Exploring the Impact of COVID-Related Stressors, Substance Abuse, and Firearm-Related Risks Among Black, Hispanic, and White Young Adults (RPA Pilot / Seed Project)

"Before the pandemic, young adults had the highest rates of binge/heavy drinking and illegal
drug use, substance use disorder as well as depression and suicidality [2]. The impact of COVIDrelated
stressors on mental health and substance use has especially impacted young adults [6,
7]. A recent study found that 62.9% of young adults reported anxiety or depression disorder,
24.7% started or increased use of substances to cope with the pandemic, and 25.5% seriously
considered suicide in the past 30 days [7]. At the same time, firearm sales have increased
substantially during the pandemic, and 2020 was one of the most violent years in decades [9,
34, 39]. Having a firearm in the household is associated with increased non-fatal firearm
injuries, suicides [11, 14, 17], and homicides [45]. Young adults are at high risk of firearmrelated
injuries and deaths from suicide and homicide [46]. Research shows a link between
substance use and firearm-related risks [3, 4, 8, 28], and adolescent involvement in either risk is
associated with negative outcomes in adulthood [13, 35, 47]. Furthermore, Black and Hispanic
adults have been disproportionately impacted by COVID-related stressors as well as firearm
violence [7, 10, 37, 47]. Delineating the direct and indirect pathways in which substance use and
firearm-related risks are linked, identifying specific factors to target to reduce substance use and firearm-related risks, and understanding how substance use and firearm-related risks differ by gender and race/ethnicity among adolescents and young adults is crucial for tailoring interventions to prevent firearm violence among substance-involved youth [5]. Additionally, understanding how COVID-related stressors have impacted substance use and firearm-related risks among young adults as the pandemic goes on and as society transitions to normal will be
crucial for targeted interventions and future research on risk and protective factors. The
overarching AIM of this study is to gather pilot data highlighting the urgent need to address the
intersection of substance use and firearm-related risks as well as COVID-related stressors that
may impact both risks among young adults and differences in those intersections by
race/ethnicity and gender to develop acceptable and feasible interventions. The specific AIMS
of this study are:
1. To conduct focus groups (n=8 groups) with youth (18-25) and parents of youths (n=5
groups) to better understand the intersection of substance use and firearm-related risks,
the impact of COVID-related stressors on those risks, and acceptability of interventions for
adolescents and young adults.
2. To interview youth (n=20) with firearm-related injuries treated at UK’s Level I Trauma
Center about their substance use and firearm-related risks before and after their injury and
acceptability of interventions to reduce substance use and firearm-related risks.
3. To conduct an online survey, developed from Aim 1 and 2, of at least 1,000 young adults
(18-25) in Kentucky to explore the: (a) nature and scope of firearm-related victimization,
access (including family home, ownership, and plans to get a gun soon), and firearmrelated
risk behaviors among young adults who have, and who have not, engaged in
problem drinking and/or illicit drug use by gender and race/ethnicity; and (b)association of
COVID-related stressors on substance use and firearm-related risks during the pandemic.
4. To provide results to community-based stakeholders for clinical services, public health
practice and policy and to develop an externally funded intervention proposal targeting
youth and young adults to prevent firearm violence particularly among substance-involved
youth."