting.

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Supporters of the Second Amendment contend the right to keep and bear arms is a way to increase public safety. But some researchers are concerned that rising numbers of gun owners in the country could increase suicide rates. "I look at this as a really dangerous, scary turn in that it could foretell other coming problems," said Michael Anestis, executive director of the New Jersey Gun Violence Research Center, who specializes in firearm suicide scholarship. Click here for more information

Dan Semenza, the director of interpersonal violence research at the New Jersey Gun Violence Research Center at Rutgers University, said that the safest way to prevent children from using guns “is to not have a firearm in the home of a child.” Still, he said, there were ways to limit access even with guns in the home. “You are talking about a gun locker or a gun safe, where the firearm is separate from the ammunition,” he said. Click here for more information

Stopping gun violence and mass shootings must happen at the systemic level, not the individual level, according to Dr. Daniel Semenza, the Director of Interpersonal Violence Research at the Rutgers Gun Violence Research Center. "If you don't want to see this kind of level of gun violence and you want to stop seeing these headlines, then you have to bring in people into power who can make the decisions to start reducing access to the weapons that are causing this." Dr. Semenza said that in the aftermath of shootings, like the one at Michigan State University, people tend to look for motive, wondering what drove the individual shooter to commit the attack. Click here for more information

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The GVRC talks with the NJSpotlight on the recent shooting in Tennessee.

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“NJ and California are the two states in the country with an A rating from the Gifford Foundation for gun laws why aren’t they able to prevent mass shootings?” Briana Vannozzi discusses this question with Mike Anestis, executive director of the GVRC.

COMMUNITY PROJECTS

Community THE LIVED

EXPERIENCE OF ILLICIT FIREARM OWNERS IN NEWARK NJ

Distribution of FREE Safe Secure Firearm Storage

Distrubution of FREE Safe Secure Firearm Storage

We are providing cable locks, trigger locks, and biometric gun safes to four community partners: (1) Community Hope (2) Keep Our Veterans Alive (KOVA) (3) Newark Community Street Team and (4) Superior Arts. These community partners will distribute the locking devices as they see fit and we will then conduct qualitative interviews with the community partners to better understand what worked and what didn’t, what devices community members preferred, and what we might do differently in the future to ensure that New Jersey firearm owners can access the locking devices they’re most likely to use.

Conferences GVRC presentations, sample posters, and award ceremony

THE EQUITY AND JUSTICE AWARD

Dr. Nazsa Baker GVRC Doctoral Fellow

Presentation: Performance of the Adverse Childhood Experiences (ACEs) Questionnaire with Black male firearm violence survivors in a hospital-based violence intervention program

Events

Rutgers Day

Rutgers Giving Day #RUGivingDays is an annual campaign to fuel the engine of Rutgers research and amplify academic excellence. The #NJGVRC raised over 6k, which will strengthen the research and efforts to combat firearm violence through research.

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Eagleton & The GVRC

NJGVRC executive director, Mike Anestis, presents on individuals, communities, and societal consequences of gun violence.

GVRC Student Day

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GVRC Student Day is a day when our doctoral students present their gun violence prevention research, funded by the GVRC.

GVRC Summit GVRC Summit was a day of conversation between researchers, policy makers, and gun violence prevention stakeholders to discuss the next steps in preventing all forms of gun violence across New Jersey.

NJ 101.5 talks with the GVRC

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Take a look at the recordings from the GVRC Research Day Click here for more information

SOCIAL MEDIA CHANNELS

GVRC WEBSITE

TWITTER

#NJGVRC KEY INTERACTION

246k 45k IMPRESSIONS

The number of times any content from or about your Pages or accounts was displayed on a Twitter users screen

FOLLOWER COMPARISON BY YEAR 2023

1,200

2022

845

2021

500

POST REACH The number of people who saw #NJGVRC posts on

10k

ENGAGEMENTS The number of times people have engaged with your tweets.

748

MENTIONS The number of tweets where your Twitter handles are specified. This includes @mentions and replies

F A C E B O O K #NJGVRC

#NJGVRC

45k IMPRESSIONS

The number of times any content from or about your Pages or accounts was displayed on a Twitter users screen

2.7K

POST LINK CLICKS The number of clicks on the links in your posts that did not generate a feed story

1.5K

CONTENT INTERACTION The number of reactions, saves, comments, shares and replies on your content. Content can include formats such as posts, stories and more.

INSTAGRAM #NJGVRC

2.8k IMPRESSIONS The number of times any content from or about your Pages or accounts was displayed on a Twitter users screen

23k POST REACH The number of people who saw #NJGVRC posts on

106

ENGAGEMENTS The number of times people have engaged with your tweets.

Website Analytics These metrics are an important way to track, monitor effectiveness, and develop communications strategies to enhance the reach of the NJ Gun Violence Research Center message. Analyzing these metrics (website users, page views, engagements, firsttime users) helps uncover new opportunities for content and identifies platforms that are the most effective means of communicating and engaging with our audience.

Overview of User Acquisition and Engagment Website Traffic of Total Users, New Users, and Returning Users

103k

Event Count: The number of times a user played a video, submitted a request, clicked a button, read an article

Website Analytics Overview of Age, Gender, Page Views, and User Channels