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Acad Pediatr. 2018 Nov 30. pii: S1876-2859(18)30753-8. doi: 10.1016/j.acap.2018.11.007. [Epub ahead of print]

Acceptability and Use of Evidence-Based Practices for Firearm Storage in Pediatric Primary Care.

Author information

1
Department of Psychiatry (RS Beidas, S Jager-Hyman, EM Becker-Haimes, CB Wolk, GK Brown, CA Gregor, and A Lieberman),. Electronic address: rbeidas@upenn.edu.
2
Department of Psychiatry (RS Beidas, S Jager-Hyman, EM Becker-Haimes, CB Wolk, GK Brown, CA Gregor, and A Lieberman).
3
Division of Emergency Medicine, Children's Hospital of Philadelphia (JA Fein).
4
School of Social Policy and Practice, University of Pennsylvania (SC Marcus), Philadelphia, Pa; Center for Health Policy and Health Services Research, Henry Ford Health System (BK Ahmedani), Detroit, Mich.
5
Center for Applied Health Research, Baylor Scott & White Health (JE Zeber), Temple, Tex.
6
Department of Medical Ethics & Health Policy (RS Beidas), University of Pennsylvania Perelman School of Medicine.

Abstract

OBJECTIVE:

Promoting safe firearm storage in pediatric primary care is one way to address youth suicide by firearm. The study objective was to determine the perspectives of primary care physicians (PCPs) and leaders of primary care practices regarding the acceptability and use of screening, counseling, and firearm locks-all components of an adapted evidence-based intervention known as the Firearm Safety Check.

METHODS:

In 2016, an online survey was conducted in two large US health systems. PCPs (n = 204) and leaders (n = 57) from 83 clinics were invited to participate. Respondents included 71 clinics (86%), 103 PCPs (50%), and 40 leaders (70%). Main outcomes included acceptability (6-point Likert scale, with higher scores indicating better acceptability) and use of the 3 intervention components (4-point Likert scale, with higher scores indicating greater use), as measured by an adapted validated instrument.

RESULTS:

Analyses were conducted in 2017. PCP acceptability of screening (mean = 4.28; standard deviation [SD] = 1.12) and counseling (mean = 4.56; SD = 0.89) were high, but acceptability for firearm lock provision was more neutral (mean = 3.78; SD = 1.16). Most PCPs endorsed sometimes screening (85%) and counseling (80%). Few PCPs offered firearm locks to caregivers (15%). Leaders reported consistent information.

CONCLUSION:

The acceptability of screening for firearms and safe storage counseling was high; both components were used commonly but not routinely. The acceptability of providing firearm locks was neutral, and use was rarely endorsed. This study provides important insights about areas of focus for future implementation efforts from policy and research perspectives.

KEYWORDS:

evidence-based practice; firearm safety; pediatric primary care

PMID:
30508600
DOI:
10.1016/j.acap.2018.11.007

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