Plate Nº 16 · recorded September 29, 2026
Health & Medicine ResearchReported finding
Smartphone-Aided ER Counseling Cuts Risky Firearm Behavior in Youth
A clinical trial of the IntERact program found telehealth counseling plus a smartphone app cut risky firearm behaviors by 57% in young ER patients at six months.
By Nathan Brooks3 min read666 words
In brief
- Nearly 400 emergency department patients ages 16–30 who had carried a firearm in the past three months participated in the trial.
- IntERact participants showed a 57% reduction in risky firearm behaviors at six months — more than twice the reduction in the standard-care comparison group.
- The intervention combined three telehealth counseling sessions with a mobile app offering daily assessments, tailored therapy content, GPS alerts about high-risk locations, and local resource information.
Firearm violence sends roughly 65,000 U.S. teens and young adults to emergency departments every year, and interpersonal violence causes 60% of all firearm deaths in this age group. A new clinical trial suggests the emergency room itself could become a starting point for breaking that cycle.
The trial, published online in JAMA Pediatrics, tested a program called IntERact, developed at the University of Michigan and housed within the U-M Institute for Firearm Injury Prevention. It found that telehealth counseling sessions, supplemented with digital therapeutic tools delivered through a smartphone app, can significantly reduce risky firearm behaviors — such as threatening or using a gun against another person — among at-risk youth and young adults.
A sharp drop in risky behavior
The researchers enrolled nearly 400 emergency department patients between the ages of 16 and 30. All of them reported carrying a firearm within the previous three months.
Six months after their emergency department visit, patients who received the IntERact intervention showed a 57% reduction in risky firearm behaviors. That decrease was more than twice the reduction seen in the comparison group, which received standard care: information from a social worker about local community violence and substance misuse prevention programs.
The benefits went beyond firearm behavior. Compared with patients receiving standard care, IntERact participants reported less overall involvement in violence, fewer violent injuries, and lower rates of substance use and mental health symptoms such as anxiety and depression.
How the program works
Within 30 days of their emergency department visit, patients randomly assigned to IntERact took part in three telehealth sessions offering behavioral counseling — a form of talk therapy that aims to change patterns of thinking and behavior — along with care management support.
Between sessions, they received digital support through a mobile health app. That support included automated daily check-ins, behavioral therapy content tailored to each user, GPS-enabled notifications warning about high-risk locations, and information about local resources.
"This new data is really promising," said Patrick Carter, director of the Institute for Firearm Injury Prevention and professor of emergency medicine and public health. "We know that youth who engage in risky firearm behaviors are at elevated risk of injuring other people or being harmed themselves, so to see that a preventive intervention delivered in a clinical setting can decrease the risk of these behaviors, as well as associated behaviors such as substance use, that perpetuate the cycle of firearm violence, is really encouraging. Ultimately, it is about keeping young people safe and providing them with the tools they need to avoid violence."
Beyond the emergency department
The researchers point to a practical advantage of digitally augmented programs like IntERact: they could ease the strain on increasingly understaffed emergency departments. Because a remote program can connect to centralized call centers already used by other behavioral management and counseling services, a single emergency department visit could open the door to ongoing support for a young person.
"While IntERact was initially designed for use in an emergency department, we are hopeful that with further testing and adaptation, we can begin using IntERact in other settings as well," Carter said. "Opportunities to implement violence prevention services for youth are numerous and include other clinical settings such as primary care visits, as well as community spaces such as schools, churches and youth criminal justice programs. We need to focus on adapting programs to meet youth and young adults where they are and address the current epidemic of firearm violence with the most effective evidence-based tools we have available."
The findings come from one clinical trial, and the approach will need further testing and adaptation before it can be applied more widely. Still, the results suggest that pairing a routine health care visit with smartphone-based support may offer a scalable way to reach young people at high risk of firearm violence.
Publication: Patrick M. Carter et al., "Efficacy of Technology-Augmented Behavioral Counseling for Risky Firearm Behaviors," JAMA Pediatrics (2026). DOI: 10.1001/jamapediatrics.2026.3893
via Medical Xpress (Source)
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