Study: With support, pediatricians are more likely to talk about firearm safety during well-child visits

DETROIT - Firearm-related injuries are the leading cause of death for young people in the U.S.; it's a sobering fact.

Research has shown individuals who have a conversation with their doctor about the importance of secure firearm storage, combined with the offer of a free cable lock, were more likely to report improving their safe gun-storage practice. Yet only two percent of pediatricians routinely broach the topic with their patients' parents.

In the largest study of its kind, researchers and pediatricians teamed up to find out what it would take to encourage more doctors to have the sometimes uncomfortable, but lifesaving, conversations.

"As pediatricians our goal is to keep our patients safe. We want to talk with families to make sure guns are locked up and ammunition is locked separately to prevent tragic accidents from occurring," said Dr. Bridget McArdle, a Henry Ford Health pediatrician and co-author of the study, which was recently published in JAMA Pediatrics.

Pediatricians at 30 Henry Ford Health and Kaiser Permanente Colorado clinics participated in a secure firearm storage program to determine what it would take to encourage more doctors to broach the uncomfortable topic with their patients' parents.

The study, which was led by researchers at Northwestern University, built on previous research by testing whether pediatricians were more likely to have these conversations and offer a free cable lock - via an evidence-based program called S.A.F.E. Firearm - if they received a "Nudge" or a "Nudge+."

During 47,307 well-child visits of children between 5 and 17, pediatricians received a "Nudge," a computer prompt reminding them to talk to parents about how to securely store their firearms, or a "Nudge+", the same reminder along with support from team members in navigating conversations with parents on how to secure their firearms. That additional support included guidance around at what point during the conversations to offer parents a free cable lock.

In the "Nudge" group, 22 percent of pediatricians delivered the S.A.F.E. Firearm program whereas 49 percent of pediatricians in the "Nudge+" group delivered the program - a significant difference.

"Parents were receptive to hearing about safety and locking firearms safely. Many commented that it was great that we were offering locks, especially with all the school shootings and one being close to home in Oxford. It was well-received," said Henry Ford Health pediatrician and study co-author Dr. Marisa Elias.

Pediatricians routinely make recommendations about other safety precautions, like bike helmets and car seats. The doctors and researchers agree pediatricians, with their close relationships with patients and their families, are uniquely positioned to affect the safety of the 33 percent of U.S. children who live in homes with firearms.

"This is a call to action," said principal investigator Rinad Beidas, chair of the department of medical social sciences and the Ralph Seal Paffenbarger professor of medical social sciences at Northwestern University Feinberg School of Medicine. "We know we can save lives, and this study offers insights on how to scale this approach nationally."

The firearm storage program was funded by a research grant from the National Institute of Mental Health and the American Foundation for Suicide Prevention. Scientists at the University of Pennsylvania also participated in the study.

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