Training and practices addressing firearm violence exposure in school-based health centers

This study aimed to characterize training, screening practices, and response supports for community firearm violence exposure among clinical staff in Washington State school-based health centers (SBHCs). We conducted a cross-sectional needs assessment survey of SBHC clinical staff (N = 36 from 19 unique SBHCs), who reported on prior training, current screening practices, use of response supports, and perceived importance of evidence-based tools. Most respondents (75%) reported no prior training in firearm violence screening/intervention. Screening practices varied with 27.8% reported universal screening, 27.8% selective screening, and 44.4% no screening. On-site counseling (83.3%) and safety planning (69.4%) were commonly reported response supports, while safe storage counseling (36.1%) and linkage to community violence prevention programs (22.2%) were less frequent. Perceived importance of evidence-based screening and intervention tools to address firearm violence was high, with 83.3% of respondents rating this as very or extremely important. All respondents reported encountering youth affected by firearm violence exposure in their clinical role. Despite universal exposure to firearm violence among youth served by SBHCs and high perceived exposure, most clinicians reported training deficits and inconsistent screening practices. Findings point to implementation strategies-targeted adaptations, training, and referral development-to strengthen capacity for addressing this leading cause of child mortality.