612 - Firearm Safety Counseling during Developmental Behavioral Pediatrics Visits: Targeted Interventions for a High Risk Population

Firearms are the leading cause of mortality in the US pediatric population. Youth with impulsive tendencies and mental health conditions, a population commonly treated by Developmental and Behavioral Pediatric providers (DBPP), are at a particularly higher risk for firearm-related injury. Little is known about DBPP attitudes toward and practice of firearm safety (FAS) counseling.








Objective:

To investigate DBPP attitudes and practices of FAS counseling and to examine response to an educational curriculum in relation to screening and counseling.








Design/Methods:

A single-center prospective longitudinal pilot survey study of DBPP pre/post FAS counseling educational curriculum was performed. Curriculum consisted of a didactic session to review injury statistics, laws and perceived barriers to counseling, followed by a training session covering strategies for counseling families. Handouts and resources were provided. DBPP completed identical pre and post-intervention surveys asking about current practice- % of patients counseled, satisfaction of current knowledge (satisfaction 5 point likert), likelihood of discussing FAS with patients (likelihood 5 point likert) and (choose all options) identification of applicable barriers to counseling (time, challenge integrating in visit, no EMR prompt, cultural stigma, personal discomfort with topic).


Results:

Overall, 13 DBPP completed the survey, most of whom have been in practice for greater than 10 years (Figure1). 0% stated they always counsel on FAS. Post FAS education, more DBPP were satisfied with their knowledge (Post 38% vs Pre 23%) and more were likely to discuss FAS with patients (Post 69% vs Pre 46%). Fewer DBPP reported cultural stigma (Post 15.4% vs Pre 30.8%) and discomfort with the topic (Post 7.7% vs Pre 23%) as barriers to counseling after FAS education. More DBPP listed both time (Post 69% vs 54%) and no EMR prompt (Post 38% vs Pre 30%) as barriers post education. Challenge integrating in visit remained similar (Post 69% vs Pre 69%)(Figure2).


Conclusion(s):

FAS education improved DBPP knowledge satisfaction on FAS counseling, as well as increased likelihood of DBPP counseling during visits. Barriers that increased included “time” and “no EMR prompt” leading researchers to understand that DBPP had underestimated the time needed to discuss FAS. Therefore, DBPP need EMR prompted, succinct, multi-step directions that guide FAS counseling. Further multicenter research is necessary to design a comprehensive, targeted FAS educational program for these high-risk patients.