Clinician Attitudes, Screening Practices, and Interventions to Reduce Firearm-Related Injury.

Area of Science:

• Public Health
• Clinical Medicine
• Health Services Research

Background:

• Firearm injury represents a significant public health crisis in the U.S., contributing to substantial morbidity and mortality.
• Existing literature on clinical firearm injury prevention screening and interventions requires systematic identification and synthesis.

Purpose of the Study:

• To systematically review and summarize the literature on clinical firearm injury prevention screening and interventions.
• To assess provider and patient attitudes and practices related to firearm safety discussions in clinical settings.

Main Methods:

• A systematic literature search was conducted across multiple databases (PubMed, Web of Science, CINAHL, PsycInfo, ClinicalTrials.gov) for English-language original research from 1992-2014.
• Studies focused on clinical screening methods, patient-level interventions, or patient/provider attitudes regarding firearm safety.
• Included articles underwent rigorous review, data abstraction, and quality scoring.

Main Results:

• The review included 72 articles from 3,260 unique titles, with 53 examining clinician attitudes and practices.
• Clinician screening frequency was linked to prior training, experience, and expectations.
• Twelve articles assessed patient interventions, including six randomized controlled trials; patient attitudes were largely based on low-quality evidence.

Conclusions:

• Healthcare providers rarely conduct firearm safety screening or counseling, even for high-risk patients.
• Healthcare-based interventions show potential for improving safe firearm storage among pediatric, suicidal, and other at-risk populations.
• While patients are generally receptive, the current evidence base is limited, necessitating high-quality, large-scale research.