Preventing firearm injuries in children: a nationwide survey of safe storage device distribution

Ariel Carpenter, MD
Kelsey Schoenmeyer, BS
Cassi Smola, MD
Meghan Hofto, MD, MPH
Kirsten Bechtel, MD
Sandra McKay, MD
Kathy Monroe, MD

Firearms are the number one cause of death in children in the United States. The presence of a firearm in a home represents an independent risk factor for increased risk of unintentional firearm injury, death and suicide in children. Despite this risk, many gun owners choose to keep their firearms loaded and accessible leading to increased risk of accidental or nonaccidental trauma in children of all ages. Safe storage devices, such as gun locks, trigger locks, gun safes or lock boxes, have been shown to decrease the risk of unintentional injury and suicide and are important tools in decreasing firearm injury and death in children. However, access and resources can be a barrier to obtaining these devices. In an effort to protect children, institutions have begun to provide these devices to children and families. Despite literature documenting this practice and evidence to support effectiveness, there is limited data on the national prevalence of this practice. Together with the Injury Free Coalition for Kids firearm injury prevention subcommittee , we aim to glean a better understanding of this practice and provide much needed data that could expand provision of safety devices to families and guide future advocacy and policy efforts.

We conducted a multi-center cross-sectional mixed methods study of injury-free coalition representatives at IFCK sites nationwide. We sent a survey to the PI and PC at each IFCK site. The survey consisted of 16 questions including both quantitative and qualitative data to characterize the prevalence and details of physician or hospital provided safe storage devices. Analysis included demographic data, descriptive statistics and analysis of common themes derived from qualitative questions.

Survey responses were collected from 40 IFCK representatives across the U.S. Among the 40, 38 stated their site is allowed to work on firearm injury prevention. Results include how many IFCK sites currently provide safe storage devices, which devices are provided, how many devices are provided each year, how this is funded, who receives devices, and barriers to providing devices.

IFCK efforts to decrease firearm injuries in children include education and provision of safety equipment such as safes and trigger locks. This study describes the various efforts, common barriers and sources of funding used by IFCK sites.

1. Firearm injury is the number one cause of death in children in the United States.
2. Safe storage of firearms is a proven effective method of preventing firearm injury in children.
3. Survey results indicate widespread provision of firearm safety devices at centers across the United States and support expansion of these efforts.