About

Ruth M Abaya, MD, MPH, is an Associate Professor of Clinical Pediatrics (Emergency Medicine) at the Perelman School of Medicine at the University of Pennsylvania. She serves as an Attending Physician in Pediatric Emergency Medicine at the Children's Hospital of Philadelphia and is a Practice-Based Scholar at the Center for Violence Prevention there. Additionally, she holds the position of Senior Scholar at the Penn Injury Science Center and is an advisory board member of the same center. Her educational background includes a B.A. from Bluffton University (2005), an MPH in Preventative Health from Northwestern University (2009), and an MD from Northwestern University (2009). Her research and professional focus are centered on firearm violence prevention, community-based efforts to reduce violence, and public health approaches to injury prevention. She has contributed to studies on guaranteed income for survivors of firearm violence, federal funding in firearm violence prevention, and community-based violence reduction strategies. Dr. Abaya's work emphasizes a public health perspective on injury prevention and violence intervention, with a focus on building capacity among violence intervention practitioners and conducting qualitative and feasibility studies in this domain.

Research topics

• Political Science
• Psychology
• Computer Security
• Medicine
• Computer Science
• Medical emergency
• Social psychology
• Law
• Public relations
• Nursing
• Business
• Communication
• Engineering
• Geography
• Philosophy
• History
• Linguistics

Selected publications

• The Impact of Firearm Violence in Black Communities

  RAND Corporation eBooks · 2026-01-01

  bookSenior author

  Firearm violence occurs disproportionately in Black communities. This review of articles focuses on that impact and is intended to support effective public safety strategies and future firearm research. Despite limitations in the available evidence, it is clear that increases in firearm violence are associated with adverse mental health, physical health, educational, and economic outcomes.

  PublisherDOI

• Effects of a Hospital-Based Violence Intervention Program on Community Violence in Boston, Massachusetts

  Annals of Internal Medicine · 2026-01-26 · 1 citations

  article

  BACKGROUND: Hospital-based violence intervention programs (HVIPs) are widespread, but their effectiveness for violence prevention is unclear. OBJECTIVE: To determine the effects of Boston Medical Center's HVIP on future violence outcomes among violently injured young adults. DESIGN: Target trial emulation using observational data. SETTING: Boston, Massachusetts. PARTICIPANTS: Young adults aged 16 to 34 years who survived a shooting or stabbing. INTERVENTION: Target trials of 2 treatment strategies using the same eligibility criteria, time zero, and control group were emulated: 1) any treatment: engaging with the HVIP within 1 month of injury and 2) sustained treatment: initiating within 1 month and engaging more than 4 of the first 8 weeks. MEASUREMENTS: Combined measure of violent reinjury or violence perpetration at 1, 2, and 3 years, using hospital and police data. RESULTS: 1328 patients met criteria; 565 (42.5%) initiated within 1 month. Of these, 58 (10.2%) sustained engagement. In the any-treatment analysis, estimated cumulative incidence was roughly equal between the treatment and control strategies at 1, 2, and 3 years. In the sustained engagement analysis, treatment was associated with considerably lower cumulative incidence (4.5% [95% CI, 1.1% to 9.3%] at 1 year; 5.1% [CI, 1.1% to 9.3%] at 2 years; 6.4% [CI, 1.4% to 12.9%] at 3 years) versus the control strategy (8.7% [CI, 6.6% to 10.0%] at 1 year; 12.3% [CI, 10.2% to 14.5%] at 2 years; 14.3% [CI, 11.8% to 16.6%] at 3 years), with corresponding risk reductions of 47.6% (CI, -19.8% to 86.7%), 58.5% (CI, 21.6% to 91.2%), and 55.3% (CI, 4.9% to 90.2%). Confidence intervals were wide. LIMITATION: Despite our target trial emulation approach, results could be confounded by unmeasured factors associated with program engagement. CONCLUSION: Although HVIPs can improve long-term violence outcomes, these effects seem to require intensive participant engagement. PRIMARY FUNDING SOURCE: Fund for a Safer Future.

  PublisherDOI

• An Antiracist Approach to Firearm Injury Prevention Screening and Safety Counseling

  PEDIATRICS · 2025-09-09

  article

  Since 2019, firearms have been the leading cause of death for children and adolescents aged 1 to 19 years.1 In response, some clinicians and health systems have recognized that providing families with counseling on secure firearm storage and firearm injury prevention falls within their scope of practice.2 Storing firearms unloaded, locked in a safe, and separate from ammunition is an evidence-based practice to reduce firearm injury.2Stark disparities in firearm injury rates among racial and ethnic minority groups,3–5 including Black, Hispanic, and American Indian/Alaska Native (AI/AN) populations, alongside rising firearm ownership rates among these groups, highlight the need to recognize and address the effects of racism on firearm ownership and firearm injury prevention.6,7 This commentary presents an antiracist framework for firearm injury prevention screening and safety counseling in clinical settings.An antiracist approach recognizes that policies and practices can either perpetuate or disrupt racism and seeks to intentionally design systems that advance racial equity.8 In the context of firearm safety counseling, this approach involves identifying and anticipating inequities that could result from existing counseling strategies and proposing alternative interventions that actively counteract or mitigate the effects of racism. Specifically, this framework addresses racism at structural, institutional, and interpersonal levels and offers strategies for intervention development, safety risk assessment, documentation, resource distribution, and family- and community-centered support (Figure 1).9,10 Applying an antiracism framework to firearm safety counseling could improve equitable access to resources that reduce firearm injury risk.Most existing literature on firearm ownership among racial and ethnic minority communities focuses on Black or African American individuals. Structural racism likely also shapes firearm ownership practices for Hispanic, Asian American, and AI/AN families, yet there remains a notable gap in research on firearm access, ownership, and storage practices in these communities. We offer strategies that could apply broadly across racial and ethnic minority populations.Disparities in firearm victimization are caused by policies and practices rooted in racism. Discriminatory policies, such as redlining, have contributed to increased firearm violence within Black communities in the United States. Redlining and associated financial disinvestment by banking and real-estate institutions reshaped the built environment in these communities, creating segregated areas of concentrated poverty, limited employment and educational opportunities, and decreased access to health care.11–14 This concentration of poverty and limited economic resources and opportunities increases the likelihood of firearm violence.15 Consequently, children from racial and ethnic minority groups are disproportionately impacted by firearm violence.4Black, AI/AN, and Hispanic adolescents are more likely to be victims of firearm homicides than their white counterparts.4 Between 2019 and 2020, firearm suicide rates increased for AI/AN males aged 10 to 44 years, and in 2022, the rate of firearm suicide among Black youth aged 10 to 19 years in the United States outpaced the rate among white youth for the first time.5,16 Additionally, from 2019 to 2023, the crude death rate from unintentional firearm injuries among Black children has remained 5 times higher than that of white children.17Simultaneously, firearm ownership rates among racial and ethnic minority adults have increased from 2015 to 2021, with surges in purchasing during the COVID-19 pandemic.6,7 In a survey study conducted from January 2019 to April 2021, 21% of new firearm owners identified as non-Hispanic Black adults, compared with 9% prior to 2019.6,7 Additionally, 20% of new firearm owners during this period self-identified as Hispanic.6 In a nationally representative 2022 survey of 527 individuals self-identifying as AI/AN, 45.5% reported access to a firearm.18Although motivations behind this trend are an active area of research, historical contexts may provide some insights. During the Jim Crow era, laws rooted in white supremacy barred racial and ethnic minority individuals from legally owning or purchasing firearms.19,20 These laws were founded on racist beliefs that Black individuals were inherently dangerous and intentionally disarmed and disempowered Black communities to reinforce social hierarchies and suppress resistance.20 For example, the 1967 Mulford Act in California, which prohibited public carrying of loaded firearms, was crafted in response to the Black Panther Party’s armed patrols against police brutality.21Similarly, firearms were used as a tool of oppression, colonization, genocide, and forced removal of AI/AN individuals from their ancestral land.22 Despite this history, firearm ownership has remained high among AI/AN individuals, partly due to the critical role of firearms in subsistence hunting and other AI/AN cultural practices.22 Understanding this history is critical to engaging patients in culturally responsive safety counseling.An antiracist approach to firearm safety intervention development requires recognizing racism as a root cause of disparities in firearm injury, acknowledging the diversity of firearm owners and reasons for firearm ownership, and challenging racial stereotypes related to ownership.23–25 Regarding the latter, one study found that white individuals with anti-Black bias were more likely to associate firearm rights with white Americans and were less supportive of extending those rights to Black Americans.24 In reality, some Black Americans and first-generation immigrants may see firearm ownership as an exercise of their rights and a strategy for self-protection against racism.17,18 For example, during the COVID-19 pandemic, firearm ownership among Asian Americans increased, motivated in part by experiences of interpersonal racism.25Firearm injury prevention interventions should therefore center on safety and avoid questioning families’ motivations for firearm ownership. Although evidence demonstrates that the safest home is one without firearms, we recognize that removing firearms from the home may not be a feasible or desirable first step for some individuals.2,26–29 Pediatricians should adopt strengths-based, family-centered approaches to collaboratively develop firearm safety practices that honor families’ values while reducing the risk of intentional or unintentional injury.For instance, a caregiver may choose to keep a loaded firearm in her car while driving through an unsafe neighborhood to take her son to school. This decision might reflect her concern for her family’s safety and commitment to her child’s education. These priorities should be recognized and affirmed as strengths. Rather than focusing on risk alone, a clinician might ask: “How can we work together to find a way for you to feel safe, get your child to school, and also reduce the chances that your child or someone else could gain access to your firearm, leading to an injury?” This reframing could create space for shared problem-solving that aligns evidence-based recommendations with the caregiver’s lived experience and values, grounding firearm safety counseling in empathy, trust, and collaboration. Positive individual-level interactions between providers and patients around firearm injury prevention have the potential to mitigate disparities and enhance trust.Health systems should aim to implement trauma-informed and targeted universal approaches to firearm safety counseling.30 All health care providers should be trained in performing firearm safety counseling in a trauma-informed manner, as this has been noted as a critical barrier to implementation.2 A trauma-informed approach recognizes that many racial and ethnic minority families experience trauma related to community and racialized violence, discriminatory policing, and systemic inequities. For some families, firearm acquisition may represent a rational response to lived experiences of danger and the absence of reliable institutional protections. Trauma-informed counseling seeks to understand families within this social and historical context and to partner with them to promote safety in a respectful, nonjudgmental way. Examples of trauma-informed techniques for addressing safety risks could include encouraging incremental steps toward safety, such as the purchase of a lockbox or safe, and identifying local spaces where children and families can gather safely and feel supported.31Recent evidence suggests that patients from racial and ethnic minority groups are less likely to be screened for firearm access.32 However, a recent national survey found that unsecure firearm storage is most prevalent among Black firearm owners, suggesting that individuals from this community might be most likely to benefit from safe storage interventions.33 Although universal screening and counseling may help mitigate stigma and maximize the reach of firearm safety interventions, targeted universalism goes a step further by refining strategies to assess and address safety risk within specific subpopulations, improving outreach and intervention effectiveness and preventing unintended consequences, such as erosion of trust. This approach reflects an antiracist commitment to equity rather than equality, addressing community-specific barriers and engaging local partners to co-design outreach and assessment tools that achieve a common goal across all populations.For example, Da El Siguiente Paso, a national public education campaign on secure firearm storage featuring 2 Hispanic fathers and firearm owners, was created by the Ad Council to maximize the cultural relevance of safe storage messaging for Hispanic firearm owners.34 In another example, a pilot intervention in 2 predominantly Alaska Native villages in Bristol Bay, Alaska, partnered with local village public safety officers, firearm owners, and medical, mental health, and law enforcement professionals to co-develop a firearm safe and trigger lock distribution program. At a 3-month follow-up, 86% of the safes distributed were in use with firearms stored inside, demonstrating both feasibility and cultural acceptability.35Health systems should ideally track rates of screening and resource provision across demographic groups to identify and address inequities as they arise. One strategy to achieve this could involve a quality improvement analyst regularly tracking rates of firearm safety screening and resource provision, disaggregated by race, ethnicity, preferred language, and insurance status. Additionally, health systems should ideally provide multilingual educational materials on safe storage to improve access for families who prefer a language other than English.Health systems adopting firearm injury prevention screening should ensure they have the resources to support families effectively. Rather than just documenting families’ firearm storage practices, health systems should provide tangible, concrete resources like educational information about secure storage practices, locking devices, and temporary storage maps.Health systems should also ensure their own practices reflect antiracist principles, for example, through thoughtful and nonjudgmental documentation of firearm safety discussions in electronic health records. Documentation that avoids stigmatizing phrases, such as “family refused [firearm safety counseling],” may help preserve patient-provider trust, especially given that patients and families can access their medical records. Instead, providers could use phrasing that emphasizes families’ strengths and priorities, such as “family expressed a strong commitment to protecting their child from community violence. Educational materials on firearm safety were provided, and they were open to discussing this further at future visits.”Biases in documentation of firearm practices could also lead to unintended consequences if used inappropriately to, for example, support child neglect reporting.36,37 For example, a caregiver may be documented as engaging in unsecure storage despite never receiving education on how to store their firearm safely. This documentation could then be misinterpreted as neglect, despite the issue stemming from a lack of awareness and access to safe storage resources.38,39 Documentation of firearm storage practices should only be linked to child neglect cases if these practices directly result in injury or are adjudicated separately under child access prevention laws. Standardized documentation templates that minimize bias may help mitigate these risks.Clinicians should guide patients along a spectrum of storage practices toward the safest standards, identifying opportunities for education, shared decision-making, and support, and building on shared values like family safety and well-being.Successful implementation of an antiracist approach to screening and counseling also requires authentic, longitudinal partnerships with community-based organizations (CBOs) engaged in firearm injury prevention. External partnerships should avoid exacerbating existing inequities and eroding trust. For example, referring families to law enforcement agencies to obtain locking devices may have unintended consequences, as protection from law enforcement has been cited as a reason for firearm purchasing among racial and ethnic minority individuals.18,23,40 Although law enforcement agencies can be important partners in firearm safety promotion, health systems should, when possible, invest in community-based device distribution as an additional approach. For example, Youth Empowerment for Advancement Hangout (YEAH Philly) is a CBO that serves the community near our hospital and primary care sites and that promotes violence prevention among Black adolescents and young adults through peer mediation, conflict resolution, and community-based distribution of firearm locks.41Family and community involvement is critical to promoting culturally responsive firearm safety strategies. Gathering ongoing feedback from families from minoritized racial and ethnic backgrounds can help ensure strategies are responsive to community needs.Structural, institutional, and interpersonal racism may influence clinicians’ ability to provide effective firearm safety counseling to patients and families from racial and ethnic minority groups. Health systems engaging in firearm safety counseling should aim to mitigate individual and institutional biases, use data to identify and address disparities, and prioritize community partnerships. By embedding antiracist principles into aspects of firearm injury prevention, health systems can better serve diverse communities and advance health equity.

  PublisherDOI

• Community-Based Efforts to Reduce Violence: A Scoping Review on the Implementation of Cure Violence

  INQUIRY The Journal of Health Care Organization Provision and Financing · 2025-07-28 · 3 citations

  reviewOpen access

  This scoping review aimed to identify implementation determinants, strategies, mechanisms, and outcomes of Cure Violence (CV) programs to develop an Implementation Research Logic Model (IRLM) and integrate Implementation Science (IS) principles into community violence intervention research and practice. Following Mak and Thomas methodology, we conducted a comprehensive literature search across multiple databases, including peer-reviewed articles and grey literature from 2008 to 2023. Data extraction focused on implementation constructs, study characteristics, and CV intervention details. Thematic analysis was used to synthesize findings and develop the IRLM. The review included 29 publications covering 19 distinct CV programs, primarily in the United States. While 62% of studies incorporated IS elements, only one explicitly mentioned using an IS framework. We identified 42 implementation strategies across 6 categories: hiring and retention, training, violence interruption and detection, identifying and treating high-risk individuals, changing community norms, and general implementation and sustainability. Key contextual determinants influencing implementation included funding stability, community trust, and staff characteristics. The adapted IRLM visually depicts the relationships between implementation strategies, mechanisms, and outcomes. This review highlights the need for greater integration of IS principles in CV research and practice. The proposed IRLM provides a framework for practitioners to guide implementation and for researchers to design more rigorous studies unpacking the layers of implementation, including strategies, mechanisms, and outcomes that contribute to the variation in the effectiveness of CV across different contexts. Future research should focus on testing specific implementation strategies and measuring a broader range of implementation outcomes beyond fidelity.

  PublisherDOI

• Community-Based Efforts to Reduce Violence: A Scoping Review on the Implementation of Cure Violence

  CrimRxiv · 2025-08-07

  reviewOpen access

  This scoping review aimed to identify implementation determinants, strategies, mechanisms, and outcomes of Cure Violence (CV) programs to develop an Implementation Research Logic Model (IRLM) and integrate Implementation Science (IS) principles into community violence intervention research and practice. Following Mak and Thomas methodology, we conducted a comprehensive literature search across multiple databases, including peer-reviewed articles and grey literature from 2008 to 2023. Data extraction focused on implementation constructs, study characteristics, and CV intervention details. Thematic analysis was used to synthesize findings and develop the IRLM. The review included 29 publications covering 19 distinct CV programs, primarily in the United States. While 62% of studies incorporated IS elements, only one explicitly mentioned using an IS framework. We identified 42 implementation strategies across 6 categories: hiring and retention, training, violence interruption and detection, identifying and treating high-risk individuals, changing community norms, and general implementation and sustainability. Key contextual determinants influencing implementation included funding stability, community trust, and staff characteristics. The adapted IRLM visually depicts the relationships between implementation strategies, mechanisms, and outcomes. This review highlights the need for greater integration of IS principles in CV research and practice. The proposed IRLM provides a framework for practitioners to guide implementation and for researchers to design more rigorous studies unpacking the layers of implementation, including strategies, mechanisms, and outcomes that contribute to the variation in the effectiveness of CV across different contexts. Future research should focus on testing specific implementation strategies and measuring a broader range of implementation outcomes beyond fidelity.

  PublisherOA PDFDOI

• POLITENESS IN NONVERBAL COMMUNICATION: A COMMENTARY ON NON-VERBAL COMMUNICATION IN A LINGUISTICS CLASSROOM CONTEXT IN A SELECTED KENYAN UNIVERSITY

  European Journal of Applied Linguistics Studies · 2023

  1st authorCorresponding
  • Political Science
  • Linguistics
  • Psychology

  The aim of this article was to explain the effects of politeness as entailed in nonverbal language use in the instructional process. Non-verbal communication skills also known as silent language, include all behaviours performed in the presence of others or perceived either consciously or unconsciously. Nonverbal communication entails; facial expressions, body movements, posture, gestures, eye contact, touch, dressing, space, voice and paying attention to inconsistencies. All these are synchronized to reinforce verbal messages, clarify meaning and create a sense of the speaker’s presence and purpose. Thus, instructors in a classroom setting determine whether a message sent has been received majorly through immediate nonverbal feedback. This paper tries to substantiate the pivotal role enhanced by body language and the impression both the teacher and the student draw from using nonverbal language and the politeness issues that are accrued to such usage. The study adopted the qualitative method and used observation and the data collection procedures were observation and focus group discussions. The findings indicated that instructors/ lecturers use politeness through diverse nonverbal cues during their linguistics lessons in order to convey the relevant message to students. This enables the students to grasp the major concepts being learned and at times the use of nonverbal consciously or unconsciously posed a threat to both the negative and positive faces of lecturers and students.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0031/a.php" alt="Hit counter" /></p>

  PublisherOA PDFDOI

• Politeness Strategies in Computer Mediated Communication (CMC): An Issue of University Professors and Students.

  International Journal of Linguistics Literature & Translation · 2023-08-13

  articleOpen access1st authorCorresponding

  This paper examines the politeness theory in the light of Austin & Searle’s speech act theory as reflected in CMC between students and their lecturers or supervisors. Thus politeness aspects were analyzed as enacted in the five categories such as: Assertives, commisives, directives, expressives, and declaratives. The paper also examined politeness in other language aspects that are usually present in any form of communication, such as: Address phrases, meeting requests, request for reply, and adjunct phrases. The objective of this article was to shed light on the politeness strategies employed by the lecturers and students in their e-communication through Whatsapp and SMS (short messages or text messages) platforms. Fifty communications were downloaded from the lecturers’ phones through their permission and the students’, which were used as data for this study. Five lecturers and seven postgraduate students made the population of this study. The findings indicated that students seem to be comfortable using this mode of communication, and it is important to understand how students and lecturers make choices and how these choices affect the perception of the cultural appropriateness of CMCs. The results also revealed that elements of politeness greatly decrease in the follow-up messages, that is, messages that require some kind of response. From the study, lecturers adhered to formal language use as compared to the students in their communication.

  PublisherOA PDFDOI

• Reducing Harm — Having Conversations about Firearm Storage

  New England Journal of Medicine · 2023

  1st authorCorresponding
  • Medicine
  • Medical emergency
  • Psychology

  In this video from the New England Journal of Medicine, Drs. Emmy Betz (University of Colorado), Ruth Abaya (Children’s Hospital of Philadelphia), and Sandra McKay (University of Texas) discuss the importance of clinicians having conversations about firearm safety and storage with patients and families, and they outline high-yield opportunities to have such conversations. The video also shows several different types of gun safety and storage devices.

  PublisherDOI

• 0044 Assessing the acceptability, feasibility, and uptake of a collective impact model to address gun violence: a case study of code red PA

  Abstracts · 2021

  Senior authorCorresponding
  • Political Science
  • Computer Security
  • Computer Science

  Statement of purpose Gun violence is a multi-faceted, complex public health problem, historically underfunded in research. With an uptick in funding gun violence research, we are better able to build the evidence around impactful community-based interventions, state laws, and policies. The collective impact model offers a promising strategy to implement change at a large scale with broad, cross-sector collaboration. Evidence suggests that in order for collective impact initiatives to be successful, five conditions must be in place: a common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and backbone support organizations. Methods/Approach The current study applies implementation research methods to examine the success or failure of applying the collective impact model to address gun violence at a large scale. To do this, we use Code Red PA, a cross-sector, statewide initiative in Pennsylvania with the collective goal of reducing gun violence in PA, as a case study. Given the diverse gun culture in Pennsylvania, and the overall complexity of the problem, a collective impact approach is well justified. We will collect data from in-depth, key-informant interviews, observations, and relevant documents, and examine outcomes related to the acceptability, uptake, and feasibility of adopting the tenants of collective impact. Results/Conclusions Results from this study will inform how Code Red PA is successfully adopting a true collective impact model. Broadly, results will also inform how the collective impact model can be effectively applied to gun violence efforts in other states and municipalities. Significance This is the first known study to examine the feasibility of a collective impact model to reduce gun violence. As new evidence related to the effectiveness of gun violence strategies become available, we need to understand how to best implement these strategies using the tenants of collective impact that are often required to address complex problems.

  PublisherOA PDFDOI

• Characteristics and behavioral risk factors of firearm-exposed youth in an urban emergency department

  Journal of Behavioral Medicine · 2019-08-01 · 27 citations

  article1st authorCorresponding
  PublisherDOI

Frequent coauthors

• Joseph J. Zorc

  Children's Hospital of Philadelphia

  22 shared

• Richard J. Scarfone

  Children's Hospital of Philadelphia

  21 shared

• Eva M. Delgado

  Children's Hospital of Philadelphia

  21 shared

• Bonnie Rodio

  Children's Hospital of Philadelphia

  20 shared

• Ann Marie Reardon

  Children's Hospital of Philadelphia

  20 shared

• Denise Simpkins

  Children's Hospital of Philadelphia

  20 shared

• Elizabeth D. Moxey

  Children's Hospital of Philadelphia

  19 shared

• Vaidehi Nayar

  Children's Hospital of Philadelphia

  19 shared

Labs

• Ruth M Abaya LabPI

Awards & honors

• Guaranteed Income for Survivors of Firearm Violence in HVIPs…
• The Critical Role of Federal Funding in Combating Firearm Vi…
• Community-based efforts to reduce violence: A scoping review…
• An Anti-Racist Approach to Firearm Injury Prevention Screeni…
• Guaranteed Income: An Innovative Strategy for Reducing Firea…