P0106 - Pediatrician Firearm Safety Screening and Counseling Practices in New York

Background: The United States has the highest rates of firearm-related deaths among high-income countries. Three thousand American children and teens are shot and killed annually, making firearms the second leading cause of death overall in this population. The American Academy of Pediatrics has framed pediatric firearm-related injury and death as a critical public health issue, calling on pediatricians across the country to intervene. While various studies have shown that in-office firearm safety counseling may be an effective intervention strategy, data show that clinician self-reported screening and counseling rates are still low. Our objective was to determine current attitudes, frequency of screening, and counseling practices related to firearms amongst ambulatory pediatricians in New York compared to national historical data.

Methods: Pediatricians throughout New York were electronically surveyed via REDCap using an adapted survey based on the AAP Periodic Survey of Fellows (PSF) #47 (2000) and #86 (2013). This data was then compared to data from PSF surveys in 1994 (n= 982) and 2000 (n= 922) as presented in Olson et al. 2007.

Results: There were a total of 98 respondents with 79 (80.6%) of those providing direct patient care in an ambulatory care setting. The majority (>85%) of pediatricians surveyed in all three years believe that violence prevention should be a priority issue for pediatricians (Table 1). Although an increasing percentage of pediatricians between 2000 and 2019 felt adequately trained in firearm safety (32.7% and 41.6%, respectively), there was minimal change in the percentage who felt comfortable discussing firearm injury prevention with parents (73.6% and 79.5%, respectively). There was an increasing percentage of respondents who replied that they always or sometimes identify families who have firearms at home and counsel on safe storage (Table 2). However, a similar proportion between 2000 and 2019 recommended removal of firearms from the home (55.9% and 54.4%, respectively). Respondents of our survey cited several reasons why they did not customarily ask about firearms including time (34.2%), parental objection to counseling (8.9%), and believing that firearm injury is not an important issue in their practice (5.1%) or that families in their practice do not own firearms (5.1%). As in previous years, the majority of those surveyed (79.7%) felt that gun control legislation would help reduce pediatric firearm-induced injuries and/or deaths.

Conclusions: The majority of New York ambulatory pediatricians believe that firearm injury prevention is an important part of their practice and have increased their efforts relative to historical national data to counsel families accordingly.