140 - Standardized Firearm Screening: A qualitative assessment of perceptions in the inpatient pediatric setting

Poster Number: 140
Publication Number: 140.121

Kirsten Rose C. Fernando, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Cara J. Haberman, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Rebecca Palmer, Wake Forest Baptist Health - Brenner Children's Hospital, Winston-Salem, NC, United States

Background: Since 2020, firearm injuries and deaths have increased at our level one trauma center in the southeastern United States. This reflects a similar trend throughout the country, with firearm injury surpassing motor vehicle accidents as the number one cause of death in children. With strong evidence supporting the efficacy of safe firearm storage in reducing firearm injuries, the American Academy of Pediatrics recommends pediatricians perform firearm counseling during patient encounters. The specifics of how, when, and where to perform such counseling are less clear. Furthermore, it is not well understood how families feel about firearm screening and counseling in a hospital setting.

Objective: This study aims to use qualitative analysis to assess pediatric family perspectives on firearm screening and firearm safety education in the inpatient healthcare setting.

Design/Methods: Fifteen semi-structured interviews with families who owned firearms were conducted in the pediatric acute care unit and newborn nursery at an academic medical center. All participants consented to be interviewed. Topics included behaviors of firearm ownership and storage, perspectives on firearm screening, and attitudes towards a firearm safety education program. Interviews were transcribed and thematic analysis with inductive coding was performed. Codes were developed through an iterative process to identify themes.

Results: Qualitative analysis revealed personal protection as the primary purpose for firearm ownership. Analysis of storage behaviors demonstrated themes of efficacy versus cost, with most participants finding inexpensive storage options such as trigger locks effective in safe storage. Regarding patient attitudes towards firearm screening, a dichotomy emerged wherein most interviewees considered it acceptable, and a smaller number deemed it an invasion of privacy. Almost all participants regarded firearm safety counseling and safe storage education acceptable in the context of pediatric firearm injury prevention. Preferences for intervention methods demonstrated themes of direct and open dialogue, respectful discourse, normalization, standardization, and optionality.

Conclusion(s): While some resistance to firearm screening exists due to concerns for privacy, implementation of firearm education and counseling as a means of preventing firearm injury appears to be a well-received preventive measure among pediatric inpatient families. This information could inform and direct standardized screening practices in the future.