Caregiver Perceptions of Firearm Education

Rahul Shah, MD
Sharon Smith, MD
Mohsin Mirza, BS
Sumeet Kadian, BS, BA
Brendan Campbell, MD, MPH
Kevin Borrup, DrPH, JD, MPA
J. Leslie Knod, MD
Garry Lapidus, PA-C
Danielle Chenard, MPH
Steven Rogers, MD

Firearm related injuries are the leading cause of death in children older than one year of age. Safety counseling and prevention are cornerstones of injury prevention. Little is known about caregivers’ perceptions regarding safety counseling in the ED (emergency department) setting. This survey study sought to assess caregivers’ recollection of firearm safety counseling and who provided that counseling in the past two years. It further sought to determine whom they entrusted to provide this information, and their preferred modalities for future counseling. Secondary objectives included assessing the relationship between parental perspectives on who provided this counseling and how this counseling was provided based on presence of a firearm in the home.

A prospective cross-sectional survey was implemented at a single institution’s emergency department. Parents of children birth-18 years of age were recruited between November 2020 through May 2022, in a private ED treatment room and the survey was administered using a handheld tablet. Excluded were parents of critically ill/injured children (ESI level 1) or those presenting with a primary psychiatric complaint such as suicidal ideation.

A total of 820 of 1,181 of eligible caregivers were recruited (response rate of eligible caregivers: 69.4%). 24.1% of respondents recall receiving counseling on firearm safety within the last two years. 56.1% responded affirmatively that pediatricians ought to counsel parents/guardians on firearm safety. 17.4% reported having a firearm in their home, and these respondents were more likely to have received recent safety counseling. Police departments and pediatricians were the most trusted sources for information; with 58.3% and 55.5% of caregivers identifying them as a highly reputable source of such counseling respectively.

Just over half of caregivers in our convenience sample are following AAP firearm recommendations regarding safe storage of guns and ammunition. Caretakers who own a firearm are more likely to recall counseling on safety measures, equally as likely to believe their pediatrician should offer such counseling, and less likely to entrust their pediatrician to provide them with high-quality information when compared to caretakers who do not own a firearm. Pediatricians and police were viewed as trusted sources of information on firearm safety. In-person counseling was preferred while social media and online resources were not.

1. Review compliance of AAP firearm recommendations among firearm owners.
2. List trusted sources of firearm safety information among caregivers.
3. Compare and contrast differences between caregivers who possess a firearm and those who do not with regards to firearm safety counseling preferences.

How to Develop a Youth Suicide Prevention Center

Steven C. Rogers MD, MS
Kristen Volz-Spessard MS

Suicide has become the second leading cause of death among children greater than 10 years of age, and continues to remain a leading cause of death throughout most of our lifetime. Suicide rates in youth have only continued to climb over the last decade, therefore prevention measures are crucial. To address this epidemic, Connecticut Children’s recently established a comprehensive Youth Suicide Prevention Center to reduce the occurrence of youth suicide deaths and those youth suffering with suicidal thoughts through identification, education/training, research, and advocacy. Aiming to implement validated and evidence-based programs to create safer and healthier communities. Suicide is preventable, and implementation of suicide prevention efforts including universal screening may save lives of youth in crisis.

During this workshop we will provide you with the basic knowledge and background you need to understand suicide specifically in your state or region. We will review and highlight reliable suicide prevention resources including the Suicide Prevention Resource Center, CDC, NIMH/NIH and the American Foundation for Suicide Prevention. Additionally, discuss suicide screening measures which can be implemented within your community.

You will learn how to build an evidence-based foundation for suicide prevention. There are many interventions and proven prevention strategies that can be easily adopted by you, your injury prevention center and your institution including the following, which we will highlight during this workshop:

Outline:
1. Youth Risk Behavior Survey and WISQARS
2. Suicide Screening Workflows – Emergency Department and Inpatient
   a. Ask Suicide Screening Questions (ASQ)
   b. Columbia- Suicide Severity Rating Scale (C-SSRS)
3. Lethal Means Restriction Counseling
4. Zero Suicide Programs
5. Staff education opportunities
   a. Annual suicide prevention trainings
   b. Question Persuade Refer Training (QPR)
6. Funding Opportunities

1. Appreciate the growing epidemic of youth suicide and need for prevention programs
2. Identify reliable sources of information about suicide and prevention programs
3. Develop a familiarity with some of the basic prevention strategies and explore how they can be implemented
4. Recognize potential funding sources for your suicide prevention work

Question, Persuade, and Refer Gatekeeper Training

Steven C. Rogers, MD, MS
Kristen Volz-Spessard, MS

Surveys show that most healthcare professionals, including mental health professionals, do not receive specific or adequate training in how to help those at risk of suicide. Unless you are a psychiatrist, the odds are you did not receive adequate and specific suicide intervention or treatment as part of your professional academic experience. Your patients assume that you are competent to help them or their loved ones survive a suicide crisis.

QPR stands for Question, Persuade, and Refer – the 3 simple steps anyone can learn to help save a life from suicide. Just like CPR, QPR is an emergency response to someone in crisis and can save lives. QPR is the most widely taught Gatekeeper training in the world. A gatekeeper is someone in a position to recognize a crisis and the warning signs that someone may be contemplating suicide. Gatekeepers can be anyone, but include parents, friends, neighbors, teachers, ministers, doctors, nurses, office supervisors, squad leaders, foremen, police officers, advisors, caseworkers, firefighters, and many others who are strategically positioned to recognize and refer someone at risk of suicide.

Each participant receives a booklet that contains all the material covered in the class, as well as referral numbers/information. A certificate of completion is provided to all participants after the class. Participants also receive addition items such as stress balls, pens/pencils, and other suicide prevention items for attending.

NOTE: This training will be provided at no cost to the participants. Cost of materials will be covered by grant funding. Total number of trainings to be determined. Please contact Steven Rogers to discuss further (860)560-3640.

Outline:

• PowerPoint presentation
  • Suicide Myths and Facts
  • Clues and Warning signs
  • How to Ask the Question
  • How to Persuade someone to get help
  • Where to Refer
• Videos
• Web-based role play exercises
• Questions

1. Recognize the common causes of suicidal behavior
2. Recognize the warning signs of suicide
3. Identify local and national resources to help themselves or someone in crisis
4. Recognize opportunities to bring suicide prevention training to clinical and non-clinical team members within your institution