Implementation of a firearm safety guidance training program for pediatric providers

• Published in: Journal of pediatric surgery 2022-08, Vol.57 (8), p.1622-1629
• Main Authors: Johnson, Brittany L., Beckworth, Kristen, Bhalakia, Avni, DeMello, Annalyn, Naik-Mathuria, Bindi
• Format: Article
• Language: English
• Subjects: Education; Firearm safety; Implementation; Pediatrics; Safe firearm storage
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2021.07.016

•Implementation of a firearm safety training program increases delivery of the firearm safety message to parents.•Provider comfort with the topic of firearms increased following participation in a firearm safety training program.•The firearm safety training program can be modified for implementation in any clinical setting. Pediatric unintentional firearm injuries are potentially preventable with firearm safety guidance (FSG). In baseline assessment, we learned that providers feel uncomfortable delivering FSG due to lack of training, but are inclined to learn. Here we present the development and concept testing of an FSG training program. Using Kern's 6 rules of curriculum development, a training template was developed: 1. Program development, 2. Review by multidisciplinary expert team, 3. Concept testing, and 4. Modifications. Foundations included: raising awareness, increasing provider knowledge of safe storage methods, introducing a visual aide (American Academy of Pediatrics [AAP] infographic), and providing examples of guidance delivery. In-person training was provided and modifications made until there was uniform provider satisfaction. Program effectiveness and satisfaction were evaluated through surveys and focus groups. Descriptive statistics and univariate analyses were utilized. Over one year, in-person training was provided to 44 pediatric providers (residents and practicing pediatricians) at 8 clinics. Modifications included: addition of a Spanish-version visual aide, instruction on safety device use, simulation scenarios, making the handout more child-friendly, and development of a home safety video to include firearm safety with other topics. Following training, routine FSG by pediatricians increased from 34% to 71% (p = 0.001). Focus groups revealed provider satisfaction with the AAP infographic and increased comfort of FSG delivery. Following development and quality improvement, our FSG training model received positive feedback and increased provider delivery by pediatric providers. This model could be used for development of FSG training programs in other settings.