TABLE 3

Studied Interventions With Null Findings (ie, Did Not Improve Gun Safety)

First Author, YearStudy DesignStudy SettingStudy PopulationIntervention GroupResultsLimitationsKey Conclusions
Oatis, 199962QuasiexperimentalMidwest urban pediatric clinic, OhioParents of pediatric patients (median age 2 y, range 0–17 y) seen for annual school physical clinic visitClinician-delivered verbal and written counseling on firearm safety (n = 1617, 381 with complete follow-up data)No change in prevalence of guns in the home, guns stored unlocked or guns loadedSelf-reported, low follow-up rate, underpoweredOffice-based clinician-delivered verbal and written counseling on firearm safety did not improve safe storage of firearms.
Brent, 200063QuasiexperimentalPsychiatry clinic, PennsylvaniaParents and families of adolescents with diagnosis of major depressionRepeated firm recommendations by provider to remove guns for parents reporting firearms in the home (n = 29)No difference in families of depressed teens who removed guns from homeSmall sample size, post hoc analysis, not standardized intervention, self-report, social desirability biasIn a high-risk group of parents of teens receiving psychotherapy for depression, the majority did not comply with office-based provider’s verbal recommendations to remove firearms from the home.
Grossman, 200064Randomized controlled trial9 urban and suburban family medicine and pediatric practices, WashingtonFamilies of children 2 mo–18 y old for well child visitPractitioner-delivered verbal and written gun safety counseling, with coupons for obtaining discounted trigger locks and lockboxes for firearm-owning families (n = 309), counseling to not acquire a gun for non–gun-owning familiesNo difference in firearm acquisition between groups, rates of firearm removal, or rates of purchase of firearm safety equipment among firearm ownersDifficulty assessing whether intervention was delivered, self-reported outcomes, not a validated questionnaireOffice-based practitioner’s verbal and written counseling along with coupons for safety devices did not improve safe storage or removal of firearms from homes.
Stevens, 200265Randomized controlled trial12 pediatric clinics, mostly rural New EnglandGun-owning and non–gun-owning families of fifth- and sixth-graders seen for well child visitsPractitioner-delivered counseling on safety, including gun safety, clinic support, and written materials (n = 6 practices)No difference in safe storage of guns at 12, 24, or 36 moMultiple-injury prevention intervention, self-reported outcomes, low baseline report rate of gun ownershipOffice-based counseling with long-term reinforcement did not improve safe storage of guns.
Johnston, 200266Randomized controlled trialUrban level 1 trauma center pediatric ED Pacific NW, Washington12- to 20-y-old medically stable and cognitively able patients presenting with an injury20-min behavior change counseling by a trained therapist regarding injury risk behaviors (n = 318)No difference in likelihood to carry a weapon at 3 and 6 moIntervention targeting multiple risky behaviors, low baseline rates, secondary outcome self-reported dataED-based behavior change counseling for adolescents seen for injury on overall injury risk reduction does not reduce the likelihood of carrying a weapon.