One Step Closer to Safer: Counseling Outcomes from American Academy of Pediatrics Firearm Safe Storage Education Training

Abstract

To assess pre- and post-self-reported counseling outcomes for Safer: Storing Firearms Prevents Harm, an American Academy of Pediatrics universal firearm safe storage counseling training for pediatric clinicians providing health maintenance in outpatient settings. Safer was developed by a national multidisciplinary committee of firearm injury prevention experts with input from firearm-owning families and launched in June 2021. Pediatric clinicians completed baseline and one-month post-training surveys after signing up for the Pedialink course from February through June 2022. Primary outcomes included self-reported measures of counseling self-efficacy and frequency. Wilcoxon matched-pairs signed-rank tests compared outcome distributions at baseline and follow-up. Two adjusted, multilevel mixed-effects regression models were conducted. Of 230 clinicians who completed baseline surveys, 146 (64%) completed one-month post surveys. Regional representation included Southeast=67 (46%), Northeast=24 (16%), Midwest=21 (14%), Pacific=15 (10%), Southwest=11 (8%), and Rocky Mountain=8 (5%). At follow-up, there was significant improvement in both the distribution of self-efficacy [median [(1st Quartile-3rd Quartile)=50 (20-70) at baseline and 80 (60-85) at follow-up; p<0.001] and self-reported counseling frequency [median (1st Quartile-3rd Quartile)=10 (0-50) at baseline and 50 (10-80) at follow-up; p<0.001]. Adjusted regression model results suggested that self-efficacy significantly improved from baseline to follow-up (time coefficient 25.3; 95% CI=[21.0, 29.5]; p<0.001) as did counseling frequency (time coefficient 13.6; 95% CI=[9.2, 18.0]; p<0.001). Significant improvement in self-reported counseling self-efficacy and frequency was demonstrated one month following Safer training.