Implementing means restriction education in urban EDs

This study evaluated the impact of a mail information campaign on emergency department (ED) professionals' knowledge about the lethal role of firearms in suicide, knowledge of appropriate strategies for warning caregivers of adolescents who have attempted suicide about firearms, and practices with respect to the delivery of such warnings. Responses obtained from physicians and nurses working in ED sites within the targeted city (Chicago) were compared with responses from ED professionals employed in a comparison city (Detroit). In Chicago, the percentage of respondents recommending firearm removal strategies increased from 60% at pretest to 76% at posttest. Individual reports of caregiver warnings per adolescent suicide exposure showed a significant decline in Chicago and a marginally significant decline in Detroit. Gains in knowledge about firearm warning strategies persisted in multivariate analyses controlling for subject demographic characteristics. The pattern of results suggests that the intervention may have effected changes in knowledge while having little impact on behavior. More intensive, interactive educational strategies may be needed to effect behavioral changes among ED professionals.