A University of Michigan clinical trial tests IntERact, a telehealth-based behavioral counseling program paired with a mobile app, aimed at reducing risky firearm behaviors in youth and young adults treated in emergency departments.

The study shows IntERact uses telehealth counseling and a mobile app to reduce risky firearm behaviors among at-risk youth and young adults seen in emergency departments.

Principal investigator Patrick Carter emphasizes the goal of keeping youth safe by equipping them with tools to avoid violence, with broader implementation possible after further testing and adaptation.

Co-authors come from multiple institutions, including U-M Medical School and the U-M Institute for Firearm Injury Prevention, with collaborators from Minnesota and other facilities.

Practically, IntERact could ease burdens on understaffed emergency departments and enable remote delivery integrated with centralized counseling call centers, with potential use in primary care, schools, churches, and youth justice programs.

Researchers see digitally augmented programs like IntERact as scalable solutions that can be delivered remotely after a single ED encounter, reducing staffing needs in busy EDs and expanding to other settings.

In addition to fewer risky firearm behaviors, IntERact participants experienced less overall violence involvement, fewer violent injuries, and lower rates of substance use and mental health symptoms such as anxiety and depression.

Compared with standard care, IntERact participants showed reductions in violence involvement, violent injuries, substance use, and mental health symptoms.

The CDC-funded clinical trial enrolled nearly 400 participants aged 16–30 who had carried a firearm in the past three months, reporting a 57% reduction in risky firearm behaviors six months after an ED visit for IntERact participants.

Six months post-ED visit, IntERact participants exhibited a 57% reduction in risky firearm behaviors, more than twice the improvement seen in the standard-care group.

The trial enrolled nearly 400 patients aged 16–30 who reported carrying a firearm within the past three months and was funded by the Centers for Disease Control and Prevention.

The study is published in JAMA Pediatrics as Efficacy of Technology-augmented Behavioral Counseling for Risky Firearm Behaviors (DOI: 10.1001/jamapediatrics.2026.3893), with collaboration across multiple institutions including University of Michigan.