{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:13:17Z","timestamp":1785845597732,"version":"3.56.0"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Veterans are at increased risk of suicide, and guidelines recommend assessing firearm access and counseling to reduce access among patients with elevated suicide risk. How veterans view such discussions is critical to the effectiveness of these interactions.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess whether veteran firearm owners believe clinicians should deliver firearm counseling when patients or their family members are being cared for in specific clinical contexts that suggest heightened risk of firearm injury.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>In this cross-sectional study, data were from a probability-based online survey of self-identified veterans who reported owning at least 1 firearm (National Firearms Survey, July 1 to August 31, 2019) and were weighted to generate nationally representative estimates. Data were analyzed from June 2022 to March 2023.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Participants were asked, \u201cAs part of routine care, should physicians and\/or other health care professionals talk with their patients about firearms and firearm safety if their patient or their patient\u2019s family member (is at risk of suicide; has mental health or behavioral problems; is abusing or addicted to alcohol or drugs; is a victim of domestic violence; has Alzheimer\u2019s disease or another dementia; or is going through a hard time).\u201d Response options included \u201cNo,\u201d \u201cYes, sometimes,\u201d and \u201cYes, always.\u201d In addition, responses were dichotomized as \u201cYes, at least sometimes\u201d and \u201cNo.\u201d<\/jats:p><\/jats:sec>Results<\/jats:title>Of 4030 adults who completed the survey (65% completion rate), 678 (mean [SD] age, 64.7 [13.1] years; 638 [92.9%] male) identified as veteran firearm owners. Across the 6 clinical contexts, support for clinicians \u201cat least sometimes\u201d discussing firearm safety as part of routine care ranged from 73.4% (95% CI, 69.1%-77.3%) when someone is \u201cgoing through a hard time\u201d to 88.2% (95% CI, 84.8%-90.9%) when someone has \u201cmental health or behavioral problems.\u201d When a patient or family member is at risk for suicide, 79.4% (95% CI, 75.5%-82.8%) of veteran firearm owners responded that clinicians should \u201cat least sometimes\u201d discuss firearms and firearm safety.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This study\u2019s findings suggest that most veteran firearm owners believe that clinicians should provide firearm counseling during routine care when a patient or family member is at heightened risk of firearm injury. These findings belie concerns that discussing firearm access with veteran firearm owners is an unacceptable practice.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.21219","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T15:33:15Z","timestamp":1688052795000},"page":"e2321219","source":"Crossref","is-referenced-by-count":15,"title":["Beliefs Among Veteran Firearm Owners Regarding Whether Clinicians Should Discuss Firearm Safety With Patients"],"prefix":"10.1001","volume":"6","author":[{"given":"Frances M.","family":"Aunon","sequence":"first","affiliation":[{"name":"Veterans Affairs Connecticut Health Care System, West Haven"},{"name":"Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Azrael","sequence":"additional","affiliation":[{"name":"Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Firearm Injury Prevention Initiative, University of Colorado Anschutz School of Medicine, Aurora"},{"name":"Division of Hospital Medicine, University of Colorado Anschutz School of Medicine, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Miller","sequence":"additional","affiliation":[{"name":"Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Department of Health Sciences, Northeastern University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"issue":"1","key":"zoi230626r1","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/EDE.0b013e3181c1fa2d","article-title":"Body mass index and risk of suicide among one million US adults.","volume":"21","author":"Mukamal","year":"2010","journal-title":"Epidemiology"},{"issue":"Suppl 1","key":"zoi230626r2","doi-asserted-by":"publisher","first-page":"S154","DOI":"10.2105\/AJPH.2011.300409","article-title":"Veterans and suicide: a reexamination of the National Death Index-linked National Health Interview Survey.","volume":"102","author":"Miller","year":"2012","journal-title":"Am J Public Health"},{"issue":"2","key":"zoi230626r3","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.annepidem.2014.11.020","article-title":"Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars.","volume":"25","author":"Kang","year":"2015","journal-title":"Ann Epidemiol"},{"issue":"10","key":"zoi230626r4","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.annepidem.2009.05.004","article-title":"Is there an epidemic of suicides among current and former U.S. military personnel?","volume":"19","author":"Kang","year":"2009","journal-title":"Ann Epidemiol"},{"issue":"10","key":"zoi230626r7","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1002\/da.22075","article-title":"Lethal means restriction for suicide prevention: beliefs and behaviors of emergency department providers.","volume":"30","author":"Betz","year":"2013","journal-title":"Depress Anxiety"},{"issue":"5","key":"zoi230626r8","doi-asserted-by":"publisher","first-page":"725","DOI":"10.7326\/M20-6314","article-title":"Firearm safety discussions between clinicians and U.S. adults living in households with firearms: results from a 2019 national survey.","volume":"174","author":"Conner","year":"2021","journal-title":"Ann Intern Med"},{"issue":"6","key":"zoi230626r9","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1111\/sltb.v52.6","article-title":"Receipt of clinician-delivered firearm safety counseling among U.S. Veterans: results from a 2019 national survey.","volume":"52","author":"Simonetti","year":"2022","journal-title":"Suicide Life Threat Behav"},{"issue":"sup1","key":"zoi230626r10","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1080\/13811118.2019.1572555","article-title":"Possession of household firearms and firearm-related discussions with clinicians among veterans receiving VA Mental health care.","volume":"24","author":"Valenstein","year":"2020","journal-title":"Arch Suicide Res"},{"issue":"3","key":"zoi230626r11","doi-asserted-by":"publisher","first-page":"205","DOI":"10.7326\/M15-2905","article-title":"Yes, you can: physicians, patients, and firearms.","volume":"165","author":"Wintemute","year":"2016","journal-title":"Ann Intern Med"},{"issue":"8","key":"zoi230626r12","doi-asserted-by":"publisher","first-page":"543","DOI":"10.7326\/M16-0739","article-title":"Public opinion regarding whether speaking with patients about firearms is appropriate: results of a national survey.","volume":"165","author":"Betz","year":"2016","journal-title":"Ann Intern Med"},{"key":"zoi230626r13","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.993415","article-title":"Stakeholder perceptions of lethal means safety counseling: a qualitative systematic review.","author":"Khazanov","year":"2022","journal-title":"Front Psychiatry"},{"issue":"2","key":"zoi230626r14","doi-asserted-by":"publisher","first-page":"338","DOI":"10.3122\/jabfm.2021.02.200261","article-title":"Veterans are agreeable to discussions about firearms safety in primary care.","volume":"34","author":"Newell","year":"2021","journal-title":"J Am Board Fam Med"},{"key":"zoi230626r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2022.107039","article-title":"Perspectives on clinician-delivered firearm safety counseling during routine care: results of a national survey.","volume":"158","author":"Simonetti","year":"2022","journal-title":"Prev Med"},{"issue":"3","key":"zoi230626r16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230135","article-title":"Firearm-related experiences and perceptions among United States male veterans: a qualitative interview study.","volume":"15","author":"Simonetti","year":"2020","journal-title":"PLoS One"},{"issue":"2","key":"zoi230626r17","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.amepre.2021.08.013","article-title":"Firearm background checks in states with and without background check laws.","volume":"62","author":"Hepburn","year":"2022","journal-title":"Am J Prev Med"},{"issue":"4","key":"zoi230626r18","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"zoi230626r19","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.genhosppsych.2018.10.010","article-title":"Acceptability of potential interventions to increase firearm safety among patients in VA mental health treatment.","volume":"55","author":"Valenstein","year":"2018","journal-title":"Gen Hosp Psychiatry"},{"issue":"1","key":"zoi230626r20","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1057\/s41271-016-0007-2","article-title":"A culture gap in the United States: implications for policy on limiting access to firearms for suicidal persons.","volume":"37","author":"Marino","year":"2016","journal-title":"J Public Health Policy"},{"issue":"1","key":"zoi230626r21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1057\/s41599-020-0520-6","article-title":"What is gun culture? cultural variations and trends across the United States.","volume":"7","author":"Boine","year":"2020","journal-title":"Humanit Soc Sci Commun"},{"issue":"1","key":"zoi230626r22","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1093\/epirev\/mxv007","article-title":"Risks and targeted interventions: firearms in intimate partner violence.","volume":"38","author":"Zeoli","year":"2016","journal-title":"Epidemiol Rev"},{"issue":"4","key":"zoi230626r23","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1093\/geront\/gnac142","article-title":"Cars, guns, aging, and \u201cgiving up the keys.\u201d.","volume":"63","author":"Betz","year":"2023","journal-title":"Gerontologist"},{"issue":"9","key":"zoi230626r24","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1016\/j.ecolecon.2011.04.002","article-title":"Are internet surveys an alternative to face-to-face interviews in contingent valuation?","volume":"70","author":"Lindhjem","year":"2011","journal-title":"Ecol Econ"},{"key":"zoi230626r5","unstructured":"US Department of Veterans Affairs, Office of Mental Health and Suicide Prevention. 2022 National Veteran Suicide Prevention Annual Report. 2022. Accessed May 23, 2023. https:\/\/www.mentalhealth.va.gov\/docs\/data-sheets\/2022\/2022-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-508.pdf"},{"key":"zoi230626r6","unstructured":"US Department of Veterans Affairs, Department of Defense. VA\/DOD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide. 2019. Accessed May 23, 2023. https:\/\/www.healthquality.va.gov\/guidelines\/MH\/srb\/VADoDSuicideRiskFullCPGFinal5088919.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2806584\/aunon_2023_oi_230626_1686934967.51078.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T15:33:19Z","timestamp":1688052799000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2806584"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,29]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.21219","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,29]]}}}