Patrick M Carter

University of Michigan | U-M · Department of Emergency Medicine

Introduction: Despite promising reductions in mortality from infectious diseases, premature death is a still major public health problem in Brazil. However, little is known about which diseases and injury mechanisms are the main causes of premature death. This paper aimed to detail trends in leading causes of death among children and adolescents i...

Given increasing opioid overdose mortality rates in the USA over the past 20 years, accelerating the implementation of prevention interventions found to be effective is critical. The Helping End Addiction Long-Term (HEAL) Prevention Cooperative (HPC) is a consortium of research projects funded to implement and test interventions designed to prevent...

Researchers have documented that vacant lot greening can reduce community-level crime and violence. Busy Streets Theory (BST) suggests that residents who are involved in the greening process can help to improve physical environments and build social connections that deter crime and violence. Yet few researchers have explored how community engagemen...

Firearm possession increases the likelihood of hospital visits among adolescents and emerging adults. To better inform prevention practices, we examine data among adolescents and emerging adults (A/EAs; ages 16 to 29) presenting to an urban emergency department for any reason to understand the differences in firearm possession between males and fem...

This Viewpoint argues that academic medical centers should address firearm violence through clinical care, education of health care professionals, research, and public policy discussions.

Firearms are the leading cause of death for high-school age teens. To inform prevention efforts, we characterize the prevalence of healthcare provider (HCP) counseling of caregivers of teens around firearm safety, safety conversation elements, and caregiver receptivity towards counseling. A cross-sectional web survey (6/24/2020–7/22/2020) was condu...

Background Motor vehicle collisions remain a leading cause of unintentional injury deaths among children in the United States. despite the proven effectiveness of child restraint systems (CRS). Laws and public education campaigns have fallen short of ensuring child passenger safety guideline adherence (i.e., correct use of a size-appropriate CRS in...

Firearm injury is a significant public health concern among youth living in the United States. Youth with exposure to violence (ETV) are more susceptible to carrying and using a firearm. Few researchers, however, have examined psychological mechanisms undergirding the association between ETV and firearm aggression. Retaliatory attitudes have been d...

Statement of Purpose The purpose of this study is to determine the association between prior exposure to violence and violent victimization has on firearm carriage among parents. In order to examine this association, the research question examined in this study is, what is the role of exposure to violence and prior victimization on firearm ownershi...

Statement of Purpose Firearms are the leading cause of death for high-school aged youth, with firearm access the most significant risk factor for adolescent firearm injury. Parental rules regarding teen firearm access have not been previously characterized. We estimate prevalence of firearm safety/access rules among parents of high-school age teens...

Researchers have reported that improving the condition of vacant lots through greening (e.g. remediation, mowing, landscaping) can help to reduce fear of crime and violence. Busy Streets Theory (BST) suggests that residents who are involved in neighborhood improvement can help to establish orderly physical environments and social connections that c...

Violence affects people across the lifespan with significant short- and long-term consequences for individuals, communities and society at large. Neighborhood environments play an important role in health and safety outcomes with a demonstrated relationship between some of the poorest socioeconomic conditions and greatest disparities. The purpose o...

Statement of Purpose The emergency department (ED) visit provides an opportunity for initiating opioid prevention interventions. This presentation describes baseline injury-related characteristics among a sample of adolescents and young adults in the ED enrolled in an opioid prevention trial. Methods/Approach Patients (ages 16–30) in the ED comple...

Firearms are a leading cause of injury mortality across the lifespan, with elevated risks for older adult populations. To inform prevention efforts, we conducted a probability-based web survey (12/1/2019–12/23/2019) of 2048 older adults (age 50–80) to characterize national estimates of firearm ownership, safety practices, and attitudes about health...

Loneliness is a public health problem causing morbidity and mortality. Individuals with substance use problems are often lonelier than the general population. We evaluate the longitudinal associations between social influences, substance use, and loneliness among adolescents and young adults recruited from an urban Emergency Department (ED). We use...

Background A pediatric injury prevention course has not been available as a massive open online course (MOOC). Creating a comprehensive topic course is particularly challenging because the traditional, week-by-week linear curriculum design is often a barrier to learners interested in only specific topics. We created a novel, flexible course as both...

The objective of this study was to assess parents’ firearm storage behaviors during the COVID-19 pandemic and characterize reasons why some parents made their firearms more accessible during this time. In June-July 2020, the study team conducted the FACTS National Survey—a cross-sectional, web-based, survey of 2,924 parents and their teens (ages14–...

Firearms are the leading cause of death among young adults. Given community violence is an important correlate of youth firearm carriage, we evaluated: 1) If the association between perceived community violence and firearm carriage is stronger when perceived police bias is greater; and 2) If this moderated association differs by race. Cross-section...

The classical two-arm randomized clinical trial (RCT) is designed to test the efficacy or effectiveness of an intervention, which may consist of one or more components. However, this approach does not enable the investigator to obtain information that is important in intervention development, such as which individual components of the intervention...

Background and objectives Youth violence is an alarming public health problem, yet, violence screening and interventions are not systematically offered in primary care (PC). This paper describes data from a pilot effectiveness-implementation trial of an efficacious youth violence prevention programme (SafERteens). Methods The study was conducted i...

Background: Youth violence is a leading cause of adolescent mortality, underscoring the need to integrate evidence-based violence prevention programs into routine emergency department (ED) care. Objectives: To examine the translation of the SafERteens program into clinical care. Methods: Hospital staff provided input on implementation facilita...

Firearm injury is a significant public health problem in the United States. Almost 40,000 people died and 134,000 were injured in the United States in 2017. Two-thirds of U.S. firearm deaths in 2017 were suicides, just as in every year in the last decade. Although the majority of firearm deaths are White men, the epidemic disproportionately affects...

Unmaintained vacant land in urban areas is associated with a number of negative outcomes for residents of urban areas, including mental and physical health, safety, and quality of life. Community programs which promote land parcel maintenance in urban neighborhoods have been found to reverse some of the effects that unmaintained land has on nearby...

Preventing opioid misuse and opioid use disorder is critical among at-risk adolescents and young adults (AYAs). An Emergency Department (ED) visit provides an opportunity for delivering interventions during a rapidly changing opioid landscape. This paper describes pilot data and the protocol for a 2 × 2 factorial randomized controlled trial testing...

To describe and identify the correlates of firearm purchasing at the beginning of the COVID-19 pandemic among US families with teenagers. In June–July 2020, we conducted a national survey of 2924 parents and their teenagers in the US. We report results from this survey to describe firearm purchasing behaviors following the start of the COVID-19 pan...

The main purpose of this article and this special section is to encourage greater attention to the key gaps that exist in our understanding of the epidemiology of adolescent firearm violence and to provide a pathway forward for future longitudinal research that will inform prevention efforts. This increased attention is especially salient given: (a...

Cannabis-using youth are a large epidemiologic subgroup whose age and smoking-related risks underscore the importance of examining the impact of the COVID-19 pandemic in this population. Within a clinical trial (n = 36 received an intervention prior to data collection reported herein), we surveyed cannabis-using emerging adults (ages 18-25) about p...

Research Summary We examined petition and respondent characteristics from extreme risk protection order (ERPO) cases in Oregon for the 15 months after implementation (n = 93). Most petitions were filed by law enforcement (65%) a were more likely to be granted than petitions filed by family/household members (p < 0.001). Most ERPO respondents were r...

Statement of purpose Preventing opioid misuse and opioid use disorder (OUD) is necessary given the opioid epidemic. Prevention programs for adolescents/young adults are needed to alter risk trajectories. We developed interventions using telemedicine (synchronous video conference) and a patient portal-like messaging system to address risk factors fo...

Statement of purpose To use data from a state-wide opioid overdose surveillance system in Michigan to evaluate changes in opioid overdose frequency during the COVID-19 pandemic. Methods/Approach The System for Opioid Overdose Surveillance (SOS) is a near real-time overdose surveillance system in the state of Michigan run out of the University of M...

Statement of purpose The purpose of this study was to explore how land parcel maintenance is associated with positive mental health outcomes using data collected during community greening efforts conducted in Flint, MI in 2017–2018. Unmaintained vacant land in urban areas is associated with a number of negative outcomes for residents of urban areas...

Youth firearm injury is a worsening public health crisis, and the risks are not distributed evenly. Bottiani et al. skillfully explicated those health disparities, described sociological factors underlying them, and explored avenues for prevention. We supplement their analysis by detailing problems and solutions related to a critical barrier to fir...

Firearm injuries are the second leading cause of child and adolescent death in the United States, with homicides currently responsible for 1915, or nearly 60%, of all firearm deaths occurring in the pediatric population. Rates of pediatric firearm homicide have increased over 20% in the past 4 years, and significant disparities persist with regard...

More than 652 000 people in the US died from firearm injuries between 1999 and 2018.¹ Given that firearms are embedded within US culture (in 2018, 21.9% of individuals owned a firearm and 35.2% lived in households with firearms²) evidence-based public health measures and policies that enhance firearm safety are needed. Firearm injuries are multifac...

Objectives: To evaluate motivations for firearm possession among urban young adults and determine if differences emerge between parents and non-parents, and to identify if storage practices differed according to motivation for firearm possession and parenting status. Methods: We used cross-sectional data among young adults seeking urban emergenc...

Introduction: Prescription opioid use and driving is a public health concern given the risks associated with drugged driving, but the issue remains under-studied. We examined the prevalence and correlates of driving after taking prescription opioids (DAPO) among adults seeking emergency department (ED) treatment. Methods: Participants (aged 25-6...

Introduction Exposure to violence is a risk factor for firearm carriage. Youth exposed to violence also have difficulty envisioning positive future outcomes (e.g., educational outcomes), which can increase the likelihood of firearm carriage over time. Researchers, however, have not yet examined whether changes in exposure to violence over time can...

Objective This study examined the association between baseline substance use and mental health, and non-partner violence trajectories among youth presenting to an urban emergency department who screened positive for drug use. Non-partner violence is physically violent victimization or aggression involving someone other than a dating partner. Metho...

Introduction Youth who carry firearms—and peers that surround them—are at increased risk for violent injuries. Because firearm carriage behaviors can change over time within an individual, it is important to identify individual and social-contextual determinants that explain this within-person variability in carriage. Methods The authors identifie...

Statement-of-Purpose Firearm violence is a leading cause of U.S. mortality. Intensive longitudinal daily data studies [ILDDS] have not examined firearm carriage or same-day/next-day predictors of carriage or violent conflict. Such data are necessary to inform violence interventions. Methods/Approach ED youth/young adults (age=16–29) screening posi...

Statement-of-Purpose Despite a 30% reduction nationwide in new opioid prescriptions since 2012, prescription opioid overprescribing, as well as opioid misuse and overdose remain significant U.S. public health issues. To address a deficit in educational resources/tools for clinical providers and their patients, the Injury Prevention Center (UM-IPC),...

Statement of Purpose Youth violence is a leading cause of morbidity and mortality. Adolescent primary care visits provide an opportunity for violence screening and delivery of interventions, which are not typically offered in this setting. Thus, we examined implementation of an evidenced-based behavioral intervention (SafeERteens) in primary care....

Firearm violence is a leading cause of death for urban adolescents and young adults (A/YAs). Little is known about patterns of risky firearm behaviors (RFBs) that may increase firearm-related fatality and non-fatal injury risk. To inform prevention efforts, we examined the rates and correlates of RFBs, including firearm carriage in risky situations...

What's New Pediatric residents report lack of confidence in providing firearm safety anticipatory guidance. A self-paced online curriculum, including video demonstration of firearms, safe storage options, and counseling methods for families improved resident self-efficacy, confidence, and knowledge surrounding firearm injury prevention counseling.

The original version of the article unfortunately contained a typo in the last author name. The author name was incorrectly listed as Mark Zimmerman. The correct name should be Marc A. Zimmerman.

Firearm injuries are the second-leading cause of death for US children and adolescents (ages 1-18). This analysis quantified the federal dollars granted to research for the leading US causes of death for this age group in 2008-17. Several federal data sources were queried. On average, in the study period, $88 million per year was granted to researc...

Background: The psychosocial correlates and longitudinal trajectories of driving after drinking (DAD) among youth remain understudied in at-risk populations. Objectives: We investigated the relationships of DAD trajectories and negative peer and parental influences, substance use, and mental health among predominantly marijuana-using youth seeking...

Objective: Interpersonal violence is a significant public health problem, with substance use a key risk factor. Intensive longitudinal methods (ILMs) provide data on daily patterns/relationships between substance use and violence, informing prevention. Prior daily research has not focused on these relationships among urban minority samples. Metho...

Firearm carriage is a key risk factor for interpersonal firearm violence, a leading cause of adolescent (age < 18) mortality. However, the epidemiology of adolescent firearm carriage has not been well characterized. This scoping review examined four databases (PubMed; Scopus; EMBASE; Criminal Justice Abstracts) to summarize research on patterns, mo...

Risk and protective factors for firearm assault (FA) have been established, but little is known about factor preceding transitions in FA behavior. We modeled covariate effects on individuals’ transitions in FA behavior (Yes/No) using inhomogeneous, continuous-time, Markov Chains. 3287 assessments were made across five initial biannual follow-ups, a...

Five teams of FACTS researchers conducted a series of rigorous scoping reviews of the existing published scientific literature from the fields of medicine, public health, psychology, behavioral health, and criminology from January of 1985 through April of 2018 utilizing the Preferred Reporting Items for Scoping Reviews (Tricco et al., Ann Intern Me...

Importance Firearm injuries are the second leading cause of death among US children and adolescents. Because of the lack of resources allocated to firearm injury prevention during the past 25 years, research has lagged behind other areas of injury prevention. Identifying timely and important research questions regarding firearm injury prevention is...

Motor vehicle crashes are a leading cause of injury, and teen drivers contribute disproportionately to that burden. Graduated Driver Licensing (GDL) programs are effective at reducing teen crash risk, but teen crash rates remain high. Between-state variation in the teen crash rate reduction following GDL implementation has been documented, but this...

This report details the 10 leading causes for the 20,360 deaths of children and adolescents in the United States in 2016. The analysis also includes trends over time and comparisons among countries.

Introduction: Violence is a leading cause of morbidity and mortality for youth, with more than 600,000 emergency department visits annually for assault-related injuries. Risk for criminal justice involvement among this population is poorly understood. The objective of this study was to characterize arrests among high-risk, assault-injured, drug-us...

Objectives Violence is one of the leading causes of death among youth ages 14 to 24. Hospital‐ and emergency department (ED)‐based violence prevention programs are increasingly becoming a critical part of public health efforts; however, evaluation of prevention efforts is needed to create evidence‐based best practices. Retention of study participan...

Aim: To examine dual trajectories of anxiety/depression symptoms and alcohol use among drug-using youth seeking care from an urban emergency department (ED), their baseline correlates and co-occurring trajectories of severe violence. Short summary: There were five characteristic dual trajectories of alcohol use and depression/anxiety symptoms. C...

Video gaming, a remarkably popular hobby in the United States, has been consistently identified as a correlate of aggressive behavior, and this association is not limited to violent video gaming. Prior studies of sex differences in the association between video gaming and aggression have not controlled for other well-known violence correlates (e.g....

Purpose: Perpetration of violent behavior begins to increase in adolescence and peaks in young adulthood (e.g., age 18-29) before decreasing by the early 30s. Considerable variability in reported perpetration, targets, and severity of violence suggests youth may change their violent behavior patterns over time. Methods: We use latent transition...

The number of children and adolescents affected by firearm violence are staggering. To help you better understand the public health impact, order this print compendium of AAP editor-curated articles with quick access to the latest most salient studies. https://shop.aap.org/pediatric-collections-firearm-related-injuries-and-preventions-paperback/

The number of children and adolescents affected by firearm violence are staggering. To help you better understand the public health impact, order this print compendium of AAP editor-curated articles with quick access to the latest most salient studies. https://shop.aap.org/pediatric-collections-firearm-related-injuries-and-preventions-paperback/

Statement of Purpose The purpose of this study was to develop and pilot test a remote therapy intervention (RTI) for youth with aggression and alcohol use. Methods/Approach First, we conducted secondary data analysis of the SafERteens study. Participants (ages 14–18) receiving a therapist brief intervention (n=215) were classified as responders (2...

Statement of Purpose There is a tremendous need within public health to translate efficacious interventions into sustainable programs. Violent behaviours have enormous impacts on morbidity and mortality among adolescents residing in urban communities. This study aims to implement an evidence-based violence prevention intervention (SafERteens) into...

Statement of purpose Empirical studies of the relationship between aggression and playing violent video games have produced mixed results; one possible reason is the inattention to effect modifiers, such as sex. Our purpose is to analyse the relationship between serious violence perpetration and video gaming frequency among a sample of urban youth,...

Statement-of-Purpose Violence is a leading cause of death for urban youth. This pilot evaluated the feasibility of a remote therapy intervention (RTI) for violence and substance use among drug-using youth seeking Emergency Department (ED) care for assault. Methods Youth (age:14–24) with assault-injury were approached in the ED; those screening pos...

Statement-of-Purpose This analysis examined daily patterns of violence among emerging adults. Methods/Approach Participants (n=352) from a 2 year study (Flint Youth Injury Study) of drug-using youth seeking ED care (for assault or other reasons) were enrolled in a 2nd wave study, in which they were randomised to complete daily or weekly assessment...

Statement of purpose To describe rates and characteristics of criminal arrests in a sample of drug-using, violently injured youth during the 36 months surrounding an emergency department (ED) visit. Methods/approach Participants (ages 14–24) screening positive for past six-month drug use and presenting for an assault (AIG) or as part of a proporti...

Statement-of-purpose On April 25, 2014, Flint’s water source was changed without adding essential anti-corrosive agents, leading to lead contamination of the potable water supply. Individual-level consequences resulting from this community-wide traumatic event have yet to be examined. We examined rates of violence and substance use following the in...

Statement of purpose Partner violence (PV) is associated with long-term health consequences including alcohol and drug use. This study examines severe PV victimisation and perpetration among a sample of drug-using youth seeking emergency department (ED) care, and assesses baseline correlates of PV over 2 years. Methods/approach We consecutively sa...

Firearm homicide is the leading cause of violence-related youth mortality. To inform prevention efforts, we analyzed event-level data to identify unique precursors to firearm conflicts. Youth (ages:14–24) seeking Emergency Department (ED) treatment for assault or for other reasons and reporting past 6-month drug use were enrolled in a 2-year longit...

Objective: To describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network, and assess the influence of both individual and neighborhood factors on firearm-related injury risk. Methods: This was a retrospective, multicenter cross-sectional analysis of children (<19-years-old) presenting to 16 ped...

We describe the self-reported socioeconomic and health impacts, as well as the coping mechanisms employed by a drug-using cohort of adults during the Flint water crisis (FWC) in Flint, Michigan. Participants from an ongoing longitudinal Emergency Department study were contacted between April 2016 and July 2016 and completed a survey focusing on exp...

Background: Interpersonal firearm violence among youth is a substantial public health problem, and emergency department (ED) physicians require a clinical screening tool to identify high-risk youth. Objective: To derive a clinically feasible risk index for firearm violence. Design: 24-month prospective cohort study. Setting: Urban level 1 ED...

Objective Depressive symptoms frequently co-exist in adolescents with alcohol use and peer violence. This paper's purpose was to examine the secondary effects of a brief alcohol-and-violence-focused ED intervention on depressive symptoms. Method Adolescents (ages 14–18) presenting to an ED for any reason, reporting past year alcohol use and aggres...

Aims: This paper examined longitudinal marijuana use trajectories among drug-using youth presenting to the ED to inform intervention development. Methods: Given interest in substance use and violence, this study oversampled those presenting with assault injuries. Assault-injured youth (ages 14-24) endorsing past 6-month drug use (n=349), and a s...

The study sought to describe the occurrence of adolescent driving after drinking (DD) and riding with a driver who had been drinking (RWDD) and associations with substance use for both males and females. As part of screening for a randomized controlled trial, we surveyed 16-20year olds (N=3418) recruited from an emergency department (ED) and analyz...

Study objective: To identify critical emergency medicine-focused firearm injury research questions and develop an evidence-based research agenda. Methods: National content experts were recruited to a technical advisory group for the American College of Emergency Physicians Research Committee. Nominal group technique was used to identify research...

Objectives: To evaluate the impact of the partial repeal of Michigan's universal motorcycle helmet law on helmet use, fatalities, and head injuries. Methods: We compared helmet use rates and motorcycle crash fatality risk for the 12 months before and after the April 13, 2012, repeal with a statewide police-reported crash data set. We linked poli...

Motorcycle crashes result in a significant health burden, including many fatal injuries and serious non-fatal head injuries. Helmets are highly effective in preventing such trauma, and jurisdictions that require helmet use of all motorcyclists have higher rates of helmet use and lower rates of head injuries among motorcyclists. The current study ex...

Adolescent Medicine: State of the Art Reviews (AM:STARs) is the official publication of the American Academy of Pediatrics Section on Adolescent Health. AM:STARs is a series of clinical reviews that detail advances in the diagnosis and management of a wide range of health problems affecting adolescents. Edited by the AAP Section on Adolescent Healt...

Background: Little is known about characteristic profiles of substance use - and their individual- and neighborhood-level correlates - among high-risk youth. Objectives: To identify characteristic substance misuse profiles among youth entering an urban emergency department (ED) and explore how those profiles relate to individual- and community-l...

Background: Violent injury is the leading cause of death among urban youth. Emergency department (ED) visits represent an opportunity to deliver a brief intervention (BI) to reduce violence among youth seeking medical care in high-risk communities. Objective: The objective was to determine the efficacy of a universally applied BI addressing viol...

Background: While the relationship between underage drinking and injury has been well established, few studies have examined whether presenting for an acute injury moderates the efficacy of a brief intervention (BI) on alcohol misuse. Method: Patients (aged 14-20) in the emergency department screening positive for risky drinking (AUDIT-C score)...

Firearms are responsible for more than 33,