327 - Video-Based Firearm Safety Education for Caregivers of Adolescents in the Pediatric Emergency Department: A Block Randomized Control Trial

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 327
Publication Number: 327.42

Maya Haasz, University of Colorado School of Medicine, Aurora, CO, United States; Lilliam Ambroggio, Children's Hospital Colorado, Aurora, CO, United States; Marian Betz, University of Colorado School of Medicine, Aurora, CO, United States; Shale L. Wong, University of Colorado/Farley Health Policy Center, Aurora, CO, United States; Jan Leonard, University of Colorado School of Medicine, Aurora, CO, United States; Ashley Brooks-Russell, CU Anschutz, Aurora, CO, United States; eric sigel, University of Colorado School of Medicine, Denver, CO, United States

Presenting Author(s)

MH

Maya Haasz, MD

Assistant Professor
University of Colorado School of Medicine
Aurora, Colorado, United States

Background: Firearms (FAs) are the leading cause of death among US adolescents. Safe storage protects against unintentional and self-inflicted FA injuries. There is little research on FA safety education in the Pediatric Emergency Department (PED) for FA-owning households of adolescents.

Objective:

To 1) Evaluate acceptability of video-based FA safety education among caregivers of adolescents in FA-owning households; 2) Assess feasibility of 3-month follow-up.

Design/Methods: We conducted a prospective block-randomized control trial in a large PED (Aug 2020-Aug 2022). Eligible participants were English-speaking caregivers of children ages 10-17 years endorsing household FAs. Caregivers were excluded if the child was critically ill. Participants were surveyed about child safety behaviors (including FA storage) and assigned to no video (Aug 2020-Mar 2021) or a FA safety video (Nov 2021-Aug 2022). The 3-minute video described safe storage principles, temporary FA removal, and a survivor testimonial. The primary outcome was acceptability, measured by responses to “The pediatric emergency room was an appropriate place to show this video” on an after-video survey. Likert responses of “agree”/“strongly agree” on a 5-point scale were collapsed. Feasibility of follow-up was defined as proportion of participants that completed a survey at 3-months. Results were reported using descriptive statistics and McNemar’s test.

Results: We recruited 157 participants to control (CG) (n=95) and intervention (IG) (n=62) groups. IG participants were more likely patient’s mother (90.3% vs 81.1%; p=0.01) and less likely to feel their neighborhood was safe (91.9% vs 99.0%; p=0.04); sociodemographics were otherwise similar. Across the cohort, 24.4% stored ammunition unlocked, 9.0% stored a gun unlocked, and 7.4% stored at least one gun loaded, with no difference between groups; 17.9% purchased a FA since COVID-19 onset. Most IG participants felt the PED was an appropriate place to show the video (70.5%) and liked the video (80.3%). More CG participants completed follow up (53.7% vs 37.1%; p=0.04). There was no difference in sociodemographic characteristics or baseline storage behaviors among those who did or did not complete follow up.

Conclusion(s): This study shows that FA safety education is acceptable in the PED among FA owners with adolescent children. Strategies to improve follow-up rates (eg. shorter follow-up time, larger incentive) should be considered. Video-based FA safety education can be used to provide consistent education to this at-risk cohort in PEDs and would benefit from larger efficacy studies in diverse settings.