Paired video-based counseling and firearm safety device distribution in a pediatric emergency department

OBJECTIVES: We examine the acceptability and impact of video-based education on firearm secure storage for caregivers of patients presenting to a pediatric emergency department (ED). 

METHODS: Prospective, pre-post intervention study of caregivers in a pediatric ED who received video-based firearm secure-storage education and were offered a free gun cable lock. Caregivers completed pre- and post-intervention surveys on secure-storage practices and if they ask about firearms where their children visit. Caregivers who reported having a firearm in or around the home were assessed for changes in these behaviors two weeks, two months, and six months after the ED visit. 

RESULTS: Of 307 enrolled participants, 43 (14.0%) reported firearm access; 35 (81.4%) of these reported access to handguns. While 34.5% of caretakers reported they asked about firearms when their child/teen visited other homes, after video-based education, 85.3% reported they intended to ask or would continue to ask (p<0.01); this persisted on 2-week follow-up. At two-week follow-up, 31/35 respondents (88.6%) of those with firearm access reported using a secure-storage device at that time. Most caregivers (89.1%, 213/239) at 2-week follow-up felt the ED was an appropriate place to discuss secure-storage. 

CONCLUSIONS: In this pilot study using research staff to deliver the intervention, providing video-based firearm secure-storage education and cable locks to caregivers of pediatric ED patients is acceptable and led to a significant increase in caregivers asking or planning to ask about firearms in homes where their child visited. We also found significant changes in self-reported practices of safer firearm storage for handguns.