Breaking the Silence: The Role of Screening in Physician-Initiated Firearm Safety Conversations.
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| Titel: | Breaking the Silence: The Role of Screening in Physician-Initiated Firearm Safety Conversations. |
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| Autoren: | Dineen JN; University of Connecticut, Hartford, CT, USA., Grasso D; University of Connecticut, Hartford, CT, USA.; UConn Health, Farmington, CT, USA., Hoey A; University of Connecticut School of Law, West Hartford, CT, USA., Kahn AR; University of Connecticut School of Medicine, Farmington, CT, USA., Raissian KM; University of Connecticut, Hartford, CT, USA. |
| Quelle: | Health education & behavior : the official publication of the Society for Public Health Education [Health Educ Behav] 2025 Dec; Vol. 52 (6), pp. 665-672. Date of Electronic Publication: 2025 Jun 03. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Sage Publications Country of Publication: United States NLM ID: 9704962 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6127 (Electronic) Linking ISSN: 10901981 NLM ISO Abbreviation: Health Educ Behav Subsets: MEDLINE |
| Imprint Name(s): | Publication: Thousand Oaks, CA : Sage Publications Original Publication: Thousand Oaks, CA : Sage Periodicals Press, c1997- |
| MeSH-Schlagworte: | Firearms* , Physicians*/psychology , Communication* , Wounds, Gunshot*/prevention & control, Humans ; Female ; Male ; Interviews as Topic ; New Jersey ; Qualitative Research ; Adult ; Attitude of Health Personnel ; Middle Aged ; Physician-Patient Relations |
| Abstract: | Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. This article expands and investigates what physicians perceive as facilitators and barriers to initiating preventive health education, also called anticipatory guidance or medical education, around secure firearm storage in the home (safe storage) and outside the home (Emergency Risk Protection Orders [ERPO]). We employ in-depth qualitative interviews with 36 New Jersey physicians randomly selected from two national physician panels. Participants were screened for inclusions based on their specialty (family medicine or internist, obstetrics/gynecology, or pediatrics), practice setting (office-based rather than hospital-based), and time spent (80% or more) on direct patient care. Based on interviews, we identify five physician-perceived barriers to providing secure firearm storage counseling: inadequate screening mechanisms to prompt conversations, physician perceptions of who is at risk for firearm injury, time pressures, concerns about patient receptivity, and a need for physician training. Our findings indicate that there are structural barriers to physician-initiated firearm safety guidance. Interventions designed to increase physicians' willingness to have these conversations must first address why these conversations fail to occur. Physician participants expressed the need for revised patient screening tools, training on approaching conversations about secure firearm storage, and a mechanism to allocate sufficient time in a well-visit, among the many other topics they must discuss. Interview participants had minimal understanding of ERPO and how to counsel patients on petitioning for ERPO. |
| References: | JAMA Intern Med. 2013 May 13;173(9):732-40. (PMID: 23467753) J Gen Intern Med. 2016 Oct;31(10):1242-5. (PMID: 27206538) Prev Med. 2020 Feb;131:105952. (PMID: 31843466) Ann Intern Med. 2013 May 21;158(10):741-54. (PMID: 23609101) Am J Public Health. 2018 Apr;108(4):532-537. (PMID: 29470124) Inj Prev. 2024 Nov 21;30(6):474-480. (PMID: 38519144) J Community Health. 2021 Oct;46(5):1050-1058. (PMID: 33547617) J Am Board Fam Med. 2006 Sep-Oct;19(5):450-8. (PMID: 16951294) Am J Public Health. 2021 Dec;111(12):2105-2110. (PMID: 34878863) Ann Intern Med. 2018 Nov 20;169(10):704-707. (PMID: 30383132) N Engl J Med. 2022 May 19;386(20):1955-1956. (PMID: 35443104) Accid Anal Prev. 2005 Jul;37(4):661-7. (PMID: 15949457) J Am Board Fam Pract. 2003 Jan-Feb;16(1):40-6. (PMID: 12583649) Pediatrics. 1992 May;89(5 Pt 1):902-7. (PMID: 1579402) AMA J Ethics. 2018 Jan 1;20(1):56-68. (PMID: 29360028) AMIA Annu Symp Proc. 2020 Mar 04;2019:487-493. (PMID: 32308842) Ann Intern Med. 2014 Jan 21;160(2):101-10. (PMID: 24592495) J Urban Health. 2002 Mar;79(1):26-38. (PMID: 11937613) Epidemiol Rev. 2016;38(1):111-24. (PMID: 26769724) Patient Educ Couns. 2024 Feb;119:108062. (PMID: 37992529) Curr Opin Pediatr. 2003 Dec;15(6):630-5. (PMID: 14631211) |
| Contributed Indexing: | Keywords: Emergency Risk Protection Orders; anticipatory guidance; guns; physicians; safe storage |
| Entry Date(s): | Date Created: 20250603 Date Completed: 20251107 Latest Revision: 20251109 |
| Update Code: | 20251109 |
| PubMed Central ID: | PMC12592564 |
| DOI: | 10.1177/10901981251338864 |
| PMID: | 40458874 |
| Datenbank: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.<br />This article expands and investigates what physicians perceive as facilitators and barriers to initiating preventive health education, also called anticipatory guidance or medical education, around secure firearm storage in the home (safe storage) and outside the home (Emergency Risk Protection Orders [ERPO]). We employ in-depth qualitative interviews with 36 New Jersey physicians randomly selected from two national physician panels. Participants were screened for inclusions based on their specialty (family medicine or internist, obstetrics/gynecology, or pediatrics), practice setting (office-based rather than hospital-based), and time spent (80% or more) on direct patient care. Based on interviews, we identify five physician-perceived barriers to providing secure firearm storage counseling: inadequate screening mechanisms to prompt conversations, physician perceptions of who is at risk for firearm injury, time pressures, concerns about patient receptivity, and a need for physician training. Our findings indicate that there are structural barriers to physician-initiated firearm safety guidance. Interventions designed to increase physicians' willingness to have these conversations must first address why these conversations fail to occur. Physician participants expressed the need for revised patient screening tools, training on approaching conversations about secure firearm storage, and a mechanism to allocate sufficient time in a well-visit, among the many other topics they must discuss. Interview participants had minimal understanding of ERPO and how to counsel patients on petitioning for ERPO. |
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| ISSN: | 1552-6127 |
| DOI: | 10.1177/10901981251338864 |