How to Prevent Firearm Injury Using a Public Health Approach, with Examples and Resources

“Identify data systems and metrics in multiple sectors that help identify state and local-level firearm injury prevention priorities. Stratify the data to understand which communities face the highest burden of firearm injury and deaths.”

Considerations for Identifying Data Systems and Stratifying Data

Take inventory of existing federal data sources on firearm-related harms (injury, death, crime). You may find this CDC resource helpful. Many of these data sources allow for state-level analysis of outcomes:

• National Vital Statistics System (NVSS): Firearm-related death.
• National Violent Death Reporting System (NVDRS): Firearm-related death and preceding individual/family/life circumstances.
• Gun Violence Archive: Though this is not the only archive of mass shootings nationwide, it is the one most consistently used in research.
• National Incident-Based Reporting System (NIBRS): Crimes involving firearms.
  • This Guide to Understanding NIBRS describes the history and use of the dataset.
• Web-based Injury Statistics Query and Reporting System (WISQARS): Fatal and nonfatal injury, violent death, and cost of injury data; by state and county.
• Wide-ranging Online Data for Epidemiologic Research (WONDER): Provides access to multiple health-related databases, including mortality data.
• State/local hospital EHR/trauma registries; no national EHR/registry exists.

Stratify injury and death data by:

• Type (e.g., suicide, homicide, interpersonal violence, different types of shootings, nonfatal firearm injuries).
• Demographics (e.g., age, sex, race/ethnicity, gender identity).
• Geography (e.g., congressional districts, urban/suburban/rural/frontier, county, zip code/census block, tract in urban areas).

Opportunities to Expand Existing Data Systems

• Explore circumstantial data in your violent death reporting system.
• Consider implementing the optional Behavioral Risk Factor Surveillance System (BRFSS) firearm module.
• Explore mapping local jurisdiction crime data.

Examples Stratifying Data to Demonstrate Burden

• The Colorado Department of Public Health and Environment compiles data from a variety of sources through Colorado’s Violent Death Reporting System and the Injuries Among Colorado Residents Dashboard (which has a firearm variable). These systems allow for a more comprehensive understanding of who and which communities are most impacted by firearm-related injury and violence in Colorado.
• California’s Violent Death Reporting System allows the California Department of Public Health to integrate data reports to track trends, understand the circumstances and underlying causes of violent deaths, and translate findings into actionable information.
• New Mexico completed a comprehensive report on firearm injury and violence across the state using multiple data systems and outlining the populations that bear the highest burden.

“Use data to understand risk and protective factors associated with different types of firearm injury and death in the jurisdiction, including individuals’ mental and physical health and safety (past or present), social determinants of health, exposure to violence, racism and discrimination, and access to firearms.”

Risk factors are known indicators or predictors of how likely an individual is to engage in firearm-related behaviors whether unintentionally or intentionally. In some cases, individuals may live in communities with exposure to multiple risk factors, such as socioeconomic instability, access to an unsecured firearm in their household, and a caregiver involved in the justice system. Protective factors are the supports that can be put in place to buffer the risk factor for an individual or community. For example, access to prosocial activities and caring adults, (e.g., through after-school activities, volunteering, and youth leadership opportunities) are protective factors.

Understanding risk and protective factors through data will ensure you implement the most effective evidence-based initiatives into your firearm injury prevention program. Use the CDC's Connecting the Dots tool to learn more about the known risk and protective factors associated with firearm-related harms like suicide, youth violence, and intimate partner violence.

Considerations for Utilizing Data

Review with your data team how your agency is leveraging available surveillance systems to look at risk and protective factors that relate to firearm injury and death.

Many comprehensive surveillance systems like the Behavioral Risk Factor Surveillance System (BRFSS) and Youth Risk Behavior Survey (YRBS) help collect information about both the presence of risk and protective factors, including economic instability and access to a firearm, as well as related health behaviors, like suicidal ideation, exposure to violence, substance misuse, and mental or emotional distress. You can view the breakdown of optional BRFSS modules that states can use by category and YRBS data by topic.

Additional Risk and Protective Factor Data Sources

Note: This is not an exhaustive list. Data sources available to your jurisdiction may vary.

Firearm Access

• RAND State-Level Estimates of Household Firearm Ownership
• National Instant Criminal Background Check System (NICS); data by state
• BRFSS (optional module 23, page 101)
• YRBS (high school survey, page 5)

Exposure to Violence

• NORC Live Crime Tracker
• CDC Funded Firearm Violence Research Findings

Adverse Childhood Experiences

• Healthy People 2030: Adverse Childhood Experiences
• Electronic Health Records

Substance Misuse (alcohol, opioids, other drugs)

• Healthy People 2030: Drugs and Alcohol

Mental/Emotional Distress (depression, anxiety, suicidal ideation, recent loss)

• Healthy People 2030: Mental Health

Physical Violence

• Healthy People 2030: Violence

Domestic and Interpersonal Violence

• National Intimate Partner and Sexual Violence Survey (NISVS)
• National Crime Victimization Survey (NCVS)

Criminal Justice Involvement

• FBI National Incident-Based Reporting System (NIBRS)
• Guide to Understanding NIBRS

Social Determinants of Health

• Economic Stability
• Education Access and Quality
• Health Care Access and Quality
• Neighborhood and Built Environment
• Social and Community Context

Racial and Discrimination

• Racial Equity Impact Assessment
• Health Impact Assessment

Examples Using Risk and Protective Factor Data to Inform Prevention

• An urban county in Kansas examined the roles that built environment and social determinants of health played in community violence outcomes.
• The Pennsylvania Horticulture Society assessed the impact of the protective nature of green spaces in urban areas on outcomes of community violence.
• The Colorado Department of Public Health and Environment assessed firearm access among middle and high school students through its Healthy Kids Colorado Survey. Researchers used this data to publish a profile of unsupervised adolescent access to firearms.
• Nationally, CDC examined firearm storage behaviors in eight states from 2021-2022 to better understand interventions to reduce the risk of access to firearms among certain populations, such as youth.

“Link datasets together to more deeply investigate firearm-related injuries and death and risk factors linked to these issues to expand understanding of the systems and factors that contribute to putting certain individuals and communities at risk.”

Linking available datasets can help you understand associations between risk and protective factors and firearm-related harms. Examples of these associations may include:

• Geographical analyses or individual identifiers (if possible) to bring together law enforcement and hospital data.
• Examining historical redlining and firearm violence outcomes.
• Substance misuse and firearm injury/death indicators.

Considerations for Linking Data

• Of the data sources you identified in Roadmap Step 1.1 and 1.2 (or additional data sources you can access), is there a possibility of linking any of these, whether at the individual level (e.g., person, incident) and/or geographic levels (e.g., county)?
  • Review CDC’s National Center for Health Statistics Data Linkage Program a resource that helps researchers and policymakers answer complex health questions by linking health-related data.
  • Consider challenges your health agency might face with linking data and design your data-linking around lessons learned.
  • Read about challenges and lessons learned from linking datasets in ASTHO’s Overcoming Common Barriers to Data Linkage.
• Can you link datasets with Census data to understand community/societal factors?
• Does your health agency have the staffing/capacity to link or map these datasets (e.g., epidemiologist, GIS mapping, funding, dedicated program staff, etc.)?
• Ensure that your agency has the appropriate data-sharing arrangements in place to link datasets appropriately.

Examples Linking Data to Inform Prevention Efforts

• Building off the model of the social vulnerability index, researchers examined a firearm violence-specific vulnerability index in major cities by linking data about risk factors, social determinants of health, and violence outcomes.
• Colorado’s LINC project is pioneering linking datasets across the state to understand complex risk and protective factors for firearm-related harms. Though their project has not yet linked their data to firearm outcomes, the data collected and case studies are great resources to consider what may be possible in linking data to better understand risk and protective factors.

“Expand quantitative and qualitative data collection within existing or newly created systems in collaboration with partners from hospitals, coroners/medical examiners, criminal justice, health and human services, schools, and individuals with lived experience.”

Considerations for Collecting Additional Firearm-Related Data

• What data are you unable to gather from existing surveillance systems about the knowledge, attitudes, and/or behaviors of firearm owners in your jurisdiction?
• What data are you unable to gather from existing surveillance systems about the knowledge, attitudes, and/or behaviors of those with lived experience from firearm-related harms?
• Where might those two populations intersect and why?
• Read about the lessons learned from four states that created their own state-specific surveys on firearm-related harms in ASTHOBrief "Recommendations for Developing State Firearm Surveys and Applying Findings."

Examples of Expanded Data Collection Efforts

• The University of Colorado School of Medicine and the Colorado School of Public Health conduct the Colorado Firearm Injury Prevention Survey, with funding from the state health department’s Office of Gun Violence Prevention. This survey provides comprehensive, Colorado-specific data and insight into the impact and prevention of firearm-involved harms.
• The California Safety and Wellbeing Survey is an ongoing, all-online survey research project, directed by the California Firearm Violence Research Center at UC Davis with funding from the State of California. This survey provides detailed and timely state-representative data on a wide range of topics related to firearm ownership, preferences, practices, and exposure to violence and its consequences.
• The New Jersey Firearm Report shares findings of a telephone survey conducted in 2022 with the purpose of providing an accurate description of firearm access in New Jersey.
• Results from the 2020 Missouri Firearm Survey, conducted by Missouri Foundation for Health, highlights different beliefs and behaviors involving firearms in communities throughout Missouri.

“Make firearm injury, death, and risk and protective factor data accessible to the public. Contextualize available data to minimize stigma and re-traumatizing affected communities.”

Considerations for Making Data Accessible

• Do you have other dashboards, reports, or dissemination mechanisms for other state or local data you provide as a jurisdiction?
• What resources do you have to improve data visualization and interactivity for public consumption?
• What language should you use to avoid stigmatization of firearm owners or those who have perpetrated or are victims of intentional or unintentional firearm harms?
• Have you incorporated feedback from firearm owners and communities impacted by firearm-related harms into the design and language of the dashboard?

Examples of How States Are Making Data Accessible to the Public

• The California Storymapping Project for Mapping Gun Homicides combines data with storytelling to make information more easily understood.
• The interactive Colorado Firearm Data Dashboard makes a wide range of firearm injury and death data accessible, including firearm ownership rates and policies at state and local levels.
• The New Mexico Gun Violence Data Dashboard allows New Mexico citizens to understand how gun violence intersects with public safety and public health.
• The Washington State Office of Firearm Safety and Violence Prevention provides a comprehensive overview of how researchers are linking and using data as a foundation for policymaking. The Office of Firearm Safety and Violence Prevention Dashboard is an interactive tool for users to view firearm deaths and injuries by type, county, age, and race.

“Include firearm injury prevention in the jurisdiction’s health assessments, shared planning, and health improvement plans. Identify existing resources in the community that may have already outlined these needs.”

Considerations for Embedding a Firearm Prevention Approach into Planning

• Does your upcoming health assessment include any analysis of firearm-related injury and death in your jurisdiction?
• Have you prioritized any firearm-related prevention efforts in past or current health improvement plans?
• What are ways in which you might include the prevention of firearm-related harms or the related risk and protective factors in your planning moving forward?

Examples of Statewide Shared Planning to Build a Comprehensive Community-Based Approach

• The University of New Mexico Prevention Research Center developed a five-year strategic plan on behalf of New Mexico Department of Health’s Epidemiology and Response Division. This Statewide Strategic Plan for Preventing Firearm Injuries and Death in New Mexico, 2021-2026 is a collaboration among New Mexico Department of Health’s Office of Injury Prevention, New Mexicans to Prevent Gun Violence, the University of New Mexico Hospital Department of Surgery, and community stakeholders.
• Colorado’s Public Health Roundtable on Firearm-Related Violence Prevention report showcases how partners from multiple sectors and communities are involved in a statewide effort to reduce firearm-related injury and violence. Through a public health lens, the roundtable presents available data and shared strategies to address root causes of injury and violence.

Jurisdiction Capacity to Prioritize Firearm Injury Prevention

• The Joyce Foundation released its report Making Firearm Safety a Permanent Part of State Government outlining the infrastructure, staffing, funding, and placement of existing state offices of firearm violence prevention.
• The National Opinion Research Center’s 2021 report includes practical steps for building state capacity and infrastructure to use data for evidence-based decision making.

Data Infrastructure

• A Public Health Approach to Firearm Violence: Strengthening Our Nation’s Gun Data Infrastructure outlines Safe States Alliance’s Firearm Infrastructure Workgroup’s action plan to advance recommendations that strengthen the nation’s firearm data infrastructure.
• NORC at the University of Chicago convened subject matter experts to develop a Blueprint for a U.S. Firearms Data Infrastructure.
• County Health Rankings provides county level and national trends on community safety with tools to assist health agencies in moving from data to action.
• The US Census Bureau American Community Survey can help to identify community-level risk for firearm violence.
• The Network of Public Health Law provides an Overview of Data-Sharing Agreements.
• The Rural Health Information Hub is a resource for Rural Data Visualizations.
• The National Academy for State Health Policy developed the Public Health Modernization toolkit, which includes recommended strategies to advance collaboration between Public Health and Health Systems which may help with improved data collection and integration.
• Resources for Conducting Injury Epidemiology are available from the Council of State and Territorial Epidemiologists.

Risk and Protective Factors

• CDC’s Connecting the Dots provides an overview of the shared risk and protective factors associated with multiple forms of violence. The Connections Selector is an interactive tool that helps you visualize how different types of violence share certain risk and protective factors.
• CDC’s Interactive Social Vulnerability Index Map is an interactive tool to visualize local, state, and national levels of social vulnerability.
• This Morbidity and Mortality Weekly Report highlights how monitoring county-level data can be used to help guide tailored prevention efforts by understanding levels of social vulnerability.
• Safe States Alliance’s Connections Lab outlines a self-paced overview of a shared risk and protective factor approach.
• ASTHO’s Introduction to the Shared Risk and Protective Factors Framework is a self-paced presentation that teaches jurisdictions how to implement a shared risk and protective factor framework to improve health outcomes.

“Enhance internal staff capacity to understand the cultural landscape of firearms, firearm ownership, lived experiences of communities affected by firearm injury and violence, underlying risk and protective factors within communities, and the state of the evidence to prevent firearm injury.”

Considerations for Developing Staff Capacity

• Support staff engagement that increases knowledge and awareness of local attitudes and language about firearms, as well as the perspectives of firearm owners and retailers. Talking About “Firearm Injury” and “Gun Violence”: Words Matter highlights the importance of language when addressing firearm injury through a public health lens.
• Additionally, encourage your staff to engage with communities impacted by firearm-related harms. Though academics explore qualitative analyses of the lived experience of those impacted by firearm harms (see Unlocking Gun-Violence Solutions: The Necessity and Power of Lived Experience and Lived experiences of people impacted by gun violence: qualitative analysis of the prescriptions for repair project), it is important to understand the unique experiences of your local communities related to firearms. ASTHO created a tool for developing non-traditional multisector partnerships that may be helpful for staff newer to this type of diverse partner engagement.

Examples of Building Jurisdiction Staff Capacity

• The Joyce Foundation released its report Making Firearm Safety a Permanent Part of State Government outlining the available infrastructure for state offices of firearm violence prevention. The report outlines available funding, numbers and qualifications of staff hired to support each office of firearm prevention.
• Many jurisdictions collaborate closely with academic partners, including the Colorado Office of Gun Violence Prevention and the University of Colorado Anschutz Medical Campus Firearm Injury Prevention Initiative.
• ASTHO is working to create a Firearm Injury Prevention Leadership certificate.

“Determine the feasibility of effective prevention strategies and alignment to the jurisdiction’s priority areas and climate, keeping in mind many effective prevention strategies are less likely to garner political attention. Disseminate effective strategies that prevent risk and promote protective factors for individuals and communities and interrupt the cycle of violence in local communities.”

Considerations for a Breadth of Effective Interventions

• Consider available resources from trusted partners. CDC released Community Violence Prevention and Suicide Prevention Resources for Action to outline best practices for prevention strategies that address risk and protective factors of firearm-related harms.
• Review existing policies for effectiveness to learn if similar initiatives are most appropriate for your jurisdiction. In What Science Tells Us About the Effects of Gun Policies, RAND reviews the effectiveness of a variety of policy initiatives aimed at reducing multiple firearm-related harms.
• Inventory existing evidence-based programs. Blueprints for Healthy Youth Development is a comprehensive registry of evidence-based programs that focus on promoting the health and well-being of youth, families, and communities.
• Explore strategies that effectively address risk and protective factors in other jurisdictions. The Colorado Department of Public Health and Environment and the University of Colorado School of Public Health Injury and Violence Prevention Center developed this Menu of Strategies to Address Risk and Protective Factors to outline policy and systems change strategies that are effective in preventing risk factors or promoting protective factors in a jurisdiction.

Increasing Feasibility of Secure Firearm Storage Interventions

Secure firearm storage is effective at preventing some types of firearm-related harms, and public health often leads education efforts with the public about this best practice. The need for public education about secure storage may be identified a few different ways: through data about secure storage behaviors, legislation that expands to new secure storage options, or policy monitoring that reveals some populations are not accessing or using secure storage options at the same rates of other populations.

Resources and Examples of Public Education About Secure Storage Options

• The Gun Shop Project is an evidence-based public education partnership with firearm retailers to increase conversations about suicide and storage at point of firearm sale.
• The University of Colorado Anschutz Medical Campus developed a Toolkit for Creating Maps to help individuals find temporary firearm storage locations near where they live.
• ASTHO reviewed proposed legislation across the country that addressed secure storage of firearms in this 2024 Health Policy Update.
• The American Academy of Pediatrics Alaska Chapter promoted the Be Smart for Kids safe storage campaign that encourages responsible firearm ownership throughout the state. Participating clinics and schools have access to educational materials and gun locks.
• The Illinois Department of Health’s Pause to Heal campaign raises awareness about the life-saving potential of Firearm Restraining Orders, or “red flag laws.”
• The Michigan State Police and Michigan Department of Health and Human Services partner to provide free gun locks.
• The North Carolina Department of Public Safety NC S.A.F.E. Initiative provides information about safe and secure gun storage.
• The New Mexico Safe Storage Campaign provides information about firearm-related injuries and deaths in New Mexico with links to gun safety and safe storage tips, where to access free gun locks, and a partner toolkit.
• Colorado launched Let’s Talk Guns Colorado to educate residents about secure firearm storage options.
• Through the Safe Gun Storage Texas campaign, the Texas Department of Public Safety makes public resources available to educate Texans about how to teach children about firearm safety, how to talk about safe firearm storage, and different safe firearm and ammunition storage options. Toolkits are available for educators and partners.
• In response to the Governor’s Challenge to Prevent Suicide Among Service Members, Veterans, and Their Families and to increase lethal means safety in Nebraska, a broad coalition of state, business, and nonprofit partners teamed up to develop the Nebraska Firearm Storage Map to promote safe storage options.

“Monitor policies and ensure firearm laws are implemented equitably.”

It is important to keep in mind that the process of implementing policies is cyclical and iterative and relies on continuous assessment and monitoring. Monitoring helps bring visibility to inequities and unintended barriers that surface during implementation and from enforcement. Public education, administrative policy or regulation change, or amendments to policies can help to address these inequities and barriers. Though legal landscapes vary across states and territories, health agencies and their partners can play an important role in drawing attention to implementation challenges and opportunities to improve health outcomes.

Considerations for Policy Monitoring

• When new firearm-related policies are implemented in your jurisdiction, assess the available data indicators to monitor implementation of that policy and help evaluate its impact on firearm-related outcomes.
• Consider additional data sources that may help monitor for unintended consequences of the policy, particularly among populations that already experience disparities in outcomes.
• Consider the unintended consequences policies may have on communities. The Educational Fund to Stop Gun Violence’s Racial Equity Impact Assessment Tool for Gun Violence Prevention describes how one can use Racial Equity Impact Assessments to assess how proposed policy actions might have potentially adverse effects on different racial groups.
• Embed equity into enforcement. The Equitable Enforcement to Achieve Health Equity guide provides information for policymakers and practitioners about how to enforce public health policies equitably.

Examples of Monitoring Policies to Inform Public Health Action

• Researchers in Maryland explored physician knowledge of the Emergency Risk Protection Order legislation passed in that jurisdiction to reduce access to firearms among people at risk for harm. These results could be used to improve policy education for physicians to better exercise the role they play in implementing this legislation.
• Researchers in California assessed differences in implementation of Extreme Risk Protective Orders (ERPOs) across racial and ethnic groups within the state.
• The Colorado Firearm Data Dashboard includes an interactive ERPOs section that shares information about ERPOs and allows the public to view a breakdown of ERPO petitions by county and demographics.

“Build flexibility into jurisdiction-wide programs that allow communities most affected by firearms to prioritize their community risk and protective factors and to identify effective strategies that address challenges at a local level.”

Considerations for Building Flexibility into Jurisdiction-Wide Programs

• Consider how building flexibility into funding opportunities can help address health equity through initiatives led by organizations serving at-risk communities. See ASTHO’s blog about the importance of flexible funding to address a community’s most pressing needs.
• Assess available funding to implement strategies that impact the social determinants of health as well as other strategies that reduce risk and increase protective factors. These strategies may include economic stability and workforce programs, policies that support parenting, mentoring programs, after-school programs, and school curricula that teach healthy relationship development and appropriate coping skills.
• Assess available funding for strategies that directly address firearm-related harms, including strategies like hospital-based violence intervention, partnerships with firearm retailers to prevent suicides, and other efforts to reduce access to lethal means.
• If your jurisdiction has additional funds for the prevention of firearm-related harms, which types of prevention strategies are least funded?
• Can your funding opportunity provide local jurisdictions with the flexibility to implement strategies that address risk or protective factors for violence instead of addressing firearms explicitly? For example, this Alcohol Misuse and Gun Violence report explores the intersection of alcohol misuse prevention strategies and their impact on firearm-related harms.

Examples of State Funding Opportunities

• Connecticut’s Community Gun Violence Prevention Program is funding communities to implement a variety of initiatives like the COMPASS Youth Collaborative which connects people affected by violence with community health workers who provide mental and physical health care resources and connection to mentors and initiatives that help bolster the social and emotional well-being of youth throughout Connecticut.
• Illinois Department of Public Health funded communities to implement secure firearm storage strategies.
• Washington’s Department of Commerce’s Office of Firearm Safety and Violence Prevention distributes grant funds to support state and local efforts to holistically address root causes of gun violence. Their updated Request for Proposals invites Tribal governments and Tribal-led community-based organizations to apply.
• Colorado’s Office of Gun Violence Prevention is funding communities to address firearm-related harms. Colorado funds other initiatives addressing the risk and protective factors of violence outside of the Office of Gun Violence Prevention.

“Collaborate with agencies working with communities most affected by firearm injury to support existing firearm prevention activities or to integrate firearm injury prevention assessments or activities into existing initiatives.”

Considerations for Working with Communities Most Affected

• Involve people with living and/or lived experience. The Prevention Institute created a toolkit for addressing community violence through a health equity lens, centering much of their work on elevating the voices and experiences of those with lived experience impacted by violence.
• Consider how to build new or strengthen existing partnerships. Prevention Institute's Collaboration Multiplier is an interactive tool to help partner organizations identify how they can improve their collaboration to be more effective.

Examples of Partnerships with Communities Most Affected by Firearm Violence

• Recipients of SAMHSA’s Project ReCAST: Resiliency in Communities After Stress and Trauma have many incredible examples of using community voice to inform prevention and healing strategies.
• The Impact of CVI video on Community Violence Intervention addresses the importance of community-led initiatives.
• Project ChildSafe is a comprehensive firearm safety education initiative created by and for firearm owners.
• Researchers from HealthPartners Institute in Minnesota and the University of Wisconsin-Madison School of Medicine and Public Health published their work to build common ground for prevention using the Gun Shop Project, a partnership with firearm retailers to encourage suicide prevention through secure storage and public education.
• The Connecticut State Department of Public Health’s Community Violence Prevention Program builds on existing and forms new partnerships with organizations working to address gun violence at the community-level.
• The University of Colorado launched Pause to Protect in partnership with community members and firearm retailers to create national networks promoting secure firearm storage when someone is in crisis.

“Seek opportunities to increase financial support for community-based interventions. Health agencies can directly fund the implementation of prevention strategies, help communities identify how their existing funding and strategies addressing risk and protective factors may also help prevent firearm injury and violence, braid or layer existing funding for solutions, support communities to access firearm injury prevention funding (federal, foundation), pursue reimbursement policies that support hospital-based interventions, and/or work with additional agencies or foundations to identify innovative funding solutions for strategies.”

Funding Considerations

• Similar to Step 2.4, assess and identify gaps in available funding to implement strategies that reduce risk and increase protective factors.
  • Many funding sources dedicated to substance misuse or chronic disease prevention may allow the funds to be used on the same social determinants and factors known to impact firearm violence.
  • ASTHO offers multiple resources to help you better understand how braiding and layering funding can benefit jurisdictions.
• Assess and identify gaps in available funding for strategies that directly address firearm-related harms. Strategies may include hospital-based violence intervention, partnerships with firearm retailers to prevent suicides, and other efforts to reduce access to lethal means.
• Access available resources to identify new funding opportunities that may be a good fit in supporting your work. Here are some webpages dedicated to identifying available federal funds for prevention and intervention strategies:
  • Everytown’s Support Fund GovGrant Navigator allows you to search available federal funding by Community Violence Intervention Program type.
  • The Health Alliance for Violence Intervention shares Resources on Public Funding for Community Violence Intervention.
  • On its factsheet web page, The White House shares federal funding priorities for Community Violence Intervention initiatives.
• Examine how federal funds are being used in your jurisdiction and identify opportunities for enhancement. The Bipartisan Safer Communities Act made the following investments for the prevention of firearm-related harms:
  • Building Stronger Connections Grant Program to improve safe and supportive learning environments. Find your state’s allocation.
  • Updates to a comprehensive guide for Medicaid school-based services to support mental and physical health services for eligible students in school.
  • Mental Health Service Professional Grant Program
  • School-Based Mental Health Services Grant Program 

Examples of Braided Funding

• Colorado’s Gun Violence Prevention Grant Program is a partnership between the Colorado Division of Criminal Justice and the Colorado Department of Public Health and Environment.
• The Joyce Foundation released its report Making Firearm Safety a Permanent Part of State Government outlining the infrastructure available within state offices of firearm violence prevention, and the different funding sources each state uses to stand up their office and support local prevention work.

“Make funding for diverse prevention approaches available to community-based organizations with minimal administrative burden by improving jurisdiction funding and grant-making infrastructure.”

Considerations for Reducing Funding Burden

Embed equity into your grantmaking practices, where permissible within your jurisdiction’s policies and infrastructure to generate grants or contracts with local communities. This resource by Exponent Philanthropy shares fundamental practices for equitable grantmaking.

Examples of State Efforts to Reduce Burden

• Through the Reimagine Public Safety Illinois Act, the Illinois Department of Human Services Office of Firearm Violence Prevention streamlined and simplified the request for funding process as much as possible. They implemented the following strategies to increase the likelihood that smaller organizations who may lack grant-writing infrastructure could have more time and capacity to apply for a new funding opportunity:
  • Made the content and questions more understandable.
  • Reduced the number of forms required to apply.
  • Made the forms more accessible.
  • Increased the amount of time for response by introducing a rolling funding opportunity.
  • Got an exception to be able to leave the funding cycle open longer.
  • Hired a marketing firm to publicize the available funding opportunity more broadly to partners they may not have worked with prior.
• Colorado enacted HB21-1247 to allow some eligible organizations to receive up to 25% of their annual grant budgets from the state as a cash advance. This allows smaller community-based organizations to access operating dollars more readily without waiting closer to 90 days for reimbursement of expenses.

“Build jurisdiction infrastructure to provide funding, technical assistance, training, and networking opportunities to communities implementing effective prevention strategies.”

Considerations for Building a Technical Assistance Infrastructure

• Support your workforce to close skill and knowledge gaps between what they know to be effective and what they do each day by incorporating principles of implementation science. University of Washington explains the fundamentals of the science of implementation with important recommendations to consider.
• Some practitioners may need support to understand and act for each of the following areas. It is important to assess their current knowledge and developmental needs related to each:
  • Available data.
  • Risk or protective factors.
  • Effective strategies.
  • Culture of firearm use.
  • Impact of firearm violence and trauma on individuals or communities.
  • Political sensitivities or beliefs about firearm policies.
  • Program evaluation.
• Consider what your program may need to support community grantees to do this work well.
• Where appropriate, connect communities with resources from the National Office of Violence Prevention Network.

Examples of Jurisdictions Building Infrastructure to Support Community-Led Efforts

• The Joyce Foundation released its report Making Firearm Safety a Permanent Part of State Government outlining the infrastructure available within state offices of firearm violence prevention to support funding, technical assistance, and networking for communities implementing prevention strategies.
• The Illinois Department of Public Safety funded a variety of technical assistance provider organizations to support effective implementation of prevention and intervention strategies.
• The North Carolina Department of Public Safety and North Carolina Department of Health and Human Services Opportunities for Philanthropy to Support Violence Prevention and Reduction initiative takes a whole of government approach through multi-sector partnerships and philanthropic opportunities to implement violence prevention programs.

“Connect researchers and communities to collaboratively develop research or evaluation questions most relevant to those affected by firearm-related harms.”

This step requires significant trust-building between academic partners and community members to align available funding for research with the research questions most relevant to impact the lives of communities that have experienced violence.

Considerations for Connecting Researchers and Communities

• Build partnerships with academic public health institutions in your jurisdiction.
• Establish a coalition that includes researchers and community representatives.
• Create a directory of researchers, public health practitioners, and other sectors involved in firearm-prevention throughout the state.

Examples of How States Are Connecting Research and Community Partners

• CDC funded National Centers for Excellence in Youth Violence Prevention, many of which are academic and community partnerships for implementation, research, and evaluation.
• The Colorado Firearm Safety Coalition is comprised of gun shop owners, firearm trainers, and public researchers and focuses on advancing suicide prevention and firearm safety.

“Fund (or assist in finding funding for) researchers and evaluators to collaborate with communities to develop, implement, and evaluate prevention strategies not previously studied.”

Example of Leveraging Research and Evaluation to Improve Prevention Strategies

• Colorado Public Health and Environment’s Office of Gun Violence Prevention works closely with and provides funding to the University of Colorado’s Firearm Injury Prevention Initiative and its network of researchers and practitioners to continuously improve their firearm injury prevention efforts. They do this by:
  • Collaborating statewide with subject matter experts to develop, implement, and evaluate evidence-based initiatives that address risk and protective factors of firearm injury and violence.
  • Funding the university to assess the evidence for effective prevention strategies and to update the resource bank as new evidence emerges.
  • Funding the university to evaluate community grantee implementation of prevention strategies.
  • Leveraging quality improvement to inform training and resources that advance statewide firearm injury prevention.

“Expand evaluation of existing prevention strategies addressing risk and protective factors of injury and violence, including firearm-related behavior and outcome metrics.”

Considerations for Expanding Program Evaluation

Ensure evaluation planning is considered from the start of your program and that evaluation efforts are sufficiently funded. Follow CDC best practices for program evaluation.

“Help communities integrate quality improvement into efforts to continue having the greatest impact among communities most affected by firearm injuries and death.”

Considerations for Integrating Quality Improvement

• Develop a quality improvement plan. ASTHO’s Quality Improvement Plan Toolkit may be a helpful resource.
• Learn how to describe process improvement steps, identify techniques to create effective improvement processes, and access resources to support process improvement. ASTHO’s Introduction to Process Improvement will help you get started.
• Health agencies can also follow CDC's best practices for performance management and quality improvement.
• Consider available funding to support your agency’s quality improvement work. Many health agencies have existing quality improvement staff and approaches funded through the Public Health Infrastructure Grant that can help to support community quality improvement efforts.

“Conduct ongoing assessments of the jurisdiction’s capacity to support these efforts by leveraging strengths and minimizing gaps/barriers in infrastructure.”

Considerations for Conducting Ongoing Capacity Assessment

• Revisit the Roadmap and this toolkit to assess changes in your jurisdiction’s capacity to implement each step and leverage new opportunities to improve local prevention strategy implementation.
• Reflect on how emerging research, evidence, and new data can inform future iterations of your prevention planning.