TABLE 2

Studied Interventions With Positive Findings (ie, Improved Gun Safety)

First Author, YearStudy DesignStudy SettingStudy PopulationIntervention GroupResultsLimitationsKey Conclusions
Kruesi, 199923QuasiexperimentalMidwest rural ED, IllinoisParents of 6- to 19-y-old patients seen in the ED for a mental health assessmentMeans restriction verbal counseling to limit access to lethal weapons targeting parents of youth at risk for suicide(n = 41)Increased likelihood of locking up or disposing of firearms in those who had guns in the homeNot randomized, small sample size, self-reported dataMeans restriction counseling delivered to parents of children seen for mental health assessment in an ED may increase likelihood of decreasing access to firearms.
0 of 7 control, 5 of 8 intervention (P < .05)
Albright, 200331Quasiexperimental (3-arm)Family practice clinic, urban community-based, university affiliated teaching clinic, TexasAdult patients or families of children attending clinic visits (mostly female and Hispanic); restricted to gun ownersGroup 1: survey and verbal counseling (n = 36)Made safe changes: 31% control, 64% group 1, 58% group 2 (P = .02)Not randomized, small sample sizeOffice-based verbal counseling with or without written materials improved safe firearm storage habits.
Group 2: survey, verbal counseling, and written counseling (n = 52)
Made an unsafe change: 31% control, 22% group 1, 31% group 2 (P = .09)
Carbone, 200529QuasiexperimentalPediatric clinic, urban community health center, ArizonaFamilies at clinic visits (mostly Hispanic); restricted to gun ownersPhysician-delivered 1- to 2-min verbal counseling, gun safety brochure, and free gun lock (n = 73 families)Improvement in gun safety practices: 27% control, 62% intervention (P < .001)Time series design, small sample size, self-reported data, social desirability biasOffice-based safe storage counseling with written materials and a free gun lock led to significant improvements in safe gun storage behaviors (but not removal of firearms from home).
Improvement in gun safe storage: 12% control, 51% intervention (P < .001)
Barkin, 200821Randomized controlled trialPediatric clinics in 41 US states, Canada, and Puerto Rico participating in practice-based research network of the AAPFamilies of children 2–11 y old for well child visitPhysician-delivered counseling using motivational interviewing with provision of free cable locks (n = 68 practices, 470 families)Using firearm cable locks at 1 mo: 59% control, 64% intervention (P = .006)Self-reported dataOffice-based counseling with provision of free cable firearm locks significantly increased safe firearm storage in firearm-owning families.
Safe firearm outcomes only analyzed by gun owners
Using firearm cable locks at 6 mo: 54% control, 68% intervention (P < .001)
Grossman, 201230Randomized controlled trial6 villages in 2 regions, AlaskaGun-owning households with no operational gun safe for storageStepped wedge design in 2 phases (early vs late), installation of a free metal gun cabinet with verbal and written instructions on use, and safety message about safe storage of guns and ammunition (early n = 129, late = 126)Report both gun and ammunition unlocked at 12 and 18 mo: 23% control, 78% intervention (P < .001)Lack of generalizability of the intervention and results to other settings and populationsCommunity-based intervention to install gun cabinets along with verbal and written safety messages increased safe firearm storage practices.
Zatzick, 201432Randomized controlled trialInpatient setting in a level 1 trauma center, WashingtonInpatient adolescents (12–18 y old) hospitalized for both intentional and unintentional injuriesStepped collaborative care intervention including motivational interviewing targeting risk behavior and substance abuse, and cognitive–behavioral therapy targeting PTSD and depression (n = 59)Collaborative care intervention: Patients had reduced weapon carrying at 1 yPrimary outcome was not specific to carrying weapons, but the study did include weapon carrying at 1 y as a secondary outcome; small sample.Stepped collaborative care intervention for assault-injured teens reduced likelihood of carrying a weapon at 1 y.
21% control, 7% intervention, odds ratio = 0.31 (95% confidence interval, 0.11–0.9)
  • Table adapted from Rowhani-Rahbar et al28 and Roszko et al.61 AAP, American Academy of Pediatrics; PTSD, posttraumatic stress disorder.