256 - Efficacy of a Safe Firearm Storage Curriculum for Pediatric Trainees

Publication Number: 256.4833

Priya P. Shah, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Deniz Cataltepe, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Dorothy R. Novick, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Noreena S. Lewis, Children's Hospital of Philadelphia, Wilmington, DELAWARE, United States, DE, United States; Anireddy R. Reddy, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Kimberly Sterner-Stein, CHOP-Center for Violence Prevention, Phil, PA, United States; Joel A. Fein, Children's Hospital of Philadelphia at the Perelman School of Medicine, University of Pennsylvania, Media, PA, United States

Background: Firearms are the leading cause of death for U.S. children. Fewer than half of firearm owners store guns locked, unloaded, and separate from ammunition. Health care provider counseling coupled with free gun lock distribution can significantly increase secure firearm storage, which reduces child firearm injury and fatality. Previous studies demonstrate that for pediatric trainees, lack of confidence and background knowledge are significant barriers to safe storage counseling.

Objective: To address these barriers, we aimed to evaluate a safe firearm storage curriculum for pediatric trainees.

Design/Methods: We conducted the Firearm Safety in Clinical Care curriculum for 81 pediatric trainees across four sessions from March to April 2024. This interactive 1.5 hour session included background data, technical information, motivational interviewing techniques, and role-play opportunities. Trainees were surveyed immediately before and after the session to assess attitudes, skills, confidence, and perceived barriers. Survey questions used a five-point Likert Scale (Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree), with opportunity for open-ended qualitative feedback. Given non-normally distributed data, pre-session and post-session responses were compared using Mann Whitney U test (Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC).

Results: Of 81 total participants, 81 residents completed the pre-survey (100%) and 60 completed the post survey (74%) [Table 1]. After the session, residents were more likely to agree that firearm-related injury and death is a significant issue for children (p=0.04) and that pediatric providers should engage in firearm safety education (p=0.02). There was significant improvement in knowledge of how to screen for firearms (p < 0.01) and confidence in counseling about safe storage options (p < 0.01). Residents expressed concerns that discussing safe storage could imply support for gun ownership and/or strain therapeutic relationships.

Qualitative feedback revealed that participants valued realistic scenarios, examples of specific language to use when addressing family concerns, and visual presentation of statistical data. Suggestions for improvement included incorporating family perspectives and allowing more time to debrief challenging experiences.

Conclusion(s): Residents showed significant increase in skills and confidence regarding screening and counseling on safe firearm storage. Next steps include exploring concerns about the impact of firearm safety conversations on therapeutic relationships, and evaluating attitudes and outcomes longitudinally.

Table 1: Survey Responses Before and After Pediatric Resident Firearm Safety Curriculum
Standard descriptive statistics with n (%) reported for categorical variables and mean (SD) reported for continuous variables. Comparisons completed using Mann-Whitney U-test. Bold denotes significant p-value <0.05.
*One session of 17 participants did not have post-evaluation data