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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
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
FirearmsHealth equityImplementation sciencePediatricsSuicide Prevention

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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.