Firearm Safety
Conditions
Keywords
firearm, gun, safety, pediatric, inpatient
Brief summary
There is currently no available data regarding using the inpatient setting as an opportunity to talk to parents/guardians about firearm safety. The investigators will be doing a pre-/post-intervention study to investigate the effect of an intervention (a 5.5 minute Be SMART video and written materials developed by the organization Everytown for Gun Safety), on parental/legal guardian knowledge, attitudes and practices regarding firearm safety. While the American Academy of Pediatrics recommends the safest home for children is one without guns, the reality is that there are families with guns in the home. This non-political video focuses on ways to keep children safe from firearms. The investigators will also investigate any additional effect of physician-delivered counseling on parental/guardian knowledge, attitudes and practices regarding gun safety as compared to receiving the information solely via video and written materials. Participants will be randomized to 1 of 3 groups (intervention, intervention + MD discussion and control group). Outcomes will be assessed immediately post intervention and in a 30-day follow up phone call.
Detailed description
Eligibility: All parents/guardians of inpatients admitted to the Children's Hospital at Montefiore. Exclusion: Parents/guardians whose children are in acute distress or in the Pediatric Intensive Care Unit. Outcomes: The primary outcome is the change in parent/legal guardian's behavior over the past 30 days with respect to how often they asked whether or not there are guns in the home when their child/children goes to play in another's person's home, as indicated by a Likert scale assignment of an ordinal value (1-5, 1= never, 2=rarely, 3=sometimes, 4=most of the time, 5=always). Secondary outcomes will include: * Change in the primary outcome (intention to ask noted above) between the intervention groups (Be SMARTalone vs. Be SMART + MD) * Demographic factors associated with primary outcome * Description of general knowledge on firearm safety of parents/legal guardians of patients in our community * Description of attitudes about firearm safety of parents/legal guardians of patients in our community * Description of general practices regarding firearm safety of parents/legal guardians of patients in our community * Description of parents attitudes regarding physicians discussing firearm safety with them
Interventions
BEHAVIORALBe SMART
An educational campaign that is non-political reviewing gun safety measures for preventing firearm injuries in children. There is both a video and written materials reviewing the information. The acronym SMART stands for: Secure all guns in your home, Model responsible behavior, Ask about unsecured guns in other homes, Recognize the risks of teen suicide, Tell your peers to be SMART
BEHAVIORALControl: TSE
A video called Kids and Smoke Don't Mix and handouts on tobacco smoke exposure (TSE) developed by the New York state quit-line.
BEHAVIORALBe SMART + MD review
An educational campaign that is non-political reviewing gun safety measures for preventing firearm injuries in children. There is both a video and written materials reviewing the information. The acronym SMART stands for: Secure all guns in your home, Model responsible behavior, Ask about unsecured guns in other homes, Recognize the risks of teen suicide, Tell your peers to be SMART. After being presented to parents/guardians via video and handouts, this information will be reviewed in person with a Physician.
Sponsors
Everytown for Gun Safety
Consano Clinical Research, LLC
Montefiore Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
\-
Exclusion criteria
* parents/guardians whose child is hospitalized in the Pediatric Intensive Care Unit * parents/guardians whose child is in acute distress * parents/guardians who have previously been in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Likert Scale of Frequency of Asking About Guns in the Home When Their Child Goes to Another Person's Home, Pre-intervention and 1 Month Post-intervention | Baseline and last 30 days | The primary outcome is within each group the change in how often the parent/guardian asked whether there are guns in the home when the child went to another person's home in the last 30 days Likert Scale 1=never, 2=rarely, 3=sometimes, 4=most of the time, 5=always |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Doctors Who Take Care of Kids Should Talk to Parents About Safe Gun Storage at 1 Month Post-intervention | 1 month after intervention | Likert Scale Score of degree of agreement with the statement 1=strongly disagree, 2=disagree, 3=not sure, 4=agree, 5=strongly agree |
Countries
United States
Participant flow
Recruitment details
This study examine knowledge, attitudes, and practices of parents/legal guardians regarding firearm safety and tobacco smoke exposure. Children were not enrolled.
Pre-assignment details
The parent/guardian only was enrolled (child was not), therefore it is not a dyad.
Participants by arm
| Arm | Count |
|---|---|
| Be SMART Alone Parents/guardians in this study group will watch a 5.5 minute Be SMART video and receive the handouts reviewing the information.
Be SMART: An educational campaign that is non-political reviewing gun safety measures for preventing firearm injuries in children. There is both a video and written materials reviewing the information. The acronym SMART stands for: Secure all guns in your home, Model responsible behavior, Ask about unsecured guns in other homes, Recognize the risks of teen suicide, Tell your peers to be SMART | 76 |
| Be SMART + MD Review Parents/guardians in this study group will watch a 5.5 minute Be SMART video and receive the handouts reviewing the information and will also have an MD review the information (via a checklist to standardize the MD review).
Be SMART + MD review: An educational campaign that is non-political reviewing gun safety measures for preventing firearm injuries in children. There is both a video and written materials reviewing the information. The acronym SMART stands for: Secure all guns in your home, Model responsible behavior, Ask about unsecured guns in other homes, Recognize the risks of teen suicide, Tell your peers to be SMART.
After being presented to parents/guardians via video and handouts, this information will be reviewed in person with a Physician. | 75 |
| Control: TSE Materials Parents/guardians in this study group will watch a video Kids and Smoke Don't Mix and receive handouts reviewing information on tobacco smoke exposure (TSE).
Control: TSE: A video called Kids and Smoke Don't Mix and handouts on tobacco smoke exposure (TSE) developed by the New York state quit-line. | 74 |
| Total | 225 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 29 | 30 | 31 |
Baseline characteristics
| Characteristic | Be SMART + MD Review | Control: TSE Materials | Total | Be SMART Alone |
|---|---|---|---|---|
| Age, Continuous | 35.0 years | 32.0 years | 33.0 years | 34.0 years |
| Been shot with a gun? | 1 Participants | 1 Participants | 3 Participants | 1 Participants |
| Been threatened with a gun? | 8 Participants | 7 Participants | 21 Participants | 6 Participants |
| Child age (years), median (IQR) | 6.0 years | 4.0 years | 5.0 years | 4.5 years |
| Child gender Female | 26 Participants | 40 Participants | 109 Participants | 43 Participants |
| Child gender Male | 48 Participants | 34 Participants | 115 Participants | 33 Participants |
| Child gender Missing | 1 Participants | 0 Participants | 1 Participants | 0 Participants |
| Child has seen a gun? | 6 Participants | 4 Participants | 15 Participants | 5 Participants |
| Child has touched a gun? | 3 Participants | 2 Participants | 7 Participants | 2 Participants |
| Child's doctor has ever talked about gun safety | 9 Participants | 4 Participants | 18 Participants | 5 Participants |
| Discussed with child what to do if they find a gun? | 17 Participants | 17 Participants | 53 Participants | 19 Participants |
| Discussed with other children what do do if they find a gun? | 23 Participants | 22 Participants | 66 Participants | 21 Participants |
| For those who don't have a gun, you would feel safer if you had a gun | 7 Participants | 4 Participants | 18 Participants | 7 Participants |
| Friend or relative has a gun? | 20 Participants | 18 Participants | 59 Participants | 21 Participants |
| Guns have been brought into your home by guests | 7 Participants | 5 Participants | 19 Participants | 7 Participants |
| Have a friend/relative shot with a gun? | 27 Participants | 28 Participants | 94 Participants | 39 Participants |
| Have a gun in your home | 2 Participants | 2 Participants | 8 Participants | 4 Participants |
| Heard gunshots in your neighborhood | 42 Participants | 42 Participants | 135 Participants | 51 Participants |
| Insurance Medicaid | 49 Participants | 55 Participants | 150 Participants | 46 Participants |
| Insurance Missing | 3 Participants | 2 Participants | 5 Participants | 0 Participants |
| Insurance None | 0 Participants | 2 Participants | 4 Participants | 2 Participants |
| Insurance Other | 1 Participants | 0 Participants | 3 Participants | 2 Participants |
| Insurance Private | 22 Participants | 15 Participants | 63 Participants | 26 Participants |
| It is important to ask about guns in others' homes when your child goes there | 4.3 Likert score scale of agreement (1-5) STANDARD_DEVIATION 1 | 4.4 Likert score scale of agreement (1-5) STANDARD_DEVIATION 1 | 4.3 Likert score scale of agreement (1-5) STANDARD_DEVIATION 0.7 | 4.4 Likert score scale of agreement (1-5) STANDARD_DEVIATION 1 |
| Language English | 67 Participants | 71 Participants | 211 Participants | 73 Participants |
| Language Mixed English & Spanish | 2 Participants | 0 Participants | 2 Participants | 0 Participants |
| Language Spanish | 6 Participants | 3 Participants | 12 Participants | 3 Participants |
| Parental education College | 27 Participants | 23 Participants | 78 Participants | 28 Participants |
| Parental education Elementary school | 2 Participants | 2 Participants | 5 Participants | 1 Participants |
| Parental education Graduate school | 8 Participants | 5 Participants | 18 Participants | 5 Participants |
| Parental education High School | 32 Participants | 36 Participants | 102 Participants | 34 Participants |
| Parental education Some High school | 6 Participants | 8 Participants | 22 Participants | 8 Participants |
| Race/Ethnicity, Customized Child Race/ethnicity Hispanic | 42 Participants | 45 Participants | 126 Participants | 39 Participants |
| Race/Ethnicity, Customized Child Race/ethnicity Non-Hispanic Black | 19 Participants | 20 Participants | 68 Participants | 29 Participants |
| Race/Ethnicity, Customized Child Race/ethnicity Non-Hispanic White | 3 Participants | 5 Participants | 10 Participants | 2 Participants |
| Race/Ethnicity, Customized Child Race/ethnicity Other | 11 Participants | 4 Participants | 21 Participants | 6 Participants |
| Raised in a home with a gun? | 8 Participants | 2 Participants | 14 Participants | 4 Participants |
| Seen a person with a gun? | 24 Participants | 18 Participants | 65 Participants | 23 Participants |
| Sex: Female, Male Female | 66 Participants | 65 Participants | 196 Participants | 65 Participants |
| Sex: Female, Male Male | 9 Participants | 9 Participants | 29 Participants | 11 Participants |
| Worry your child would play with a gun if they find one | 41 Participants | 42 Participants | 128 Participants | 45 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 76 | 0 / 75 | 0 / 74 |
| other Total, other adverse events | 0 / 76 | 0 / 75 | 0 / 74 |
| serious Total, serious adverse events | 0 / 76 | 0 / 75 | 0 / 74 |
Outcome results
Primary
Change in Likert Scale of Frequency of Asking About Guns in the Home When Their Child Goes to Another Person's Home, Pre-intervention and 1 Month Post-intervention
The primary outcome is within each group the change in how often the parent/guardian asked whether there are guns in the home when the child went to another person's home in the last 30 days Likert Scale 1=never, 2=rarely, 3=sometimes, 4=most of the time, 5=always
Time frame: Baseline and last 30 days
Population: Limited sample for analysis to paired samples within each group (samples where we have responses from the same study subject pre and post)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Be SMART Alone | Change in Likert Scale of Frequency of Asking About Guns in the Home When Their Child Goes to Another Person's Home, Pre-intervention and 1 Month Post-intervention | 0.8 score on a scale | Standard Deviation 1.7 |
| Be SMART + MD Review | Change in Likert Scale of Frequency of Asking About Guns in the Home When Their Child Goes to Another Person's Home, Pre-intervention and 1 Month Post-intervention | 0.6 score on a scale | Standard Deviation 1.3 |
| Control: TSE Materials | Change in Likert Scale of Frequency of Asking About Guns in the Home When Their Child Goes to Another Person's Home, Pre-intervention and 1 Month Post-intervention | 0.9 score on a scale | Standard Deviation 1.4 |
Secondary
Doctors Who Take Care of Kids Should Talk to Parents About Safe Gun Storage at 1 Month Post-intervention
Likert Scale Score of degree of agreement with the statement 1=strongly disagree, 2=disagree, 3=not sure, 4=agree, 5=strongly agree
Time frame: 1 month after intervention
Population: Some parents unable to reach by phone at 1 month
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Be SMART Alone | Doctors Who Take Care of Kids Should Talk to Parents About Safe Gun Storage at 1 Month Post-intervention | 4.2 score on a scale | Standard Deviation 0.9 |
| Be SMART + MD Review | Doctors Who Take Care of Kids Should Talk to Parents About Safe Gun Storage at 1 Month Post-intervention | 4.3 score on a scale | Standard Deviation 0.8 |
| Control: TSE Materials | Doctors Who Take Care of Kids Should Talk to Parents About Safe Gun Storage at 1 Month Post-intervention | 4.3 score on a scale | Standard Deviation 0.8 |