Understanding Pediatric Residents' Communication Decisions Regarding Anticipatory Guidance About Firearms.

In 2014, guns were the second leading cause of death among children and teens in the U.S. and it was previously found that approximately 33% of children live in homes with a firearm (Schuster et al., 2000). Currently, the AAP recommends pediatricians address firearms and firearm safety with patients; however, available research regarding the methods pediatricians use to communicate with patients regarding firearms and the influences on decision making is mixed and in need of more studies. Utilizing concepts from the theory of planned behavior and the health belief model, this paper presents findings from an online survey of medical doctors in several pediatric residency programs and seeks to identify the influences on prioritization of firearm safety in one's anticipatory guidance. Findings indicate that many residents do not counsel on firearm safety during well child visits. Further, prioritization is influenced by comfort, training, and confidence. Gender differences were also found, wherein women are more likely to indicate that firearm safety is as important as other anticipatory guidance messages, but also indicate less confidence in abilities to counsel. Theoretical and practical implications, including possibilities for future research and interventions, are discussed.

Assessment of Pediatric Residents' Attitudes toward Anticipatory Counseling on Gun Safety.

INTRODUCTION: Guns remain a major cause of injury and death among children. We determined pediatric residents' familiarity with gun safety campaigns and their gun safety counseling practices. We determined pediatric residents' comfort with the Asking Saves Kids (ASK) campaign, which recommends that parents ask about gun safety and storage where their children play. METHODS: Cross-sectional 27-item electronic survey was distributed to three pediatric residency programs in Baltimore, Maryland, USA. Residents were asked to respond to statements using a seven-point Likert scale on familiarity with three gun safety campaigns and their attitudes toward gun safety counseling. RESULTS: 82% of respondents were not familiar with gun safety programs. 23% reported not counseling. 87% believed it is a good idea to ask about guns in a home but only 64% were comfortable recommending their patients' parents to ask about guns. 59% were personally comfortable asking about guns in the home. 15% believed their patients' parents would be comfortable asking about guns in the homes of friends and families. CONCLUSIONS: The residents in this survey supported the idea of gun safety anticipatory guidance but discussing firearms can be problematic. Educational programs and strategies are needed to support physicians' counselling on gun safety.