Garen J Wintemute, Daniel Tancredi, Veronica A Pear, Yueju Li, Christopher D McCort, Glenn Pierce, Anthony A Braga, Mona A Wright, Hannah Laqueur, Nicole Kravitz-Wirtz, David Studdert, Laurel Beckett
{"title":"从持枪违禁人员手中收缴枪支对犯罪的人口层面影响：加利福尼亚州城市实用分组随机试验的意向治疗分析。","authors":"Garen J Wintemute, Daniel Tancredi, Veronica A Pear, Yueju Li, Christopher D McCort, Glenn Pierce, Anthony A Braga, Mona A Wright, Hannah Laqueur, Nicole Kravitz-Wirtz, David Studdert, Laurel Beckett","doi":"10.1136/ip-2024-045234","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Too little is known about the effectiveness of efforts to prevent firearm violence. We evaluated California's Armed and Prohibited Persons System (APPS), which identifies legal purchasers of firearms who have become prohibited persons and seeks to recover all firearms and ammunition to which they have access.</p><p><strong>Design and methods: </strong>This cluster-randomised pragmatic trial was made possible by APPS's expansion from a small pilot to a continuing statewide programme. We included 363 California cities, allocated to early (n=187) or later (n=176) intervention in blocks stratified by region within the state, and within region by population and violent crime rate. The study period began 1 February 2015; region-specific end dates ranged from 1 May 2015 to 1 February 2016. Analysis was on an intention-to-treat, difference-in-difference basis using generalised linear mixed models and generalised estimating equations with robust SEs. The population-level primary outcome measures were monthly city-level counts of firearm-related homicides, robberies and aggravated assaults. The primary model was adjusted for stratification variables; city-level population, population density, socioeconomic status and firearm purchasing; year; and month.</p><p><strong>Findings: </strong>Allocation groups were well balanced on baseline characteristics and implementation measures. In adjusted models, allocation to early intervention was not associated with statistically significant differences in any primary outcome measure; these findings were robust to multiple sensitivity analyses. There was some heterogeneity across regions.</p><p><strong>Conclusions: </strong>The APPS intervention directly affects a very small percentage of the population, limiting its potential for population-level effects. Individual-level analyses may provide a better estimate of the intervention's effectiveness.</p><p><strong>Trial registration number: </strong>NCT02318732.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Population-level effects on crime of recovering firearms from armed prohibited persons: intention-to-treat analysis of a pragmatic cluster-randomised trial in California cities.\",\"authors\":\"Garen J Wintemute, Daniel Tancredi, Veronica A Pear, Yueju Li, Christopher D McCort, Glenn Pierce, Anthony A Braga, Mona A Wright, Hannah Laqueur, Nicole Kravitz-Wirtz, David Studdert, Laurel Beckett\",\"doi\":\"10.1136/ip-2024-045234\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Too little is known about the effectiveness of efforts to prevent firearm violence. We evaluated California's Armed and Prohibited Persons System (APPS), which identifies legal purchasers of firearms who have become prohibited persons and seeks to recover all firearms and ammunition to which they have access.</p><p><strong>Design and methods: </strong>This cluster-randomised pragmatic trial was made possible by APPS's expansion from a small pilot to a continuing statewide programme. We included 363 California cities, allocated to early (n=187) or later (n=176) intervention in blocks stratified by region within the state, and within region by population and violent crime rate. The study period began 1 February 2015; region-specific end dates ranged from 1 May 2015 to 1 February 2016. Analysis was on an intention-to-treat, difference-in-difference basis using generalised linear mixed models and generalised estimating equations with robust SEs. The population-level primary outcome measures were monthly city-level counts of firearm-related homicides, robberies and aggravated assaults. The primary model was adjusted for stratification variables; city-level population, population density, socioeconomic status and firearm purchasing; year; and month.</p><p><strong>Findings: </strong>Allocation groups were well balanced on baseline characteristics and implementation measures. In adjusted models, allocation to early intervention was not associated with statistically significant differences in any primary outcome measure; these findings were robust to multiple sensitivity analyses. There was some heterogeneity across regions.</p><p><strong>Conclusions: </strong>The APPS intervention directly affects a very small percentage of the population, limiting its potential for population-level effects. 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Population-level effects on crime of recovering firearms from armed prohibited persons: intention-to-treat analysis of a pragmatic cluster-randomised trial in California cities.
Background: Too little is known about the effectiveness of efforts to prevent firearm violence. We evaluated California's Armed and Prohibited Persons System (APPS), which identifies legal purchasers of firearms who have become prohibited persons and seeks to recover all firearms and ammunition to which they have access.
Design and methods: This cluster-randomised pragmatic trial was made possible by APPS's expansion from a small pilot to a continuing statewide programme. We included 363 California cities, allocated to early (n=187) or later (n=176) intervention in blocks stratified by region within the state, and within region by population and violent crime rate. The study period began 1 February 2015; region-specific end dates ranged from 1 May 2015 to 1 February 2016. Analysis was on an intention-to-treat, difference-in-difference basis using generalised linear mixed models and generalised estimating equations with robust SEs. The population-level primary outcome measures were monthly city-level counts of firearm-related homicides, robberies and aggravated assaults. The primary model was adjusted for stratification variables; city-level population, population density, socioeconomic status and firearm purchasing; year; and month.
Findings: Allocation groups were well balanced on baseline characteristics and implementation measures. In adjusted models, allocation to early intervention was not associated with statistically significant differences in any primary outcome measure; these findings were robust to multiple sensitivity analyses. There was some heterogeneity across regions.
Conclusions: The APPS intervention directly affects a very small percentage of the population, limiting its potential for population-level effects. Individual-level analyses may provide a better estimate of the intervention's effectiveness.
期刊介绍：
Since its inception in 1995, Injury Prevention has been the pre-eminent repository of original research and compelling commentary relevant to this increasingly important field. An international peer reviewed journal, it offers the best in science, policy, and public health practice to reduce the burden of injury in all age groups around the world. The journal publishes original research, opinion, debate and special features on the prevention of unintentional, occupational and intentional (violence-related) injuries. Injury Prevention is online only.
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