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Attitudes toward physician-provided gun safety counselling among current and prospective gun owners in the USA

Background

Americans increasingly perceive that homes with guns are safer than those without, and physician counselling about in-home firearm safety and injury risks occurs infrequently, despite encouragement from major medical organisations (eg, American Medical Association, American Academy of Pediatrics). Safety counselling that does occur may be limited to gun owners at high risk of injury; however, given the increasing rates of first-time gun ownership in the USA, understanding attitudes toward firearms and firearm safety messaging among persons who may become firearm owners is needed to inform and support continued injury prevention efforts.

Methods

Survey data from a cross-section of firearm owners (n=396) and non-owners (n=551) collected in February 2023 was used to examine differences in perceptions about the safety of firearm households, openness toward firearm safety counselling and comfort with law enforcement compared with physician firearm safety discussions.

Results

Over three-quarters of current and possible future gun owners agreed that firearms make homes safer, compared with just over one-third of non-owners. All three groups favoured law enforcement over physicians for firearm safety messengers and were more comfortable speaking with law enforcement than physicians about firearm safety.

Discussion and conclusion

Public health and injury prevention safety counselling that combines messaging from law enforcement and medical perspectives may be similarly accessible for both current firearm owners and those considering owning firearms in the future.

Education for healthcare professionals and firearm injury

Background

There is consensus on the need and ability to address firearm injury risk in healthcare settings; however, the lack of education for healthcare professionals hinders the implementation of evidence-based firearm injury and mortality prevention strategies. The objectives of this study are to develop, disseminate and evaluate education for team members to facilitate implementation in emergency departments

Method

Two-tiered education was developed in partnership with stakeholders and disseminated to the healthcare team, covering evidence-based screening and interventions for firearm access and violence risk. The implementation, development and dissemination strategies followed the framework used for systemwide Screening, Brief Intervention and Referral to Treatment implementation for substance use. Team members who screened patients for firearm injury risk received screening education and team members meeting with patients who screened positive received intervention education. Participants completed surveys to evaluate the education and learning objectives.

Results

Across three emergency departments from March 2021 to May 2022, 267 team members completed screening education. Key takeaways reported by 173 participants were how to screen (24.9%), the 5L’s of Firearm Safety (19.7%) and the prevalence of firearm injury (11.0%). Participants still had questions about workflow, resources and safety. 34 of 67 (50.7%) intervention education participants completed the postsurvey. 100% were confident they could screen, 79% were confident they could provide brief interventions and 88% were confident their site could implement firearm injury prevention strategies.

Conclusion

Tiered education for firearm injury prevention screening and intervention achieved learning objectives and facilitated programme implementation. Education increased knowledge and confidence regarding firearm injury risk screening and its importance in healthcare settings.