Knowledge Gaps Identified in a Survey of Maine Physicians' Firearm Safety Counseling Practices.

Julia Oppenheimer, Anya Cutler, Kristine Pleacher
Author Information
  1. Julia Oppenheimer: Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, USA.
  2. Anya Cutler: Center for Interdisciplinary Population and Health Research, Westbrook, USA.
  3. Kristine Pleacher: Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, USA. kmpleacher@gmail.com. ORCID

Abstract

Numerous medical associations have identified firearm injuries as a public health issue, calling on physicians to provide firearm safety counseling. Data suggest that while many physicians agree with this, few routinely screen and provide counseling. We aimed to survey Maine physicians to assess their current firearm safety counseling practices and knowledge of a new state child access prevention (CAP) law. We conducted an anonymous cross-sectional survey of Maine primary care and psychiatry physicians. We recruited multiple statewide medical organizations, residency programs, and two major health systems to distribute the survey to their membership. Group differences were compared by physician rurality and years in practice using Fisher's Exact and Chi Squared tests. Ninety-five surveys were completed. Though most participants agreed that firearm injury is an important public health issue that physicians can positively affect (92%), few had received prior firearm safety counseling education (27%). There were significant differences in firearm screening frequency, with rural physicians screening more often. More rural physicians and physicians with >���10 years of clinical practice felt they had adequate knowledge to provide meaningful counseling, compared with non-rural and early career physicians, respectively. Overall, 62% of participants were unaware of the 2021 Maine CAP law. This study highlights significant differences in firearm safety counseling practices among Maine physicians based on rurality and years of experience. Participants also reported a significant gap in knowledge of a recent state child access prevention law. Next steps include development of firearm safety counseling education tailored to Maine physicians.

References

  1. Goldstick, J. E., Cunningham, R. M., & Carter, P. M. (2022). Current causes of death in children and adolescents in the United States. New England Journal of Medicine, 386(20), 1955���1956. [DOI: 10.1056/NEJMc2201761]
  2. Roberts, B. K., Nofi, C. P., Cornell, E., Kapoor, S., Harrison, L., & Sathya, C. (2023). Trends and disparities in Firearm deaths among children. Pediatrics, 152(3). https://doi.org/10.1542/peds.2023-061296 .
  3. Centers for Disease Control and Prevention, National Centers for Injury Prevention and Control (Published 2005). Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. www.cdc.gov/injury/wisqars . Accessed March 13, 2023.
  4. Schell, T. L., Peterson, S., Vegetabile, B. G., Scherling, A., Smart, R., & Morral, A. R. (2020). State-level estimates of Household Firearm Ownership. RAND Corporation.
  5. LD 759 (2024). HP 564, Text and Status, 130th Legislature, First Special Session (maine.gov) Accessed June 3.
  6. Butkus, R., Doherty, R., Bornstein, S. S., & For the Health and Public Policy Committee of the American College of Physicians. (2018). Reducing firearm injuries and deaths in the United States: A position paper from the American College of Physicians. Annals of Internal Medicine, 169(10), 704���707. [DOI: 10.7326/M18-1530]
  7. Lee, L. K., Fleegler, E. W., Goyal, M. K., et al. (2022). Firearm-related injuries and deaths in children and youth: Injury Prevention and Harm Reduction. Pediatrics, 150(6), e2022060070. [DOI: 10.1542/peds.2022-060070]
  8. Gun, Violence, & Prevention of (Position Paper). (2018). https://www.aafp.org/about/policies/all/gun-violence.html . Accessed March 12, 2024.
  9. Gun Violence and Safety; Statement of Policy (2023). https://www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy . Accessed March 12, 2024.
  10. Statement from the American Psychiatric Association on Firearm Violence (2022). https://www.psychiatry.org/news-room/news-releases/apa-statement-on-firearm-violence . Accessed March 12, 2024.
  11. Abdallaha, H. O., & Kaufman, E. J. (2021). Before the bullets fly: The Physician���s role in preventing Firearm Injury. Yale Journal of Biology and Medicine, 94, 147���152.
  12. Betz, M. E., & Wintemute, G. J. (2015). Physician counseling on Firearm Safety: A New Kind of Cultural competence. Jama, 314(5), 449���450. [DOI: 10.1001/jama.2015.7055]
  13. McCarthy, M. (2014). US internists call for public health approach to gun violence in US. Bmj, 348, g2796. [DOI: 10.1136/bmj.g2796]
  14. Sathya, C., & Kapoor, S. (2022). Universal Screening for Firearm Injury Risk Could Reduce Healthcare���s Hesistancy in Talking to Patients About Firearm Safety. Ann Surg Open ;3(1).
  15. Hathi, S., & Sacks, C. A. (2019). #ThisIsOurLane: Incorporating Gun Violence Prevention into Clinical Care. Current Trauma Reports, 5(4), 169���173. [DOI: 10.1007/s40719-019-00174-6]
  16. Butkus, R., & Weissman, A. (2014). Internists��� attitudes toward prevention of firearm injury. Annals of Internal Medicine, 160(12), 821���827. [DOI: 10.7326/M13-1960]
  17. Rubin, N. (2019). ObGyn Physician Knowledge, Comfort, and Current Practices of Firearm Safety Counseling.
  18. Thai, J. N., Saghir, H. A., Pokhrel, P., & Post, R. E. (2021). Perceptions and experiences of Family Physicians regarding Firearm Safety Counseling. Family Medicine, 53(3), 181���188. [DOI: 10.22454/FamMed.2021.813476]
  19. Titus, S. J., Huo, L., Godwin, J., et al. (2022). Primary care physician and resident perceptions of gun safety counseling. Proc Bayl Univ Med Cent, 35(4), 405���409. [DOI: 10.1080/08998280.2021.2004532]
  20. von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., G��tzsche, P. C., & Vandenbroucke, J. P. (2007). Strengthening the reporting of Observational studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Bmj, 335(7624), 806���808. [DOI: 10.1136/bmj.39335.541782.AD]

MeSH Term

Humans
Maine
Firearms
Cross-Sectional Studies
Female
Male
Counseling
Adult
Middle Aged
Health Knowledge, Attitudes, Practice
Physicians
Wounds, Gunshot
Surveys and Questionnaires
Safety

Word Cloud

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