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Firearm injuries is the leading cause of death for children in the United States with approximately 5,000 children being injured or killed by firearms annually. Estimates show there are over 400 million legal and illicit firearms in the US, with approximately 43% of Minnesotans owning a firearm, and over 4.5 million US children living in a home where a firearm is stored loaded and unlocked. Due to the ubiquity of firearms in American homes, interventions that address safe storage can prevent a significant number of pediatric injuries and deaths. Injury prevention and safety counseling are integral parts of pediatric care. Pediatric providers already screen for and provide safety counseling regarding infant sleep location, car seats, bike helmets, and smoking. Firearm safety screening is a natural fit with pediatric practice. However, in the absence of a standardized process, screening for firearm access is rarely completed. In this randomized controlled trial (RCT), the investigators will identify the most effective firearm safety screening question(s) among caregivers of children presenting to the pediatric emergency department (PED) using a stratified, six-arm RCT. Under the assumption that individuals under-report firearm ownership, firearm safety screeners resulting in higher rates of self-reported firearm exposure will be considered more effective.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Screening | Experimental | Caregivers who receive Screening Questionnaire 1 |
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| If Firearm how stored | Experimental | Caregivers who receive Screening Questionnaire 2 |
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| Firearm in places where child spends time | Experimental | Caregivers who receive Screening Questionnaire 3 |
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| Is there a firearm, how prevented from shooting accidentally | Experimental | Caregivers who receive Screening Questionnaire 4 |
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| If firearm stored in lockbox, cable lock, unlocked | Experimental | Caregivers who receive Screening Questionnaire 5 |
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| How are firearms stored anywhere your child spends time | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Screening Questions 1 | Other | The arm asks caregiver about firearm possession and whether it is locked. |
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| Measure | Description | Time Frame |
|---|---|---|
| Highest rate of report of firearm exposure. | Per screener, which yielded the highest reported rate of firearm exposure | Screener takes 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of uptake of cable lock or lockbox in those reporting firearm exposure | For each screening, a "positive" exposure to firearms was determined. These individuals were offered a lockbox and all participants were offered a cable lock. The secondary outcome specifically assessed the rate of uptake of the locking devices in those reporting firearm exposure. | Each participant completed a one time survey in the ED. There was no extended enrollment or follow up. The survey took approximately 10 minutes to complete. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Minnesota | Minneapolis | Minnesota | 55405 | United States |
De-identified results may be shared with other researchers who contact the study PI requesting said data.
Will be available from the time of manuscript publication (still awaiting submission), for 2 years.
IPD and supporting information may be accessed by emailing the study PI and requesting this information. This will be shared via encrypted email.
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Model Description
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Masking Description
Caregivers who receive Screening Questionnaire 6
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| Screening Questionnaire 2 | Other | Caregivers are asked modified questions about firearm possession and how firearm is stored. |
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| Screening Questionnaire 3 | Other | Caregivers are asked modified questions about firearm possession and how firearm is stored. |
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| Screening Questionnaire 4 | Other | Caregivers are asked modified questions about firearm possession and how firearm is stored. |
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| Screening Questionnaire 5 | Other | Caregivers are asked modified questions about firearm possession and how firearm is stored. |
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| Screening Questionnaire 6 | Other | Caregivers are asked modified questions about firearm possession and how firearm is stored. |
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