In 2001, 2,937 children and teenagers died as a result of gun-related injuries, according to background information in the article. Although gun ownership has been identified as a risk factor for homicide and suicide in the home, a significant percentage of gun-owning parents store their guns loaded or unlocked, substantially underestimating the risk of injury to their children.
Paul S. Carbone, M.D., of the Children's Primary Care Medical Group, San Diego, and colleagues identified gun-owning families through a questionnaire in a large, predominately Hispanic pediatric clinic in Tucson, Ariz. Gun-owning families were then assigned to either an intervention group who received gun-safety counseling, a gun-safety brochure and a free gun lock, or a control group. Families were resurveyed one month later to determine changes in gun-ownership and gun storage.
Of the 2,649 parents surveyed on visiting the clinic, 206 (7.8 percent) reported that they kept guns in their homes; 151 completed both the baseline and follow-up questionnaire. "At follow-up, families who received the intervention were more likely to have improved overall gun-safety practices compared with the control group (61.6 percent vs. 26.9 percent)," the researchers report. "In those households still with guns at follow-up, 50.9 percent of the intervention group had some type of improvement in safe gun storage compared with 12.3 percent of the control group. More specifically, 25.0 percent in the intervention group improved the frequency of locked storage of guns compared with 4.8 percent of those in the control group. Twenty-six percent of the intervention group improved the use of locked storage compared with 3.1 percent in the control group."
"This study provides reason to be optimistic about the effectiveness of a brief gun-safety counseling session, reinforced with written material and a gun lock giveaway," the authors write. "Overall, those gun-owning families who received the intervention were more than twice as likely to show some type of improvement in their gun-safety practices. More specifically, although our intervention did not appear to significantly influence the removal of guns from the home, it did significantly improve safe gun storage practices."
"This study provides support to the American Academy of Pediatrics recommendations to discuss gun safety with families and encourages further research in this area," the authors conclude.
(Arch Pediatr Adolesc Med. 2005; 159:1049 - 1054. Available pre-embargo to the media at www.jamamedia.org.)
This study was funded by a grant from the American Academy of Pediatrics Research in Pediatric Practice Fund, Elk Grove Village, Ill.
Firearm Injury Prevention - Reasons for Optimism
In an accompanying editorial, M. Denise Dowd, M.D., M.P.H., from Children's Mercy Hospital, Kansas City, Mo., writes that although "the American Academy of Pediatrics states that the safest way to prevent gun injury among children is to remove guns from the places children live and play," the reality is that "approximately 35 percent of homes with children younger than 18 years have at least one gun, and of these, 43 percent contain at least one unlocked firearm."
"A major strength of the study by Carbone et al is that families were given a tangible means to risk reduction: a gun lock."
"Pragmatic approaches to risk behavior reduction must take into account current behaviors and realize that education alone is probably not sufficient to alter behavior. Emerging research that incorporates principles of motivational interviewing and brief behavioral change counseling is beginning to find its way to pediatric acute and primary care settings. Although large gaps exist in our knowledge of how to translate these principles into action, studies like that by Carbone et al give us reason to be optimistic."
(Arch Pediatr Adolesc Med. 2005;159:1081 - 1082. Available pre-embargo to the media at www.jamamedia.org.)
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