The Efficacy of Public Health Interventions Aimed at Curbing Gun Violence: An Integrative Review Brian Cook CONCLUSIONS BACKGROUND Focused deterrence interventions are the most effective at reducing gun violence. Epidemiological approaches such as CureViolence programs show mixed success. Future studies should examine why they work in some places and fail in others. Legislative and regulatory approaches can be effective, but their success depends on the specific details of the policies. Though studies haven’t examined its effect on gun violence, sustained cognitive behavioral therapy (CBT) shows success in curbing violent crime in general.8 Americans are more than 25 times more likely to be killed by a firearm than residents of 22 similarly high-income countries.1 Homicide is the second-leading cause of death of Americans between the ages of 15 to 24, and the third-leading cause of death of Americans between the ages of 25 to 34. Eighty percent of all homicides are committed with a firearm.2 Firearm-related deaths are a significant health disparity: Despite being only 13% of the population, African Americans accounted for 50% of all firearm-related homicide victims in 2013.3 African-American males are 14 times more likely to be killed by a firearm than white male Americans.4 NURSING IMPLICATIONS Nurses, especially in urban settings, should advocate for focused deterrence programs. Given CBT’s success in reducing violent crime, its use should be advocated. Researchers examining programs like the Nurse-Family Partnership should examine their effects on gun violence. Nurses should debate whether their political advocacy is best spent on policies with questionable efficacy of reducing violence, such as banning assault weapons. PURPOSE Catalogue different interventions that aim to reduce gun violence. Determine the relative efficacy of these different interventions. RESULTS Overall, 10 studies of different interventions were examined, with the type of intervention falling into four categories: Nursing/Medical, Epidemiology, Criminology, and Public Policy/Legislative. The most consistently successful intervention was Criminology’s “focused deterrence,” which incorporates law enforcement, social service providers and community stakeholders, and targets specific populations, such as gang members. A study in New Orleans found that firearm-related homicides were 17% lower than they were in 14 comparison sites that had been similar pre-intervention.6 A study in Chicago found participants were 23% less likely to be involved in a shooting and 32% less likely to be the victim of a shooting.7 Some Public Policy interventions, such as background checks, show mixed success in reducing gun violence but comprehensive programs can be effective. Banning types of firearms, such as assault weapons, demonstrated no efficacy in reducing firearm-related homicides. The main Epidemiology intervention, CureViolence programs, have a mixed record of success, sometimes working remarkably well and other times having no effects. RESEARCH QUESTION What public health interventions are most effective in reducing gun violence? REFERENCES MATERIALS AND METHODS Grinshteyn, E. and Hemenway D. (2016). Violent death rates: The US compared to other high-income OECD countries, 2010. The American Journal of Medicine, 129(3), 266-73 Grinshteyn, E. and Hemenway D. (2016). Violence Policy Center. (2016). Black homicide victimization in the United States: An analysis of 2013 crime data. Retrieved from http://www.vpc.org/studies/blackhomicide16.pdf “Fatal Injury Reports," Injury prevention & control: Data & statistics (WISQARS), accessed August 3, 2017, http://1.usa.gov/1plX Hemenway, D. and Miller, M. (2013). Public health approach to the prevention of gun violence. The New Journal of Medicine, 368(21), 2033-2035. Corsaro, N. and Engel, D.S. (2015). The most challenging of contexts. Criminology & Public Policy, 14(3), 471-505. Papachristos, A.V. and Kirk, D.S. (2015). Changing the street dynamic. Criminology & Public Policy, 14, 3, 525-558. Heller, S.B., Shah, A.K., Guryan, J., Ludwig, J., Mullainathan, S., and Pollack, H.A. (2017). Thinking, fast and slow? Some field experiments to reduce crime and dropout in Chicago. The Quarterly Journal of Economics, 132(1), 1-54 Databases searched include, CINHAL, EconLit, ProQuest Criminal Justice, and ProQuest Social Sciences Premium. Search terms: public health, gun violence, gun violence reduction, efficacy Guiding theory: Hemenway and Miller’s Public Health Approach.5