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Equitable implementation of S.A.F.E. Firearm: A multi-method pilot study
Katelin Hoskins1, Kristin A Linn2, Brian K Ahmedani3
1School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Preventive Medicine
|October 3, 2022
Summary
Implementing firearm safety programs in pediatric care requires attention to health equity. Early analysis suggests potential racial/ethnic inequities and sex-based differences in program delivery, necessitating further investigation.
Area of Science:
- Implementation Science
- Public Health
- Pediatric Primary Care
Background:
- Health equity is crucial for effective firearm safety initiatives.
- A hybrid trial is planned to promote firearm safety in pediatric primary care as a suicide prevention strategy.
- Pre-trial work identified potential variations in program delivery based on patient characteristics.
Purpose of the Study:
- To operationalize equity-oriented recommendations for a firearm safety trial.
- To identify and understand potential inequities in program delivery.
- To inform the design of an equity-informed implementation trial.
Main Methods:
- Utilized the Health Equity Implementation Framework to analyze contextual factors.
- Conducted an implementation pilot across 5 pediatric clinics involving 694 patients and 47 clinicians.
- Incorporated qualitative interviews with clinicians for deeper insights.
Main Results:
- Medical complexity did not appear to influence program delivery.
- Potential signals of inequity by race and ethnicity were observed, requiring cautious interpretation.
- Clinicians showed a tendency to deliver the program more often to parents of male patients compared to female patients.
Conclusions:
- Prospective, rigorous exploration is vital for equity-informed implementation trials.
- Further investigation is planned to address potential inequities related to race, ethnicity, and sex in the full trial.
- Findings underscore the importance of proactively addressing health equity in public health interventions.
