Vivek Ashok, MD

Firearm Violence and Health in Policymaker Discourse: Mixed Methods Social Media Analysis Background: Since 2019, firearm violence has remained the leading cause of death for U.S. children and adolescents ages 1–19. This crisis has spurred action from policymakers, health professionals, and advocates. However, political polarization has contributed to divergent views on the causes and appropriate responses to firearm violence. Communication by elected officials, especially on social media, plays a critical role in shaping public opinion and policy agendas. Understanding how state policymakers discuss firearm violence, including the use of causal blame, calls to action, and health-related narratives, can inform more effective public health strategies. Objective: To examine how Pennsylvania state legislators discuss firearms and firearm violence on social media and assess the extent to which their messaging aligns with public health perspectives. Methods: We conducted a two-phase mixed-methods analysis of X (formerly Twitter) posts by Pennsylvania state legislators from 05/27/2017 to 07/26/2022. Posts were grouped into three time periods surrounding the Tree of Life Synagogue mass shooting in Pittsburgh. Using a Boolean search strategy, we identified 4,573 posts related to firearms and firearm violence. After removing reposts and non-English content, we randomly sampled 1,491 original posts (32.6%) authored by 152 unique legislators. Posts were coded using a structured codebook based on the Multiple Streams Framework to capture rhetorical framing, causal blame, and policy content. Interrater reliability was high (Holsti’s coefficient > 0.8). We used chi-squared tests and multivariable logistic regression to assess associations between rhetorical elements and policy mentions, adjusting for time period. Results: Mass shootings were the most frequently referenced category of firearm violence, peaking after the Tree of Life shooting (51% vs 77.1% vs 63.6%, P=.004), while firearm suicide was rarely discussed. Posts using advocacy frames were nearly five times more likely to mention policy (aOR 4.67, 95% CI: 3.55–6.16), whereas those referencing mass shootings (aOR 0.54, CI: 0.37–0.77) or emotional appeals (aOR 0.53, CI: 0.40–0.69) were significantly less likely to do so. Most posts employed general advocacy (aOR 2.97) and vague blame (aOR 8.26), resulting in non-specific policy suggestions. Posts that attributed blame to firearm access were strongly associated with specific policy proposals (aOR 6.37) and inversely associated with general policy mentions (aOR 0.26). Only 9.4% of posts used health frames; when present, they more often referenced physical consequences (43.6% vs 15.9%, P

JMIR Formative Res: Firearm Violence and Health in Policymaker Discourse: Mixed Methods Social Media Analysis #GunViolence #PublicHealth #PolicyMaking #ChildSafety #MentalHealth

Extreme Risk Protection Orders—Ethics for Clinicians This Viewpoint discusses clinicians as legal petitioners of extreme risk protection orders to promote the safety and well-being of patients and communities.

Extreme Risk Protection Orders (ERPOs) can help prevent firearm-related harm — but what’s a clinician’s ethical role?
This powerful piece written by 2nd yr @vivekashok.bsky.social lays out a clear, compassionate path forward. Definitely a must-read! jamanetwork.com/journals/jam...

Extreme Risk Protection Orders—Ethics for Clinicians This Viewpoint discusses clinicians as legal petitioners of extreme risk protection orders to promote the safety and well-being of patients and communities.

Written alongside Drs. Joel Burnett, Amir Pasha, and Chris Knoepke, we explore the ethics of including clinicians as eligible petitioners for extreme risk protection orders. Looking forward to your feedback! #MedSky #Firearms #ERPO

jamanetwork.com/journals/jam...

Have CFTR modulators changed the need for liver and lung... : Liver Transplantation An abstract is unavailable.

#ScholarHighlights Exciting new research alert! Check out Nic Muñoz’s latest publication examining how CFTR modulators are reshaping the landscape of organ transplantation for patients w/cystic fibrosis. Read more here: journals.lww.com/lt/fulltext/...

Informing Families, Protecting Youth: The Case for Clearer Alcohol Guidelines in 200 Words Alcohol remains the most commonly used substance among youth, yet the Dietary Guidelines for Americans (DGA) have historically lacked explicit guidance on its risks for children and adolescents. Witho...

the dietary guidelines tell us how to “make every bite count” - but what about every sip?

federal nutrition guidance still lacks clear alcohol messaging for youth & families.

we @policylabchop.bsky.social say it’s time to fix that.

read our blog+public comment: policylab.chop.edu/blog/informi...

Throwback to an inspiring moment! 🌟 @vivekashok.bsky.social shared his career journey at the Penn/CHOP MedPeds noon conference. From research to advocacy, he continues to drive change at the intersection of medicine and policy. Grateful for his insights and dedication to a healthier future.

📢FUND DON’T FREEZE!📢

Join researchers and academics in DC on February 19th at 12 PM to stand up for research, education, and jobs! Federal attacks on science and academia put all of our futures at risk - let’s show them we won’t back down!

RSVP Here: docs.google.com/forms/d/e/1F...

In Rhode Island -

NIH FUNDING:
$256M

JOBS SUPPORTED:
2212

ECONOMIC ACTIVITY SUPPORTED:
$502M

www.unitedformedicalresearch.org/nih-in-your-...

Medicaid funding for gun violence programs could be threatened Republican Congressman Andrew Clyde, of Gerogia, unveiled the Medicaid Funds Integrity Act to restrict Medicaid funds for gun violence prevention programs.

Second year MedPeds scholar, @vivekashok.bsky.social, was recently interviewed by WHYY News! He emphasized that stable funding of violence prevention programs "would expand services, treat more patients, prevent reinjury, and improve community health." #AdvocacyinAction
whyy.org/articles/med...

A colleague wants to call ICE on a patient. What should you do? Concerns over a patient’s immigration status can create uncertainty and stress in clinic. These five legal points add clarity.

A reminder that HIPAA applies regardless of a patient’s immigration status.

A 6-year-old article from the AMA with evergreen guidance for healthcare providers facing this situation:

www.ama-assn.org/delivering-c...

Research Seminar with Craig Pollack, MD, MHS Craig Pollack is the Katey Ayers Endowed Professor at the Johns Hopkins School of Nursing and in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.

Can Housing Policy Improve Health? 🩺

This Thursday, January 9, Craig Pollack of @johnshopkinssph.bsky.social will dive into the U.S. housing crisis & its profound impact on health.

Learn how housing reform could reduce health inequities brick by brick. Register here: ldi.upenn.edu/events/resea...

Investing In Safety: Reimbursing Safe Firearm Storage Counseling | Health Affairs Forefront State Medicaid organizations must encourage clinicians to prioritize firearm injury prevention.

In support of the White House's issuance of an executive order allowing state Medicaid to reimburse locked storage counseling, we provide a perspective on why this is important, effective, and cost-conscious. #healthpolicy #GVP #MedSky #2024FirearmResearchConf

www.healthaffairs.org/content/fore...

Viewpoint: To address rising firearm-related deaths in the US, public health principles and policies should be applied to regulate bullets.

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Powerful piece by Dr. Eleanor Turi on the importance of preserving and sustaining low-barrier care settings, like mobile vans, for people experiencing homelessness, treating substance use, and caring for wounds. #MedSky #NCSP #compassion #Opioid