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Firearm Injury Interventions
Gun Safety Curriculum
Background
One possible strategy to decrease firearm
injury and deaths to children is educational programs. These can be directed at
the children themselves, or at parents and adults to store guns more safely in the
home (or out of the home). The NRA’s Eddie Eagle program is an example of the
former type of educational intervention. For more information on gun-safety education,
see the section entitled, "Firearm safety training" under the topic
Youth Violence.
Unfortunately, few of these educational interventions
have been evaluated. We review here those evaluations which have been done to date.
Review of educational interventions:
Author | Hardy et al., 1996 |
Study design and target population | Randomized controlled trial
24 pairs of preschool children from 2 day
care centers in S.E. United States (N.C.) matched on age and sex.. |
Intervention | 30 minute educational intervention stressing not to
touch or play with guns and to notify an adult if they saw a gun. Session included
firearm safety coloring book, question & answer session, warning by police
officer and signing a certificate promising not to touch gun. Parents and children
interviewed re gun ownership, access and parental responsibility. |
Outcomes | (1) Gun related play measured by video taped structured
play sessions before and 1 week after the intervention.
(2) Ability to distinguish toy guns from real guns. |
Results | No difference in gun play behavior between intervention
and control group (MANOVA p>0.5). No difference between groups for parental
gun ownership, SES, attitudes towards gun safety.
False negative errors by the children (believing
real guns are toys) more likely than false positive errors (believing toys
are real guns), p<0.001. |
Study quality and conclusions | Telling children to stay away from guns and notify
an adult when they find a gun does not appear to be an effective safety intervention.
Adults should be responsible for protecting
children. This was a careful evaluation of educational intervention using
observed behavior change, randomization to control group and adjustment for
confounding variables. |
Author | Davidson et al., 1994 |
Study design and target population | Before/after study design comparing Central Harlem,
to Washington Heights area of New York City from 1988-1991. |
Intervention | Multifaceted community wide Safe Kids/Healthy Neighborhoods
program targeted at youth 5-16 years of age. It targeted many types of child
injury problems, including firearm injuries. |
Outcomes | Hospitalization or death due to guns, assault, traffic
accidents and outdoor falls. Incidence rates during intervention 1988-91 compared
to pre-intervention rates, 1983-88. |
Results | Decrease in gun injuries in Central Harlem RR=0.56,
0.31-1.02) compared to Washington Heights, RR=1.58, 0.68-3.66) Decrease in all
targeted injuries in Harlem RR=0.56, 0.45-0.71) with no change in all non-targeted
injuries RR=1.03, 0.78-1.35) Decrease in both targeted and non targeted injuries
in comparison community due to decline in MV injuries. |
Study quality and conclusions | Poisson regression models used to adjust for annual
and seasonal variations in injury incidence. Local surveillance data collected
to validate statewide hospital data. Additional follow up necessary to determine
the effects of the program and/or its specific components on the reduction in
injury incidence. |
Summary of educational
interventions
One study of an intervention with pre-school
children failed to show an increase in gun safety. The Davidson study26 was a multi-faceted investigation of a variety
of problems and interventions, and thus is difficult to know what exactly affected
GSW rates.
Recommendations on educational
interventions
Unfortunately, not enough data exist to make a recommendation on educational interventions
for the prevention of gun injuries to children.
Recommendations on future
research
There is a clear need for evaluations of educational programs, particularly safe
storage programs and programs educating children about gun safety.
At the present time there is not a systematic framework in place to reduce firearm
injuries and deaths. This comprehensive framework should be modeled after that which
was developed for motor vehicle injuries beginning in 1968. Specifically, we have
the National Highway Traffic Safety Administration (NHTSA), nationwide databases
such as FARS and a series of laws and regulations governing motor vehicle. We need
a National Firearm Injury Surveillance System which would collect data about fatal
and nonfatal firearm related injuries, patterns of firearm ownership and use, and
specific information on the models and types of firearms used in homicides, suicides,
and unintentional injuries. This database would provide information needed to more
precisely define the risks and benefits of gun ownership and modifiable factors
that increase the risk of death and injury. Good surveillance data bases are needed
to evaluate intervention efforts.
Healthy People 2000 calls for laws
in each of the 50 states requiring new handguns be designed to minimize the likelihood
of discharge by children and product modification strategy to reduce "accidental"
death and injury. Also advocated to help minimize injuries are the reduction in
immediate access to loaded guns, changes in the laws for concealed weapon permits,
environmental and behavioral measures to increase safe storage of firearms (its
purpose being to reduce access to children and adolescents), the reduction of weapon-related
violent deaths to 12.6 per 100,000 (it currently stands at
12.9 per 100,000 by firearms and 1.9 per 100,000 by knives).27
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