Physician-driven or self-directed safe firearm storage guidance: Which one is best?


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 04 01 2021
revised: 04 04 2021
accepted: 18 04 2021
pubmed: 6 6 2021
medline: 16 2 2022
entrez: 5 6 2021
Statut: ppublish

Résumé

Access to firearms is a preventable cause of unintentional injury and suicide in children. Pediatric physicians provide injury prevention guidance, but firearm safety may not routinely be included. The purpose of this pilot study was to evaluate the effectiveness of firearm safety guidance (FSG) provided by a physician. Prospective, randomized-controlled, trial assessing physician-delivered FSG at two pediatric clinics in Houston, Texas. Firearm-owning parents were randomized to physician guidance (PG) versus control (CG) groups. The CG received a handout with firearm safety facts and a free cable lock. The PG additionally received FSG by a physician. Pre- and post-intervention surveys were conducted. Results were analyzed using descriptive statistics and Chi square analysis. Thirty-two families participated; most (70%) were satisfied with the guidance. Pre-intervention safe firearm storage was high in both groups, and the intervention did not lead to improved habits in either group [PG: Pre 93% vs. Post 89%, p = 0.7 and CG: Pre 82% vs. 78%, p = 0.7].There was no difference in use of the free cable lock among groups (44% vs. 22%, p = 0.9). The PG demonstrated improved knowledge of the state child access protection law (PG: Pre 60% vs. Post 100% vs. CG: Pre 29% vs. Post 67%; p = 0.02). For firearm-owning parents, physician-delivered safe storage guidance may not be more effective than self-directed guidance provided by a handout. A larger trial is underway to confirm the findings of this pilot study.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
Access to firearms is a preventable cause of unintentional injury and suicide in children. Pediatric physicians provide injury prevention guidance, but firearm safety may not routinely be included. The purpose of this pilot study was to evaluate the effectiveness of firearm safety guidance (FSG) provided by a physician.
METHODS METHODS
Prospective, randomized-controlled, trial assessing physician-delivered FSG at two pediatric clinics in Houston, Texas. Firearm-owning parents were randomized to physician guidance (PG) versus control (CG) groups. The CG received a handout with firearm safety facts and a free cable lock. The PG additionally received FSG by a physician. Pre- and post-intervention surveys were conducted. Results were analyzed using descriptive statistics and Chi square analysis.
RESULTS RESULTS
Thirty-two families participated; most (70%) were satisfied with the guidance. Pre-intervention safe firearm storage was high in both groups, and the intervention did not lead to improved habits in either group [PG: Pre 93% vs. Post 89%, p = 0.7 and CG: Pre 82% vs. 78%, p = 0.7].There was no difference in use of the free cable lock among groups (44% vs. 22%, p = 0.9). The PG demonstrated improved knowledge of the state child access protection law (PG: Pre 60% vs. Post 100% vs. CG: Pre 29% vs. Post 67%; p = 0.02).
CONCLUSIONS CONCLUSIONS
For firearm-owning parents, physician-delivered safe storage guidance may not be more effective than self-directed guidance provided by a handout. A larger trial is underway to confirm the findings of this pilot study.

Identifiants

pubmed: 34088532
pii: S0022-3468(21)00325-0
doi: 10.1016/j.jpedsurg.2021.04.015
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

454-461

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Brittany L Johnson (BL)

Michael E. DeBakey Department of Surgery, Pediatric Surgery Division, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.

Matthew W Webb (MW)

Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.

Annalyn S DeMello (AS)

Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.

Avni M Bhalakia (AM)

Michael E. DeBakey Department of Surgery, Pediatric Surgery Division, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.

Kristen L Beckworth (KL)

Center for Childhood Injury Prevention, Texas Children's Hospital, Houston, TX, United States.

David E Wesson (DE)

Michael E. DeBakey Department of Surgery, Pediatric Surgery Division, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.

Bindi Naik-Mathuria (B)

Michael E. DeBakey Department of Surgery, Pediatric Surgery Division, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States. Electronic address: bjnaikma@texaschildrens.org.

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