Keeping Children Safe at Home: Parent Perspectives to Firearms Safety Education Delivered by Pediatric Providers

Annalyn S. DeMello, MPH, RN; Eric H. Rosenfeld, MD, MPH; Brian Whitaker, PA; David E. Wesson, MD; Bindi J. Naik-Mathuria, MD, MPH


South Med J. 2020;113(5):219-223. 

In This Article

Abstract and Introduction


Objectives: The aims of this study were to assess parent acceptance of firearms education delivered by clinical providers, determine whether parents engage in firearms safety dialog with their children, and evaluate reasons for ownership and storage behaviors.

Methods: The parents of children ages 0 to 18 years completed surveys while in a pediatric inpatient setting in Texas. Demographics, acceptability, current behaviors, and storage practices were queried. Responses between firearms owners and nonowners were analyzed using the Fisher exact and χ 2 tests.

Results: Of the 115 parents who completed surveys, 41% reported owning firearms. Most parents were likely or highly likely to follow their pediatrician's gun safety advice (67%), were accepting of safety videos in waiting rooms (59%), and accepted firearms locks distributed by clinical providers (69%). Nonowners were less likely than owners to have spoken to their children about gun safety (P = 0.004). Parents owned firearms for self-protection and recreation (50%), self-protection only (38%), or recreation only (12%). Owners stored them unloaded (75%), used safety devices (95%), and stored them in the closet of the master bedroom (54%).

Conclusions: Talking about firearms safety in a healthcare setting was not a contentious issue in the majority of our sample. Parents were accepting of provider-led firearms guidance regardless of ownership status. This provides an opportunity for providers to focus on effective messaging and time-efficient delivery of firearms safety education.


Each year, children and adolescents are injured or killed needlessly in homes as a result of accidental firearms injuries and suicides. National data indicate 127 unintentional deaths and 1102 suicide deaths caused by firearms in the age category 0 to 19 years old.[1] Approximately 30% of US households contain firearms, highlighting the need for safe storage to help prevent these tragedies.[2] Firearms that are secured unlocked and unloaded can prevent accidents in younger children and suicide attempts in older children.

Safe storage education lies well within the boundaries of what healthcare professionals and paraprofessionals can provide. Experts from both the National Rifle Association and the American Academy of Pediatrics agree that firearms should be stored in a manner that limits access by children.[3,4] To this end, pediatricians, nurses, physician assistants, and other healthcare providers are in a unique position to provide anticipatory guidance on safe storage and prevention of firearms injuries. History suggests that healthcare providers can change parental behavior, as demonstrated by educational initiatives that increased the use of bicycle helmets and child safety seats and prevented accidental poisonings.[5,6] Parents were accepting then of provider recommendations because topics concerned the safety of their children. Firearms injury prevention may be no different.

The literature indicates that clinicians perceive lack of time, lack of training, and concerns about harming the patient–provider relationship as barriers to gun safety discourse.[7,8] Because of a lack of data measuring parental perspectives, the primary aim of this study was to assess parental acceptance of provider-led firearms safety education. Furthermore, we asked gun owners why they owned and how they stored their firearms as a secondary aim to inform future program design and expose areas for future research.