Prevention of Firearm Injury through Policy and Law: The Social Ecological Model

Parental attitudes, beliefs, and practices related to firearm storage: a qualitative study

BACKGROUND

Firearm injury is a leading cause of death among children. Safer firearm storage practices are associated with a reduced risk of childhood suicide and unintentional firearm death. However, these practices are underutilized. The objective of this study was to characterize parental attitudes and beliefs related to firearm storage and identify facilitators and barriers to safer storage practices.

METHODS

Semi-structured, qualitative interviews were conducted to identify motivations for using different storage methods among parents who kept firearms in southern Connecticut. The constant comparative method was used to code interview transcripts and derive themes directly from the data.

RESULTS

Twenty participants completed the study. 60% were male, 90% were white, and all were between 32 and 53 years old. 85% of participants stored firearms locked, 60% unloaded, 65% kept ammunition locked or did not keep ammunition in their home, and 45% stored ammunition separate from firearms. The following themes were identified: (1) firearm storage must be compatible with a specific context of use; (2) some parents engage in higher-risk storage because they believe it is adequate to reduce the risk of injury; (3) firearm practices are influenced by one's social network and lived experience; (4) parents who own firearms may be amenable to changing storage practices; and (5) parents' conceptualization of firearm injury prevention is multimodal, involving storage, education, and legislation.

CONCLUSIONS

Parents who keep firearms value convenience and utility, which may be at odds with safer storage practices; however, some may be amenable to adopting safer practices. Family and peer relationships, education, and legislation represent important facilitators of storage practices. Understanding parental attitudes and beliefs on firearm storage may inform future interventions to improve storage practices.

Income support policies and firearm violence prevention: A scoping review

Firearm violence is a major threat to global public health and safety. Several individual, family, peer, community, and societal risk and protective factors determine or modify the risk of firearm violence. Specifically, there is a strong relationship between poverty, income inequality, and firearm violence; as such, interventions that influence upstream determinants of health by providing income support may hold much promise in affecting multiple domains of risk that are on the causal pathway to firearm violence. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, we conducted a scoping review to examine the current state of evidence on the relationship between income support policies and risk of firearm violence. We searched 8 databases related to health and social sciences from inception through March 30, 2022, and placed no time, language, setting, or other publication restrictions on our search, as long as the study was quantitative or mixed-methods and addressed firearm violence specifically, rather than violence more broadly, as an outcome in relation to income support policies. We found 4 studies; of those, 3 were conducted in the United States and 1 in Brazil. All 4 found associations of policy-relevant magnitude between income support policies and reductions in risk of inter-personal firearm violence. We propose future opportunities to enhance the substantive scope and methodologic rigor of this field of research and inform policy and practice for greater impact.

Not All Survivors Are the Same: Qualitative Assessment of Prior Violence, Risks, Recovery and Perceptions of Firearms and Violence Among Victims of Firearm Injury

Qualitative exploration into the risk, experiences, and outcomes of victims of firearm injury is imperative to informing not only further research, but prevention and intervention strategies. The purpose of this study was to explore prior violent exposures, risks, recovery, supportive services, outcomes, and views of firearms and violence among survivors of firearm assaults and unintentional injuries. Adults treated at a level 1 trauma center in Seattle, WA, for assault and unintentional firearm injuries were interviewed utilizing a semistructured instrument. Interview responses were coded to identify common themes and representative quotes are reported. Sixteen participants were interviewed. Notable themes included the following: (a) prior violent exposures were experienced by half of survivors, mostly through community violence; (b) risk for firearm injury was felt to be related to general societal violence, unsafe communities, and firearm practices; (c) important aspects of recovery included family/social support, mental health care and financial support services; (d) notable outcomes included psychological problems such as PTSD and anxiety, changes in relationships, and developing a new sense of purpose or mission in life; (e) generally negative views toward firearms, supporting restricted access and firearm safety practices; (f) acknowledgement of the complexity of firearm violence in society with prevention geared toward equitable education, economic opportunities and safety net programs to reduce community violence; and (g) disappointment in the criminal justice system. These findings demonstrate the varied experiences, needs, and outcomes after injury, but highlight the significance of community and societal violence, and need for improved mental health services. Integration of mental health services and victim assistance programs into trauma centers and hospital-based violence intervention programs is imperative for all survivors. Encouraging survivors to engage in new aspirations after injury can be empowering, and there is an unmet need for victim support and advocacy within the criminal justice system.