Resident Physician UPMC Childrens Hospital of Pittsburgh Pittsburgh, Pennsylvania, United States
Background: As of 2020, firearm injuries have become the leading cause of death for children and adolescents in the United States. Allegheny County, Pennsylvania, has 152 licensed firearms dealers, which is the highest of any county in the state, as well as the most firearms sales. Guns are plentiful in our communities and stories of gun violence repeatedly banner our local and national news headlines. Despite this ubiquity, pediatricians and pediatric residents have anecdotally shared discomfort and uncertainty when it comes to firearm counseling. Only two prior studies have queried pediatric residents on this subject, and both have shown deficits in knowledge and comfort. Objective: To assess comfort, knowledge gaps, and barriers to firearm counseling among pediatric residents in an effort to educate and empower residents. Design/Methods: Pediatric residents at UPMC Children's Hospital of Pittsburgh (CHP) were surveyed for this study. The survey was created and distributed using REDCap v13.8.3. We gathered resident demographic, frequency of gun counseling, barriers to counseling, and desired resources. All responses were anonymous and without identifiable information. Data was stored on the REDCap secure server and only accessible to the study team. Results: 36 (28%) of the pediatric residency class completed the survey. The majority of respondents were in their first three years of postgraduate training, self-identified as female, and identified as white. 75% of respondents reported asking about firearms or counseling on firearm safety in half of well-child visits or fewer. Patient age, concern for mental health disorder, and history of risky behavior were the most reported characteristics that would prompt the respondents to bring up firearms. The most common barriers included time restraints, knowledge of safe storage options, comfort discussing the subject matter, and available resources. In particular, over 80% of respondents were not familiar with resources in our community or at our hospital to provide to families.
Conclusion(s): Most residents felt that it was the pediatrician's responsibility to counsel about firearm safety, yet most did not feel comfortable doing so due to lack of knowledge and available resources. Our results mirror what two prior studies have shown with pediatric residents from Maryland and Texas. Thus, this need appears to be pervasive at a national level. These results provide direction of our quality improvement project, which includes a website parents can be referred to for safe storage information as well as resource sheets to provide to families within the hospital and clinics.
