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September 1995

Firearm Injury Prevention Counseling by Pediatricians and Family Physicians: Practices and Beliefs

Author Affiliations

From the Departments of Pediatrics (Drs Grossman and Rivara), Health Services (Dr Grossman), and Epidemiology (Dr Rivara) and the Harborview Injury Prevention and Research Center (Drs Grossman and Rivara and Ms Mang), University of Washington, Seattle.

Arch Pediatr Adolesc Med. 1995;149(9):973-977. doi:10.1001/archpedi.1995.02170220039005

Objective:  To ascertain and compare beliefs, attitudes, and counseling practices of primary care physicians of children and adolescents regarding firearm injury prevention counseling.

Design:  Cross-sectional survey.

Setting:  State of Washington.

Subjects:  All active members of the state chapters of the American Academy of Pediatrics and American Academy of Family Physicians. A total of 979 pediatricians and family physicians (53%) responded to the survey after two mailings.

Main Outcome Measures:  Attitudes, beliefs, and current practices with regard to firearm safety counseling among families of child and adolescent patients.

Results:  Only 25% of pediatricians and 12% of family physicians currently counsel more than 5% of their patients. Pediatricians were more likely than family physicians (70% vs 46%, P<.001, χ2 test) to believe that physicians have a responsibility to counsel families about firearm safety. Pediatricians recommended removing guns from the home more frequently than family physicians (32% vs 19%, P<.001, χ2 test), but most physicians of both specialties perceived that parents are rarely receptive to this advice. However, 97% of physicians from both specialties agreed that firearms should be stored locked separately from ammunition, and a substantial majority believed that parents would be receptive to this advice. Compared with physicians who owned guns (32%), nonowners were 15 times more likely (odds ratio, 15; 95% confidence interval, 10 to 23) to agree that families with children should not keep firearms in the home.

Conclusions:  Few primary care physicians who see children and adolescents currently counsel families about firearm safety, although many agree that they have such a responsibility. At least half of these physicians would potentially benefit from an intervention to improve their knowledge of and counseling skills on this topic.(Arch Pediatr Adolesc Med. 1995;149:973-977)