Changes in Firearm and Medication Storage Practices in Homes of Youths at Risk for Suicide: Results of the SAFETY Study, a Clustered, Emergency Department-Based, Multisite, Stepped-Wedge Trial.
Journal
Annals of emergency medicine
ISSN: 1097-6760
Titre abrégé: Ann Emerg Med
Pays: United States
ID NLM: 8002646
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
13
11
2019
revised:
16
01
2020
accepted:
05
02
2020
pubmed:
21
4
2020
medline:
8
9
2020
entrez:
21
4
2020
Statut:
ppublish
Résumé
We evaluate whether a counseling intervention implemented at the hospital level resulted in safer firearm and medication storage by caregivers of youths aged 10 to 17 years after their child's evaluation in the emergency department (ED) for a behavioral health concern. We used a stepped-wedge clustered design rolled out at 4 hospital sites to assess primary preregistered outcomes (self-reported storage changes caregivers made to household firearms and medications), assessed by survey 2 weeks after the ED visit. Three logistic models provided estimates of the intervention effect: an unadjusted model, a model with hospital-level fixed effects, and a model that further adjusts for time. Of the 575 caregiver participants, 208 were firearm owners (123 in usual care, 85 in the intervention). Baseline (pre-ED visit) characteristics did not differ between usual care and intervention phases. During the 2-year study period, twice as many caregivers whose child visited the ED after (compared with before) a hospital adopted the intervention improved firearm storage and 3 times as many improved medication storage (odds ratio [OR]=2.1 [95% confidence interval {CI} 1.0 to ∞] and OR=3.0 [95% CI 2.2 to ∞], respectively). After adjusting for time, the intervention effect for medications persisted (OR=2.0 [95% CI 1.0 to ∞]); the effect on firearms did not (OR=0.7 [95% CI 0.1 to ∞]). To our knowledge, this study is the first controlled trial to estimate the effectiveness of an intervention on firearm and medication storage in homes of youths at elevated risk of suicide. We found evidence that caregivers' medication storage improved after their child's ED visit, with evidence suggestive of improvement for firearm storage.
Identifiants
pubmed: 32307124
pii: S0196-0644(20)30104-9
doi: 10.1016/j.annemergmed.2020.02.007
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03143283']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
194-205Informations de copyright
Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.