Evaluating a Digital Intervention to Reduce Aggression and Pro-Firearm Violence Attitudes Among Young Black Males: Pretest-Posttest Feasibility Study.

Background: Pediatric and adolescent firearm injuries and fatalities in the United States have surged to levels not seen since the mid-1990s, marking a critical public health inflection point. Young Black males (ages 15-24) experience firearm-related fatality rates 24 times higher than their White peers. Despite this disproportionate risk, they are less likely to participate in traditional firearm violence prevention programs. This disparity highlights the urgent need for innovative, culturally responsive approaches that address the emotional, behavioral, and social determinants of violence. Objective: This pilot study aims to evaluate the preliminary effects of BrotherlyACT, a culturally responsive, trauma-informed, multicomponent mobile and web-based intervention designed to support young Black males (ages 15-24) in navigating and preventing community violence, substance use, and mental health challenges. The intervention aims to increase access to precrisis support and mental health resources for youth living in low-resource, high-violence settings. Methods: Seventy young Black males with Serious Fighting, Friend Weapon Carrying, Community Environment, and Firearm Threats (SaFETy) scores between 1 and 5 (indicating low-to-moderate firearm violence risk) were enrolled in this prospective pretest-posttest study. Participants completed a psychoeducational component of the BrotherlyACT intervention, consisting of 7 video-based modules. Surveys were administered at baseline and again 4 weeks later to assess changes in attitudes toward guns and violence (Attitudes Toward Guns and Violence Questionnaire), reactive and proactive aggression (Reactive-Proactive Aggression Questionnaire), psychological distress (Kessler Psychological Distress Scale), and depressive symptoms (8-item Patient Health Questionnaire). Paired t tests were conducted to analyze pre-post differences. Results: A total of 70 young Black males (mean age 20.97 years, SD 2.44 years) participated in the study. Nearly half reported recent physical fights (48/70, 69%), gun threats (39/70, 56%), or hearing gunshots in their neighborhood (63/70, 90%). More than 50% (39/70, 56%) reported illicit drug use, and 32 out of 70 (46%) reported substance-related violence. SaFETy scores revealed heterogeneous but elevated exposure to firearm risk factors, particularly in community violence and firearm threats. Postintervention, participants demonstrated a statistically significant reduction in attitudes toward guns and violence (Attitudes Toward Guns and Violence Questionnaire; mean 29.8-26.1, P<.001, d=0.53), with the largest shift observed in "Aggressive Response to Shame" (28% reduction). Reactive aggression significantly declined (mean 10.48-8.67, P=.008, d=0.37), whereas proactive aggression remained stable. Psychological distress and depressive symptoms remained stable. Nearly all participants (68/70, 97%) completed all modules in a single session, with 47 out of 70 (67%) finishing within an hour, suggesting high feasibility and user engagement. Conclusions: Preliminary findings indicate that BrotherlyACT may reduce proviolence attitudes and reactive aggression among young Black males. These results underscore the feasibility and potential impact of culturally responsive digital interventions as a strategy to prevent firearm violence among underserved youth populations.