Paired Video-Based Counseling and Firearm Safety Device Distribution in a Pediatric Emergency Department

We examine the acceptability and impact of video-based education on firearm secure storage for caregivers of patients presenting to a pediatric emergency department (ED).

Prospective, pre-post intervention study of caregivers in a pediatric ED who received video-based firearm secure-storage education and were offered a free gun cable lock. Caregivers completed preintervention and postintervention surveys on secure-storage practices and if they ask about firearms where their children visit. Caregivers who reported having a firearm in or around the home were assessed for changes in these behaviors 2 weeks, 2 months, and 6 months after the ED visit.

Of 307 enrolled participants, 43 (14.0%) reported firearm access; 35 (81.4%) of these reported access to handguns. While 34.5% of caretakers reported they asked about firearms when their child/teen visited other homes, after video-based education, 85.3% reported they intended to ask or would continue to ask (P < .01); this persisted on 2-week follow-up. At 2-week follow-up, 31 of 35 respondents (88.6%) of those with firearm access reported using a secure-storage device at that time. Most caregivers (89.1%, 213 of 239) at 2-week follow-up felt the ED was an appropriate place to discuss secure-storage.

In this pilot study, using research staff to deliver the intervention, providing video-based firearm secure-storage education and cable locks to caregivers of pediatric ED patients is acceptable and led to a significant increase in caregivers asking or planning to ask about firearms in homes where their child visited. We also found significant changes in self-reported practices of safer firearm storage for handguns.