Citation

McKay S, Aitken ME. J. Pediatr. Clin. Pract. 2024; 11: e200106.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.jpedcp.2024.200106

PMID

38827478

PMCID

PMC11138253

Abstract

Secure firearm storage counseling is repeatedly implicated as a key factor in the reduction of firearm-related injury and death, and pediatricians have a unique role in promoting this practice within clinical encounters. The American Academy of Pediatrics, in its recent policy statement "Firearm-Related Injuries and Deaths in Children and Youth: Injury Prevention and Harm Reduction," advocates for a multipronged approach to firearm injury prevention.1 The statement calls for well-child visits to include firearm safety anticipatory guidance,1 thus affirming the role of pediatricians to lead in the effort to reduce firearm injury. However, implementation has been hindered as the result of barriers in time and comfort level, and thus it is imperative to continue to investigate factors that can improve the message delivery in an evidence-based, culturally competent manner. March et al in their paper recently published in The Journal reinforce much of what we understand about preferences of firearm owners, including nonjudgmental questions about safe storage practices with the presumption of firearm ownership and the use of trusted messengers.2, 3, 4, 5 The paper also underscores the importance of using accurate but acceptable terminology for firearms when approaching this potentially polarizing topic.6,7

It is essential to have conversations with families that are culturally competent. For example, March et al highlight the importance of using the term "firearm" over weapon, consistent with previous studies about the significance of using appropriate language within the clinical encounter. In all forms of anticipatory guidance, effective messaging is key to influence behavior change.1,2,7 Assessment of risk perception is essential during the conversation. If the parent does not perceive the risk of injury to the child, then it is more challenging to change the storage behaviors. Studies have found that using harm-reduction strategies can be helpful in the discussion of risk, formulating tailored suggestions for modification of behavior, ideally combined with provision of a safety device such as a cable lock.8, 9, 10 Using a patient-centered, nonjudgmental approach in a broad context of home safety is likely to be more acceptable among firearm owners.11

A significant barrier to secure firearm storage counseling among pediatricians is the lack...

Language: en