{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T03:46:24Z","timestamp":1777088784289,"version":"3.51.4"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Firearms used in pediatric firearm deaths are most often obtained from the child\u2019s home, making secure firearm storage initiatives imperative in prevention efforts. Evidence-based home visiting (EBHV) programs are implemented with over 277,000 families annually, providing an opportunity for secure firearm storage counseling. The purpose of this study was to assess EBHV providers\u2019 experiences with firearm screening (\u201cassessment\u201d), secure storage counseling, and their perceptions for related training needs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Providers in the U.S. from SafeCare\u00ae, an EBHV program often implemented with families experiencing increased risk of child neglect and physical or emotional abuse, were invited to participate in a survey to examine firearm assessment and attitudes toward and experiences with firearm safety counseling. Survey items were primarily Likert scale ratings to indicate level of agreement, with some open-ended follow-up questions. Descriptive statistics (i.e., frequencies and percentages) were used to report item-level agreement. A <jats:italic>post hoc<\/jats:italic> analysis was conducted using Spearman correlation to examine the association between assessment and counseling and provider-level factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty-three SafeCare providers consented to and completed the survey items. Almost three-quarters (74.6%) agreed\/strongly agreed that they assess in-home firearm availability. However, 66.7% agreed\/strongly agreed that they have not been adequately trained to discuss firearm safety topics. A substantial proportion (80.6%) indicated they would counsel more if materials and training on this topic were available. Response variability emerged by level of urbanicity. A <jats:italic>post hoc<\/jats:italic> analysis found that providers\u2019 self-reported frequency of assessment and counseling were associated with their comfort level discussing firearm safety and whether or not they had worked with families impacted by firearm injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SafeCare providers report a need for materials and training on secure firearm storage, and a willingness to provide more counseling with proper training to the families they serve. Findings illuminate the need for secure storage initiatives for EBHV programs, which have broad service reach to a substantial number of at-risk U.S. families annually.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1324656","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T04:38:14Z","timestamp":1709786294000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Firearm screening and secure storage counseling among home visiting providers: a cross-sectional study of SafeCare\u00ae providers in the U.S."],"prefix":"10.3389","volume":"12","author":[{"given":"Melissa C.","family":"Osborne","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Guastaferro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelden","family":"Banks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hari","family":"Vedantam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Self-Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"ref1","article-title":"WISQARS (web-based injury statistics query and reporting system)","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e2148823","DOI":"10.1001\/jamanetworkopen.2021.48823","article-title":"Firearm storage in US households with children: findings from the 2021 National Firearm Survey","volume":"5","author":"Miller","year":"2022","journal-title":"JAMA Netw Open"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1001\/archpedi.1995.02170250024003","article-title":"Children\u2019s and women\u2019s ability to fire handguns. The Pediatric Practice Research Group","volume":"149","author":"Naureckas","year":"1995","journal-title":"Arch Pediatr Adolesc Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"S264","DOI":"10.1016\/j.amepre.2014.05.028","article-title":"Reducing a suicidal person\u2019s access to lethal means of suicide: a research agenda","volume":"47","author":"Barber","year":"2014","journal-title":"Am J Prev Med"},{"key":"ref5","article-title":"Child Maltreatment","year":"2023"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1037\/12307-001","article-title":"Prevalence of child victimization, abuse, crime, and violence exposure","volume-title":"Violence against women and children, Vol 1: Mapping the terrain","author":"Finkelhor","year":"2011"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1080\/17457300.2021.1996397","article-title":"Child maltreatment, suicidal ideation, and in-home firearm availability in the U.S.: findings from the longitudinal studies of child abuse and neglect","volume":"29","author":"Osborne","year":"2021","journal-title":"Int J Inj Contr Saf Promot"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1177\/003335490912400211","article-title":"Gender-specific mental and behavioral outcomes among physically abused high-risk seventh-grade youths","volume":"124","author":"Logan","year":"2009","journal-title":"Public Health Rep"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1111\/bjc.12293","article-title":"Child abuse and suicidality in the context of the interpersonal psychological theory of suicide: a network analysis","volume":"60","author":"Sch\u00f6nfelder","year":"2021","journal-title":"Br J Clin Psychol"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060070","article-title":"Firearm-related injuries and deaths in children and youth: injury prevention and harm reduction","volume":"150","author":"Lee","year":"2022","journal-title":"Pediatr Int"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1001\/jamapediatrics.2019.1078","article-title":"Association of increased safe household firearm storage with firearm suicide and unintentional death among US youths","volume":"173","author":"Monuteaux","year":"2019","journal-title":"JAMA Pediatr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e20183876","DOI":"10.1542\/peds.2018-3876","article-title":"Prenatal and infancy nurse home visiting and 18-year outcomes of a randomized trial","volume":"144","author":"Kitzman","year":"2019","journal-title":"Pediatr Int"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1542\/peds.2011-1840","article-title":"A statewide trial of the SafeCare home-based services model with parents in child protective services","volume":"129","author":"Chaffin","year":"2012","journal-title":"Pediatrics"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1177\/1524838014566718","article-title":"Effects of parenting programs on child maltreatment prevention: a meta-analysis","volume":"17","author":"Chen","year":"2016","journal-title":"Trauma Violence Abuse"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1177\/10775595221100723","article-title":"Risk and protective factors associated with adverse childhood experiences in vulnerable families: results of a randomized clinical trial of SafeCare\u00ae","volume":"28","author":"Silovsky","year":"2023","journal-title":"Child Maltreat"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1001\/jama.1997.03550080047038","article-title":"Long-term effects of home visitation on maternal life course and child abuse and neglect: fifteen-year follow-up of a randomized 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workers","volume":"53","author":"Slovak","year":"2008","journal-title":"Soc Work"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e24714","DOI":"10.2196\/24714","article-title":"Digital tools to support family-based weight management for children: mixed methods pilot and feasibility study","volume":"4","author":"Staiano","year":"2021","journal-title":"JMIR Pediatr Parent"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1002\/ajcp.12331","article-title":"Who gets what? 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Cultural variations and trends across the United States","volume":"7","author":"Boine","year":"2020","journal-title":"Humanit Soc Sci Commun"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e12497","DOI":"10.1111\/soc4.12497","article-title":"The sociology of U.S. gun culture","volume":"11","author":"Yamane","year":"2017","journal-title":"Sociol Compass"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40621-019-0201-3","article-title":"An educational intervention for medical students to improve self-efficacy in firearm injury prevention counseling","volume":"6","author":"Kwong","year":"2019","journal-title":"Inj Epidemiol"},{"key":"ref34","volume-title":"Social learning theory","author":"Bandura","year":"1977"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1186\/s12909-018-1251-x","article-title":"A skill to be worked at: using social learning theory to explore the process of learning from role models in clinical settings","volume":"18","author":"Horsburgh","year":"2018","journal-title":"BMC Med Educ"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1186\/1472-6947-13-S2-S9","article-title":"Do personal stories make patient decision aids more effective? 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