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 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 the characteristics of their peers. 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. 

Project Status
In progress

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