Understanding oral health disparities in children as a global public health issue: how dental health professionals can make a difference

Oral disease in children is an urgent public health issue worldwide. Early childhood caries (ECC) affects 600 million children globally, yet it is entirely preventable. Dental health professionals around the world need to act to improve use of measures to prevent ECC and of quality dental health care to improve oral health worldwide. The University of California/Los Angeles (UCLA) Center for Children's Oral Health hosted an interprofessional innovation forum to discuss and recommend options. We present the policy, educational, and public health-related suggestions for improving outcomes and professional collaboration and five key areas for action: (1) increase advocacy efforts, (2) support interprofessional education and practice, (3) promote oral health education and increase health literacy, (4) increase collaboration with community and school-based oral health care workers, and (5) use of technology to increase access to dental care and health information.

Shifting the paradigm: physician-authorized, student-led efforts to provide harm reduction services amidst legislative opposition

Background

For over 30 years, syringe services programs (SSPs) have served as an efficacious intervention for the prevention of HIV and Hepatitis C transmission among persons who use drugs. Despite a strong body of evidence for the effectiveness of SSPs as a preventative public health measure, numerous local and state governments in the United States continue to resist the establishment of new SSPs and aggressively pursue the closure of those already in operation.

Commentary

In Orange County, California, local officials have repeatedly mobilized in opposition of the establishment of syringe access – thereby hindering access to healthcare for thousands of predominantly unhoused individuals. The county was previously served by the Orange County Needle Exchange Program from 2016 until 2018 when a civil suit brought by the Orange County Board of Supervisors resulted in the closure of the program. For more than 2 years, persons who inject drugs in Orange County lacked reliable access to clean syringes, placing them at increased risk for contracting HIV and Hepatitis C. Here, we comment on the ongoing effort to restore syringe access in Orange County. This collaborative physician-directed endeavor has brought together students and community volunteers to provide vital harm reduction services to a remarkably underserved population. Since the reestablishment of syringe access in Orange County by the Harm Reduction Institute, new legal barriers have arisen including the passage of new municipal legislation banning the operation of syringe exchanges. We are well-equipped to overcome these obstacles. This work serves as an affirmation of assertions made by previous authors regarding the unique qualifications of medical & graduate students as effective harm reductionists.

Conclusion

Harm reduction services are vital to the health and well-being of people who use drugs. The provision of these services should not be impeded by legislative interference by municipal, county, or state governments.

The Role of Patient Support Groups in Neuroendocrine Neoplasms

PURPOSE OF REVIEW

The purpose of this review is to establish the role patient support groups play in NENs.

RECENT FINDINGS

Published data on the role and work done by these groups is extremely sparse, so the review references publications in the wider cancer advocacy context. For the purposes of the review, a survey was carried out among the members of a global umbrella organization to ascertain the level of activities undertaken in support of the NEN patient community. The concept of "support groups" has changed significantly, as these groups have evolved from patient peer-to-peer support provision to a strategic focus on improving awareness and education among all stakeholders, generating patient evidence to influence policies for access to optimal diagnostics, treatment, and care, and setting the research agenda. Today, NEN patient organizations have an instrumental role of catalysts of change across the healthcare spectrum-especially relevant in a setting of less common and not well-understood diseases, where clear pathways and guidelines are still a challenge.

Strengthening community and stakeholder participation in the implementation of integrated vector management for malaria control in western Kenya: a case study

Background

Integrated vector management (IVM) is defined as a rational decision-making process for the optimal use of resources for vector control. The IVM approach is based on the premise that effective control of vectors and the diseases they transmit is not the sole preserve of the health sector. It requires the collaboration and participation of communities and other stakeholders in public and private sectors. Community participation is key to the success of IVM implementation at the local level.

Case description

The study was conducted in Nyabondo, a rural area of Kenya where malaria is endemic. The objective of the project was to promote adoption and sustainability of IVM and scale up IVM-related activities as well as increase community participation and partnership in malaria control through outreach, capacity-building and collaboration with other stakeholders in the area. Collaboration was pursued through forging partnership with various government departments and ministries, particularly the fisheries department, ministry of education, ministry of health, forestry department and the social services. In total, 33 community-based organizations working within the area were identified and their role documented. Through distribution of information, education and communication (IEC) materials alone, the project was able to reach 10,670 people using various social mobilization methods, such as convening of sensitization meetings—dubbed 'mosquito days'—mainly spearheaded by primary school pupils. A total of 23 local primary schools participated in creating awareness on malaria prevention and control during the project phase. The collaboration with other departments like fisheries led to stocking of more than 20 fishponds with a total of 18,000 fingerlings in the years 2017 and 2018. Fish ponds provided an opportunity for income generation to the community. In partnership with the county government health department, the project was able to re-train 40 CHVs on IVM and malaria case management in the area. Additionally, 40 fish farmers were re-trained on fish farming as part of income generating activity (IGA) while 10 CBOs made up of 509 members received both eucalyptus and Ocimum kilimandscharicum seedlings that were distributed to four CBOs composed of 152 members. Four primary schools made up of 113 health club members also received eucalyptus seedlings as part of IGA in addition to fish farming. In total, around 20,000 eucalyptus seedlings were distributed to the community as part of IGA initiatives. By the end of 2018, the project was able to reach 25,322 people in the community during its two-year advocacy and social mobilization initiatives.

Conclusion

Through advocacy and social mobilization, the IVM strategy improved inter-sectoral collaboration, enhanced capacity building and community participation. However, more IVM related activities are needed to effectively mobilize available resources and increase community participation in malaria control.

Health Policy and Advocacy

Awareness of the activities of federal and state legislative and regulatory activities is vital for physicians to avoid having their services misvalued and to protect patients' access to care. Professional organizations are encouraging physicians to develop political leadership and advocacy skills to protect patient care, research, and access to technology. The political polarization of the country and the public health emergency have had an impact on the ability and willingness of some to engage in policy discussions. This article reviews mechanisms by which urologists can engage in health policy and political activity and avenues to expand the number of urologists involved.

Sisters Network, Inc.: the Importance of African American Survivor Advocates in Addressing Breast Cancer Disparities

Purpose of Review

To explain the role of African American survivor advocates in addressing breast cancer disparities.

Recent Findings

The Sisters Network, Inc. is a national African American survivor advocates organization, founded in Houston Texas in 1994 and active today via affiliate chapters throughout the United States as well as its national headquarters. The Sisters Network provides essential outreach, educational, and research support to the breast oncology community.

Summary

The breast oncology community should partner with the Sisters Network and support their activities in efforts to achieve breast health equity.

Barriers and opportunities for nontraditional social work during COVID-19: Reflections from a small LGBTQ+ nonprofit in Detroit

COVID-19 has significantly changed individual lives and organizational structures throughout the world. Certain regions and populations, however, have experienced the effects of this global pandemic to a heightened degree. This article includes reflections from a small LGBTQ+ nonprofit in Detroit, a city with some of the starkest health and economic disparities in the United States. While COVID-19 has illuminated numerous barriers for LGBTQ+ older adults in Detroit, it has also revealed surprising ways that nontraditional social work is emerging. The experiences from this organization suggest that when faced with limited resources, LGBTQ+ community members and advocates have expanded their services in ways that mirror the work of many professional social workers, including interpersonal support; facilitated group discussions; direct services; program design, delivery, and coordination; community organizing; and research. Through these roles, community members are beginning to serve as nontraditional social workers to address the urgent and unmet needs of LGBTQ+ older adults and increase the visibility of this population during COVID-19.

Looking Back to Move Forward: Canadian Occupational Therapy In Public Health, 1914-2019

BACKGROUND.

Decades of literature demonstrate that occupational therapy is well-suited to collaborate with public health due to overlapping views of health. However, there has been little collaboration between these professions with few examinations of why they remain distinct.

PURPOSE.

This study examines historical events that have led to the present-day separation of occupational therapy and public health.

METHOD.

This narrative review and thematic analysis of the scholarly, archival, and grey literature was conducted to examine the development of both fields.

FINDINGS.

Fifty texts were analyzed revealing four themes: the influence of structural and social forces; professional, societal, and institutional hindrances; potential for a shared vision; and next steps for integration. These themes highlight historical barriers to collaboration and provide evidence that occupational therapy could benefit public health.

IMPLICATIONS.

Collaboration between occupational therapy and public health has many potential benefits, however new approaches to bridge the divide are needed to advance collaboration.

Community-driven citizen science approach to explore cardiovascular disease risk perception, and develop prevention advocacy strategies in sub-Saharan Africa: a programme protocol

BACKGROUND

In sub-Saharan Africa (SSA), which experiences a disproportionately high cardiovascular disease (CVD) burden, population-based screening and prevention measures are hampered by low levels of knowledge about CVD and associated risk factors, and inaccurate perceptions of severity of risk.

METHODS

This protocol describes the planned processes for implementing community-driven participatory research, using a citizen science method to explore CVD risk perceptions and to develop community-specific advocacy and prevention strategies in the rural and urban SSA settings. Multi-disciplinary research teams in four selected African countries will engage with and train community members living in rural and urban communities as citizen scientists to facilitate conceptualization, co-designing of research, data gathering, and co-creation of knowledge that can lead to a shared agenda to support collaborative participation in community-engaged science. The emphasis is on robust community engagement, using mobile technology to support data gathering, participatory learning, and co-creation of knowledge and disease prevention advocacy.

DISCUSSION

Contextual processes applied and lessons learned in specific settings will support redefining or disassembling boundaries in participatory science to foster effective implementation of sustainable prevention intervention programmes in Low- and Middle-income countries.

Advocacy to Government and Stakeholders

Participation in the health care and government advocacy arena may represent new and challenging perspectives for the traditional neurosurgeon. However, those with a strong understanding of the laws, rules, regulations, and fiscal allocation process can directly influence the practice of neurosurgery in the United States. We seek to shine light on the black box of how health care laws are passed, the influence and techniques of lobbying, and the role and rules surrounding political action committees. This practical review of health care advocacy is supplemented by a blueprint for engagement in the political arena for the practicing neurosurgeon.

Adapting the WHO recommendations on health worker roles for safe abortion to a country setting: A case study from India

In 2015, the World Health Organization (WHO) published a guideline on the role of health workers in providing safe abortion and postabortion contraception, with evidence‐based recommendations on the range of providers who can perform interventions to provide safe abortion, postabortion care, and postabortion contraception. The WHO guideline is global in nature and must be contextualized to individual country settings. The present paper compares the scenario in India, including the legal and policy frameworks, with the WHO guidelines. It provides legal and policy recommendations that are needed to improve access to comprehensive abortion care in India, with a focus on expanding the provider base. The process used to develop these recommendations was a combination of empirical evidence gathering and multistakeholder consultations. An outcome of this exercise was a policy brief entitled “Improving access to comprehensive abortion care in India with focus on expanding provider base,” which is used as an advocacy tool.

The process followed by multistakeholders to develop evidence‐based country‐specific recommendations focusing on expanding the provider base using WHO guidelines on the role of health workers to provide comprehensive abortion care.

An evaluation of cascading mentorship as advocacy training in undergraduate medical education

BACKGROUND

Physicians are in a position of great influence to advocate for health equity. As such, it is important for physicians-in-training to develop the knowledge and skills necessary to fulfil this role. Although various undergraduate medical programs have implemented health advocacy training, they often lack experiential learning and physician involvement. These aspects are foundational to the Advocacy Mentorship Initiative (AMI) which utilizes cascading mentorship as a novel approach to advocacy training. Medical students develop advocacy competency as peer mentors to youth raised in at-risk environments, while also being mentored themselves by physician residents. We aim to determine whether there are specific advantages to utilizing cascading mentorship to facilitate the attainment of advocacy competencies in undergraduate medical education.

METHODS

Medical students participating in AMI between 2017 to 2020 completed pre- and post-exposure questionnaires. Questionnaires assessed confidence in advocacy-related skills and knowledge of youth advocacy concepts, as well as learning goals, skills gained, benefits of AMI and resident mentors, and impact on future career. Sign tests were utilized to analyze quantitative results, and content analysis was used for open-ended responses. A triangulation protocol was also utilized.

RESULTS

Fifty mentors participated, 24 (48%) of which completed both pre- and post-exposure questionnaires. Participants gained confidence in advocacy-related skills (p < 0.05) such as working with vulnerable populations and advocating for medical and non-medical needs. They also reported significant improvements (p < 0.01) in their understanding of social determinants of health and concepts related to children's health and development. Content analysis showed that participants built meaningful relationships with mentees in which they learned about social determinants of health, youth advocacy, and developed various advocacy-related skills. Participants greatly valued mentorship by residents, identifying benefits such as support and advice regarding relations with at-risk youth, and career mentorship. AMI impacted participants' career trajectories in terms of interest in working with youth, psychiatry, and advocacy.

CONCLUSIONS

AMI offers a unique method of advocacy training through cascading mentorship that engages medical students both as mentors to at-risk youth and mentees to resident physicians. Through cascading mentorship, medical students advance in their advocacy-related skills and understanding of social determinants of health.

Child Sex Trafficking: Strategies for Identification, Counseling, and Advocacy

The human rights violation of sex trafficking continues to occur in the United States at alarming rates. Although sex trafficking affects individuals across various demographic groups, this crime disproportionately affects children. Counselors who work with children and adolescents are uniquely positioned to identify, support, and advocate on behalf of sex trafficked youth who may experience barriers to emotional and physical wellness. Extant literature on counseling sex trafficking survivors remain scarce and illuminate the need for victim identification, trauma-informed interventions, and advocacy strategies that support the unique needs of child sex trafficking survivors. To address these disparities, this article describes victim identification techniques, outlines trauma-focused interventions for counseling sex trafficked youth, and presents advocacy strategies. The implications for counseling child sex trafficking survivors are illuminated through a case study.

Youth Advocacy Varies in Relation to Adult Advisor Characteristics and Practices in Gender-Sexuality Alliances

With growing attention to youth's efforts to address sexual and gender diversity issues in Gender-Sexuality Alliances (GSAs), there remains limited research on adult advisors. Do advisor characteristics predict their youth members' advocacy? Among 58 advisors of 38 GSAs, we considered whether advisor attributes predicted greater advocacy by youth in these GSAs (n = 366) over the school year. GSAs varied in youth advocacy over the year. Youth in GSAs whose advisors reported longer years of service, devoted more time to GSA efforts each week, and employed more structure to meetings (to a point, with a curvilinear effect), reported greater relative increases in advocacy over the year (adjusting for initial advocacy and total meetings that year). Relative changes in advocacy were not associated with whether advisors received a stipend, training, or whether GSAs had co-advisors. Continued research should consider how advisors of GSAs and other social justice-oriented groups foster youth advocacy.

Importance of Advocacy from the Orthopedic Surgeon

Over the past century, governmental involvement in the delivery of health care has grown steadily through health policy initiatives and increased regulations. Traditionally, the involvement in this process for the orthopedic surgeon was minimal because they were focused primarily on direct patient care. These two pathways have met a crossroads, however, where it has now become necessary for the orthopedic surgeon to advocate on behalf of themselves and their patients to guide and influence the legislative and regulatory processes. This article reviews the background of orthopedic advocacy and discusses ways in which the interested surgeon can become involved.

Off to a Jump Start: Using Immersive Activities to Integrate Continuity Clinic and Advocacy

BACKGROUND

Training in advocacy is an important component of graduate medical education. Several models have been implemented by residency programs to address this objective. Little has been published regarding application of immersive advocacy activities integrated into continuity clinic.

OBJECTIVE

To create an Integrated Community Health and Child Advocacy Curriculum (ICHCA) by integrating advocacy activities that were immersive and contextualized in a continuity clinic setting and to familiarize interns with continuity clinic immediately at the beginning of their training.

METHODS

We utilized a socio-constructivist lens, Kern's Six-step curriculum development and a published curriculum mapping tool to create the curriculum. Twenty residents completed ICHCA in 2019. Evaluations from key stakeholders including participants, support staff and attendings were analyzed on four levels of Kirkpatrick's model. We compared results before intervention, immediately following intervention and ten months following intervention.

RESULTS

We demonstrated improvement in learner satisfaction, knowledge and behaviors with respect to advocacy in the clinical environment. Response rate was 70% (7/10) for attendings, 75% for support staff (15/20) and 72.5% for residents (29/40). Our intervention was feasible, no cost, and required no additional materials or training as it relied on learning in real time.

CONCLUSIONS

An integrated advocacy curriculum utilizing the mapping tool for curricular design and evaluation is feasible and has value demonstrated by improvements in reaction, knowledge, and behaviors. This model improves understanding of social responsibility and can be implemented similarly in other residency programs.

Advocating for diamorphine: Cosmopolitical care and collective action in the ruins of the 'old British system'

Britain was the first country in the world to prescribe diamorphine (pharmaceutical-grade heroin) to heroin users as a treatment for opioid dependency. Known and admired internationally as the British System, Britain has a somewhat more ambivalent relationship to its own invention. Where patients were once prescribed diamorphine and other injectable opioids on an unsupervised basis, new patients are no longer initiated in this way and those existing 'old system' patients are under threat. Carrying out ethnographic research at an advocacy service for people who use drugs, I explore this threat as an onto-epistemological concern and the advocates' work to sustain these 'old' ways of knowing and being with diamorphine as a collective matter of care and action. Accounting for advocacy as a non-objective 'emboldening' of the individual to speak, the advocates draw our attention to the inequity of knowledge production and the collective act of speaking in an environment that is increasingly hostile towards these patients. As neoliberal political economies interact with stigmatising forces against people who use drugs, the article highlights the advocate's work as essential in allowing these patients' concerns to be heard where a threat to their prescription becomes a threat to their very way of living.

The role of social advocacy in reducing road traffic accidents in India

Road traffic accidents (RTA) account for a significant proportion of mortality and morbidity worldwide, especially the developing countries. 'Hidden pandemics' such as deaths due to RTA often receive minimal attention globally. If not addressed adequately, the forecast looks bleak, especially for the developing countries in the coming decades. Healthcare professionals have an important role in advocating measures to reduce injuries following RTA and, along with like-minded social individuals, can act as a powerful lobby to implement change. Following a 'Public Interest Litigation or PIL' by the Indian Orthopaedic Association (IOA) in 2012 - which challenged the Government to accept responsibility for this glaring problem and form an apex body to enforce road safety - the Supreme Court of India identified the existing road-safety laws to be inadequate. It created an 'Empowered Committee' which oversaw various new road safety measures implemented by respective state governments. A public movement called 'UYIR' (meaning 'life' in Tamil) was launched at Coimbatore to reduce RTA. Early results following the implementation of this program showed promising results with a reduction in major accidents. It emphasized that well-planned programs involving the general public could be the way forward in reducing accidents across the country. Hence, Social Advocacy is crucial when an individual or group supports and influences political, economic, and social decisions. Such advocacy aims to gain support in an adverse environment to create the necessary change for the better.

Self-advocacy is associated with lower likelihood of living donor kidney transplantation

BACKGROUND

The Living Donor Navigator (LDN) Program pairs kidney transplant candidates (TC) with a friend or family member for advocacy training to help identify donors and achieve living donor kidney transplantation (LDKT). However, some TCs participate alone as self-advocates.

METHODS

In this retrospective cohort study of TCs in the LDN program (04/2017-06/2019), we evaluated the likelihood of LDKT using Cox proportional hazards regression and rate of donor screenings using ordered events conditional models by advocate type.

RESULTS

Self-advocates (25/127) had lower likelihood of LDKT compared to patients with an advocate (adjusted hazard ratio (aHR): 0.22, 95% confidence interval (CI): 0.03-1.66, p = 0.14). After LDN enrollment, rate of donor screenings increased 2.5-fold for self-advocates (aHR: 2.48, 95%CI: 1.26-4.90, p = 0.009) and 3.4-fold for TCs with an advocate (aHR: 3.39, 95%CI: 2.20-5.24, p < 0.0001).

CONCLUSIONS

Advocacy training was beneficial for self-advocates, but having an independent advocate may increase the likelihood of LDKT.

Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia

Stillbirth is a major public health problem with an enormous mortality burden and psychosocial impact on parents, families and the wider community both globally and in Australia. In 2015, Australia's late gestation stillbirth rate was over 30% higher than that of the best-performing countries globally, highlighting the urgent need for action. We present an overview of the foundations which led to the establishment of Australia's NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE) in 2017 and highlight key activities in the following areas: Opportunities to expand and improve collaborations between research teams; Supporting the conduct and development of innovative, high quality, collaborative research that incorporates a strong parent voice; Promoting effective translation of research into health policy and/or practice; and the Regional and global work of the Stillbirth CRE. We highlight the first-ever Senate Inquiry into Stillbirth in Australia in 2018. These events ultimately led to the development of a National Stillbirth Action and Implementation Plan for Australia with the aims of reducing stillbirth rates by 20% over the next five years, reducing the disparity in stillbirth rates between advantaged and disadvantaged communities, and improving care for all families who experience this loss.

Working in partnership to strengthen health librarianship - Shane Godbolt's legacy

This paper focuses on Shane Godbolt's commitment to international librarianship and global health and her guiding principles for international working. The authors examine and celebrate how these have been applied in practice, impacting many.

Evaluation of whether health education using video technology increases the uptake of screening for diabetic retinopathy among individuals with diabetes in a slum population in Hyderabad

Purpose:

A community-based intervention to compare the effectiveness of pamphlets and videos as education material to promote diabetic retinopathy (DR) screening in urban slums of Hyderabad and to identify barriers/facilitators for compliance with DR screening.

Methods:

A cross-sectional survey among people with diabetes (sample of 267) was followed by a health education intervention where patients were allocated into two groups (121 received pamphlets and 102 attended video sessions). The effectiveness of the intervention was assessed based on the uptake of DR screening. The facilitating factors and barriers to DR screening were explored through semi-structured interviews and focus group discussions with participants and health workers. Data analysis included Chi-square test for quantitative data and thematic analysis for qualitative data.

Results:

Among the 235 people in the health education intervention study, 131 (55.7%) received the pamphlet and 104 (44.3%) watched the educational videos. The uptake of DR screening within 2 months was higher in the group shown the educational video than who received the pamphlet (32.7% vs 11.45%; P < 0.05). Absence of an accompanying person and good vision were barriers that prevented patients from screening. Realization of consequences of DR and proximity of the screening facility were identified as motivators. The major results we found in the initial survey of 267 people were that 74.5% had never had HbA1c test and locals underwent health check-ups more regularly than migrants (62.2% versus 34%; P < 0.05).

Conclusion:

Educational videos led to greater behavior change than pamphlets in motivating diabetics for DR screening.

An ethical analysis of UK drug policy as an example of a criminal justice approach to drugs: a commentary on the short film Putting UK Drug Policy into Focus

Background

Drug-related deaths in the UK are at the highest level on record—the war on drugs has failed. A short film has been produced intended for public and professional audiences featuring academics, representatives of advocacy organisations, police and policymakers outlining the problems with, and highlighting alternative approaches to, UK drug policy. A range of ethical arguments are alluded to, which are distilled here in greater depth for interested viewers and a wider professional and academic readership.

Main body

The war on drugs is seemingly driven by the idea that the consumption of illegal drugs is immoral. However, the meaning ascribed to ‘drug’ in the illicit sense encompasses a vast range of substances with different properties that have as much in common with legal drugs as they do with each other. The only property that distinguishes illegal from legal drugs is their legal status, which rather than being based on an assessment of how dangerous they are has been defined by centuries of socio-political idiosyncrasies. The consequences of criminalising people who use drugs often outweigh the risks they face from drug use, and there is not convincing evidence that this prevents wider drug use or drug-related harm. Additionally, punishing someone as a means, to the end of deterring others from drug use, is ethically problematic. Although criminalising the production of harmful drugs may seem more ethically tenable, it has not reduced the supply of drugs and it precludes effective regulation of the market. Other potential policy approaches are highlighted, which would be ethically preferable to existing punitive policy.

Conclusion

It is not possible to eliminate all drug use and associated harms. The current approach is not only ineffective in preventing drug-related harm but itself directly and indirectly causes incalculable harm to those who use drugs and to wider society. For policymakers to gain the mandate to rationalise drug policy, or to be held accountable if they do not, wider engagement with the electorate is required. It is hoped that this film will encourage at least a few to give pause and reflect on how drug policy might be improved.

Locked and (Un)-Loaded Discussions: A Pediatric Resident Safe Firearm Storage Counseling Curriculum

INTRODUCTION

Firearm-related fatalities are a public health crisis. Despite recognizing the vital nature of counseling parents/caregivers regarding firearm safety, residents remain uncomfortable asking patients about the presence of firearms in homes and discussing American Academy of Pediatrics recommendations regarding safe firearm storage.

METHODS

We designed an interactive curriculum to improve pediatric resident knowledge, skills, attitudes, and behavior regarding counseling families about safe firearm storage. Components of the curriculum included a didactic session, a hands-on experience to better understand the parts of a firearm and its relevant storage/safety devices, and role-playing scenarios.

RESULTS

The curriculum was delivered to 53 pediatric residents in two different residency programs. A statistically significant improvement in knowledge and skills related to safe firearm storage counseling was demonstrated in both settings. Furthermore, a statistically significant change in counseling behavior was noted among one resident group. Curriculum evaluation revealed overwhelmingly positive learner responses.

DISCUSSION

An adaptable interactive safe firearm storage counseling curriculum was well received by pediatric residents and improved resident knowledge and skills, resulting in an increase in safe firearm storage counseling discussions with families.