Caregiver Perceptions of Firearm Education

Rahul Shah, MD
Sharon Smith, MD
Mohsin Mirza, BS
Sumeet Kadian, BS, BA
Brendan Campbell, MD, MPH
Kevin Borrup, DrPH, JD, MPA
J. Leslie Knod, MD
Garry Lapidus, PA-C
Danielle Chenard, MPH
Steven Rogers, MD

Firearm related injuries are the leading cause of death in children older than one year of age. Safety counseling and prevention are cornerstones of injury prevention. Little is known about caregivers’ perceptions regarding safety counseling in the ED (emergency department) setting. This survey study sought to assess caregivers’ recollection of firearm safety counseling and who provided that counseling in the past two years. It further sought to determine whom they entrusted to provide this information, and their preferred modalities for future counseling. Secondary objectives included assessing the relationship between parental perspectives on who provided this counseling and how this counseling was provided based on presence of a firearm in the home.

A prospective cross-sectional survey was implemented at a single institution’s emergency department. Parents of children birth-18 years of age were recruited between November 2020 through May 2022, in a private ED treatment room and the survey was administered using a handheld tablet. Excluded were parents of critically ill/injured children (ESI level 1) or those presenting with a primary psychiatric complaint such as suicidal ideation.

A total of 820 of 1,181 of eligible caregivers were recruited (response rate of eligible caregivers: 69.4%). 24.1% of respondents recall receiving counseling on firearm safety within the last two years. 56.1% responded affirmatively that pediatricians ought to counsel parents/guardians on firearm safety. 17.4% reported having a firearm in their home, and these respondents were more likely to have received recent safety counseling. Police departments and pediatricians were the most trusted sources for information; with 58.3% and 55.5% of caregivers identifying them as a highly reputable source of such counseling respectively.

Just over half of caregivers in our convenience sample are following AAP firearm recommendations regarding safe storage of guns and ammunition. Caretakers who own a firearm are more likely to recall counseling on safety measures, equally as likely to believe their pediatrician should offer such counseling, and less likely to entrust their pediatrician to provide them with high-quality information when compared to caretakers who do not own a firearm. Pediatricians and police were viewed as trusted sources of information on firearm safety. In-person counseling was preferred while social media and online resources were not.

Attendees will be able to:
Review compliance of AAP firearm recommendations among firearm owners
(Just over half of caregivers in our convenience sample are following AAP firearm recommendations regarding safe storage of guns and ammunition.)

List trusted sources of firearm safety information among caregivers
(Police officers and pediatricians were among the most trusted sources of firearm safety information.)

Compare and contrast differences between caregivers who possess a firearm and those who do not with regards to firearm safety counseling preferences
(Caretakers who own a firearm are more likely to recall counseling on safety measures, equally as likely to believe their pediatrician should offer such counseling, and less likely to entrust their pediatrician to provide them with high-quality information when compared to caretakers who do not own a firearm.)