Abstract
The primary objective of the current study was to examine the perspective of firearm stakeholders, including firearm safety course instructors, members of law enforcement, and firearm retailers, with regard to the implementation of an evidence-based approach to firearm safety promotion, the Firearm Safety Check, as a universal suicide prevention strategy in pediatric primary care. Twelve firearm stakeholders participated in semi-structured interviews. Using an integrated analytic approach, several themes emerged from the interviews. With regard to acceptability of the intervention, participants generally found counseling caregivers to store firearms safely and the provision of firearm locking mechanisms to be acceptable, but expressed concern about screening for firearm ownership in health systems. Participants identified distinct roles of responsibility for firearm advocacy groups, firearm owners, healthcare clinicians, and caregivers with regard to the promotion and execution of safe firearm storage. Participants called for partnerships between healthcare systems and firearm stakeholders, and also identified potential threats to these partnerships, including lack of trust firearm owners may have in health systems and the government. Finally, participants suggested strategies for preventing firearm-related suicides. Findings support a growing body of literature suggesting the value in researchers, health systems, and firearm stakeholders partnering around a shared agenda of firearm safety promotion as a strategy to prevent suicide.
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Acknowledgements
We would like to thank Steven C. Marcus, PhD, Research Associate Professor at the School of Social Policy and Practice, University of Pennsylvania, for his methodological contributions as a co-investigator. We are grateful for the support and cooperation the Mental Health Research Network has provided for this project, particularly Gregory Simon, MD, MPH, and the MHRN Suicide Prevention SIG. We would like to thank the following experts who provided their time and input on this project: Collen Barry, PhD, Shari Barkin, MD, MSHS, Maria Fernandez, PhD, Carol Runyan, MPH, PhD, Garen Wintemute, MD, MPH, Marian Betz, MD, MPH, and Megan Ranney, MD, MPH. We are also grateful for the help provided by Danielle Adams, AM; Kelly Zentgraf, BA; Shiv Nadkarni; and Peter Simonsson, MSW.
Funding
This project was supported by the following grants from NIMH: R21 MH109878 (PI: Beidas) and U19 MH092201 (PI: Simon).
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Shari Jager-Hyman, Courtney Benjamin Wolk, Brian K. Ahmedani, John E. Zeber, Joel A. Fein, Gregory K. Brown, Y. Vivian Byeon, Hannah Listerud, Courtney A. Gregor, Adina Lieberman, and Rinad S. Beidas declare that they have no conflict of interest.
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All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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Jager-Hyman, S., Benjamin Wolk, C., Ahmedani, B.K. et al. Perspectives from firearm stakeholders on firearm safety promotion in pediatric primary care as a suicide prevention strategy: a qualitative study. J Behav Med 42, 691–701 (2019). https://doi.org/10.1007/s10865-019-00074-9
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DOI: https://doi.org/10.1007/s10865-019-00074-9