You Want to Know What?!—Farmer Parents’ Attitudes Regarding Healthcare Providers Discussing Firearm Storage and the Asking Saves Kids Program

Marc Doobay, MPAS MC
Nicholas Stange, MD MPH
Pam Hoogerwerf, BA
Cassidy Branch, MA
Victor Soupene, PhD MS
Charles Jennissen, MD

Firearm-related deaths and injuries can often be prevented with safe firearm storage. The American Academy of Pediatrics (AAP) recommends clinicians discuss firearm storage with families as part of their injury prevention routine. The AAP also advocates through their Asking Saves Kids (ASK) campaign for parents/caregivers to ask about firearms and their storage in the homes where their children visit. Our study objective was to evaluate the attitudes held by Iowa parents on farms regarding healthcare providers asking about and discussing firearm storage and also about the ASK campaign.

Focus group sessions (in-person and on-line) were performed in 2024. Participants were recruited through emails to Iowa FFA club advisors who informed member parents, a mass email distributed to University of Iowa faculty/staff, and personal distribution of invites to 2024 Farm Progress Show attendees. Requirements included: (1) Must live on and actively farm/ranch in Iowa, (2) Must have at least one child between 10-19 years old, and (3) Must have at least one firearm in the home. Major themes were identified from the focus group moderator guide. Sub-themes were based on the conversations of subjects. Dedoose, a software package that facilitates qualitative analysis, was utilized to analyze transcript content. Additional coding was conducted by three research members, and coding discrepancies were discussed with a consensus achieved via an iterative process.

Thirty-two parents participated. Some deemed it appropriate for clinicians to discuss firearm storage to help ensure children’s safety and to identify families needing safety information. However, others felt it only appropriate to ask about firearms if there were mental health concerns. A few stated providers were a trusted source and that it would be easier to have firearm safety conversations with them than others, and recognized firearms were another safety issue to be addressed. The majority had negative opinions regarding clinicians discussing firearms. Many would be surprised, offended, defensive, and even stop going to the provider if asked. Specific reasons included that it was an invasion of privacy and none of their business, it was not healthcare provider’s job/responsibility, being asked was threatening and made them feel targeted, and it would not be helpful for providers to ask. Regarding the ASK campaign, many stated they would be annoyed, that asking them was offensive like they didn’t trust them or were judging them as bad parents, and asking would not change their storage behaviors.

Most study participants were not comfortable with clinicians asking about firearm storage, and in many cases, felt it had nothing to do with their family’s health. Similarly, they had negative attitudes regarding being asked about their firearm storage by other children’s parents. Healthcare providers may encounter unique barriers when addressing safe firearm and ammunition storage with rural families.

1. State at least three positive things that some farm parents relayed to focus group moderators regarding healthcare providers discussing firearm storage with them.
2. Identify at least three negative things that some farm parents discussed said to focus group moderators regarding healthcare providers discussing firearm storage with them.
3. Discuss at least three opinions shared by some farm parents to focus group moderators about parents of their children’s friends asking them about their firearm storage.