Case Synopsis

Gun violence is a growing concern in the City of Toronto. The number of injuries and fatalities related to firearm incidents has been increasing at an alarming rate over the past six or seven years. The Stop The Bleed program is a secondary injury prevention program aimed at training laypeople how to respond during critical incidents to prevent fatal outcomes caused by massive bleeding. Along with the Centre for Injury Prevention at Sunnybrook Hospital, Sarah Smith, a registered nurse working in the hospital’s emergency department, has been given the opportunity to collaborate with multiple stakeholders, including the Black Creek Community Health Centre and the City of Toronto, to pilot a Stop The Bleed expansion program in the city’s at-risk communities. Sarah is aware that several complex variables intertwine to comprise this public health issue and she knows that a multifaceted approach is needed to try to stop deaths resulting from gun violence entirely. However, to determine whether the program expansion is feasible, Sarah must complete a comprehensive planning process that considers the facilitators and barriers to program implementation, including the stigmatization of at-risk communities.

Case Objectives

1. Understand the principles and steps involved in the program expansion planning, implementation, and evaluation.
2. Develop a program expansion logic model for the Stop The Bleed program using evidence informed decision-making.
3. Apply Haddon’s Matrix, a trauma-informed approach, and evidence-informed decision making to plan a program for a complex problem.
4. Identify the facilitators and barriers to working with at-risk communities and explain how health inequities contribute to community/population health.
5. Understand the importance of stakeholder engagement and the consideration of community priorities when designing and implementing this type of program.

Case Study Questions

1. What are the important principles to consider when completing program planning, implementation, and evaluation?
2. Are there benefits to completing an environmental scan before developing the program plan? Why or why not?
3. What social determinants of health should be considered when planning this program? How do health inequities contribute to community/population health and the public health issue of gun violence?
4. How would a logic model be developed for the Stop The Bleed program expansion?
5. How would you evaluate the success or failure of this program expansion?
6. What are some facilitators and barriers to implementing the Stop The Bleed expansion program?


Gun violence, injury prevention, logic model, program evaluation, program planning, social determinants of health, trauma-informed approach, violence-prevention initiatives, stigmatization; youth, Stop The Bleed



Recommended Citation

Kwan, T., Tanenbaum, B., Sibbald, S. (2022). Gun Violence: A Public Health Issue?. in: Darnell, R. & Sibbald, S. L. [eds] Western Public Health Casebook 2021. London, ON: Public Health Casebook Publishing.