Firearm injury prevention counseling: a study of pediatricians' beliefs and practices

Members of the Maryland Chapter of the American Academy of Pediatrics completed a mail survey on their beliefs and counseling practices related to firearm injury prevention. Respondents were skeptical of the protective value of firearms in the home and most were supportive of gun control measures. Only a fifth believed that most families with handguns keep them inaccessible to children; however, many seemed to believe that the children at risk were in practices other than their own. Among those providing direct ambulatory care, 40% had had a patient who had been shot. Seventy-four percent believed pediatricians have a responsibility to counsel families about firearms. Only 13% believed parents would be offended if guns were included in anticipatory guidance discussions. Even so, only 30% had ever provided such counseling. Just half of the respondents agreed that they knew what to tell families about firearms. Ninety percent were very likely to counsel parents to store guns unloaded and locked up, whereas 54% were very likely to advise parents to remove guns from the home. More than two thirds believed parents would heed their advice about storing firearms, and 30% believed parents would follow advice about having guns. Results suggest pediatricians are ready to counsel about firearm injury prevention, but are not yet doing so.