{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:41:31Z","timestamp":1792377691870,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rural communities in the US are experiencing the fastest growing rate of suicide, where firearms are the leading cause of death for youth ages 14 to 18. This study investigates the mental health and firearm exposure burden among this age group in rural Pennsylvania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed survey results from 1570 high school students ages 14 to 19 to identify the local prevalence of firearm violence exposure. Logistic regression models estimated the association between exposure and depression among students and their interest in violence prevention education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results indicate a high prevalence of exposure to firearm violence overall, with only a third of students not exposed to any form. Exposure was associated with elevated odds of depression, especially among students reporting knowing someone who had tried to harm themselves with a firearm. Exposure was associated with elevated interest in several firearm safety topics related to risk identification and coping with trauma, although several topics had high broad interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice and Equity<\/jats:title>\n                    <jats:p>These insights can translate into the adaptation of existing safety training and suicide prevention tools that are culturally sensitive, acceptable, and feasible to rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Existing prevention programs in rural schools may be refined to incorporate widespread exposure to firearm injury and broad interest in firearm safety education.<\/jats:p>\n                  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