title: Sentinel Events Preceding Youth Firearm Violence: An Investigation of Administrative Data in Delaware.
abstract: Accurately identifying youth at highest risk of firearm violence involvement could permit delivery of focused, comprehensive prevention services. This study explored whether readily available city and state administrative data covering life events before youth firearm violence could elucidate patterns preceding such violence.
  
  
  
  Four hundred twenty-one individuals arrested for homicide, attempted homicide, aggravated assault, or robbery with a firearm committed in Wilmington, Delaware, from January 1, 2009 to May 21, 2014, were matched 1:3 to 1,259 Wilmington resident controls on birth year and sex. In 2015, descriptive statistics and a conditional logistic regression model using Delaware healthcare, child welfare, juvenile services, labor, and education administrative data examined associations between preceding life events and subsequent firearm violence.
  
  
  
  In a multivariable adjusted model, experiencing a prior gunshot wound injury (AOR=11.4, 95% CI=2.7, 48.1) and being subject to community probation (AOR=13.2, 95% CI=5.7, 30.3) were associated with the highest risk of subsequent firearm violence perpetration, though multiple other sentinel events were informative. The mean number of sentinel events experienced by youth committing firearm violence was 13.0 versus 1.9 among controls (p<0.0001). Within the sample, 84.1% of youth experiencing a sentinel event in all five studied domains ultimately committed firearm violence.
  
  
  
  Youth who commit firearm violence have preceding patterns of life events that markedly differ from youth not involved in firearm violence. This information is readily available from administrative data, demonstrating the potential of data sharing across city and state institutions to focus prevention strategies on those at greatest risk.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: hvo5@cdc.gov.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Sumner
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Maenner
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Socias
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: James A
authors.initials: JA
authors.lastname: Mercy
authors.affiliation: Delaware Division of Public Health, Dover, Delaware.
authors.forename: Paul
authors.initials: P
authors.lastname: Silverman
authors.affiliation: Trauma Department, Christiana Care Health System, Newark, Delaware.
authors.forename: Sandra P
authors.initials: SP
authors.lastname: Medinilla
authors.affiliation: Center for Drug and Health Studies, University of Delaware, Newark, Delaware.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: Division of Analysis, Research and Practice Integration, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Likang
authors.initials: L
authors.lastname: Xu
authors.affiliation: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Hillis
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D003691:Delaware / Q000453:epidemiology; D005389:Firearms / Q000706:statistics & numerical data*; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012307:Risk Factors; D014754:Violence / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot / Q000453:epidemiology*; D055815:Young Adult