Pediatricians encouraged to discuss gun safety

Researchers at the AAP National Conference & Exhibition encouraged pediatricians and pediatric residents to discuss firearm safety with patients’ parents to decrease pediatric gun injuries and deaths.

Alexandra K. Byrne, MD, a pediatric resident at the University of Florida College of Medicine, presented findings from a study showing that staff training programs and providing education materials about gun safety increased doctor-parent conversations about gun safety.

The inspiration for the study came from seeing that many pediatricians were “not aware that firearms are a leading cause of death in pediatrics,” Byrne told Healio.

“Having cared for several firearm victims on service in our pediatric hospital, I recognized that there's a really big opportunity for prevention during well-child check visits,” Byrne said. “That gap in intervention is what led me to start our quality improvement project increased firearm screening and counseling.”

Byrne said firearm injuries and sales have increased since the start of the pandemic.

“Now more than ever, this topic is really important,” Byrne said.

Byrne and colleagues surveyed residents, pediatric trainees, mid-level providers, physician assistants, nurse practitioners and faculty pediatricians in the pediatric department at the University of Florida about firearms screening practices and anticipatory guidance practices. Participants answered three anonymous, electronic, six-question surveys on a sliding scale of 0% to 100% for their practice, including how frequently they screen for or ask about firearms in their patients’ homes and what type of guidance they are providing families regarding firearm safety counseling.

The researchers then provided department-wide training for the surveyed providers on firearm epidemiology, the rates of injuries and current literature on evidence-based methods for screening and guidance. They also partnered with the Gainesville, Florida, chapter of Moms Demand Action for Gun Sense in America (MDAGSA), which provided firearm locks that providers could offer to parents.

According to the abstract, if a parent or caregiver reported a firearm in the home, only half (53.1%) of providers at baseline counseled that the safest home for a child is one without firearms. Most pediatricians (88%) reported counseling that firearms should be stored unloaded, locked and separate from ammunition. Firearm locks were offered only at 9.6% of visits. Three months after the initial intervention, the researchers conducted the same survey again.

“I looked at the data, and we saw some improvement, but we wanted to continue,” Byrne said.

The researchers provided materials from MDAGSA’s Be Smart education campaign for firearm safety to the department in the form of posters and educational cards in clinics. Following a subsequent survey, reports of firearm screening significantly improved (37.8% to 72.4%) as did free firearm lock provision (9.6% to 79.3%).

“Anticipatory guidance also improved: counseling that the safest home is one without firearms increased (53.1% to 66.2%) and counseling on safe firearm storage remained high (increasing from 88.0% to 93.1%),” the researchers wrote. “Increased screening significantly improved across all pediatric provider types (resident, PA/APRN, attending).”

Byrne said firearms are a leading cause of death in the pediatric population.

“As pediatricians we have a unique opportunity to counsel families and prevent firearm injuries during our well child checks, so I hope that pediatricians recognize how important our role is in firearm injury prevention and work toward creating effective ways to prove firearm screening,” Byrne said.

Reference:

• Doctor training and other supports promote lifesaving firearm safety conversations in pediatrics offices. https://www.aap.org/en/news-room/news-releases/aap/2021/doctor-training-and-other-supports-promote-lifesaving-firearm-safety-conversations-in-pediatrics-offices/. Published Oct. 8, 2021. Accessed Oct. 8, 2021.