TY - JOUR
AU - J. B. Ladines-Lim
AU - A. Vaishnav
AU - C. Hayse
AU - E. Corden
AU - C. Gard
AU - G. Luger
AU - J. Litzner
AU - M. Olson
AU - J. Stojan
AU - M. Naughton
AU - M. D. Esposti
AU - J. Meddings
A1 - 
AB - Firearm-related injuries remain the leading cause of mortality in children in the United States. It is not well-characterized how often clinicians perform firearms access screening and safety counseling. We examined documentation of these services in a cross-sectional study of well child exams (WCEs) at a tertiary academic center in Southeast Michigan. Overall, we found that clinicians documented screening in 25,469 of 32,582 WCE encounters due to categorical Pediatrics clinicians doing so in 73.8% of encounters; Family Medicine and Internal Medicine-Pediatrics clinicians documented some form of screening in nearly all (> 99%) encounters. Clinicians documented counseling in 21.8% of encounters with Family Medicine clinicians lagging the other two specialties (8.2% versus 23.9% and 18.4% for Pediatrics and Internal Medicine-Pediatrics, respectively). Multinomial logistic regression for screening (conducted only for Pediatrics given the near universal screening by Family Medicine and Internal Medicine-Pediatrics) and counseling (conducted for all specialties) showed decreased likelihood of both screening and counseling for certain age and sociodemographic groups; however, while there was decreased likelihood for non-attending physician clinicians (i.e. advanced practice providers and resident/fellow physicians) and high inter-clinic variability (77.1%) for screening, the opposite was true for counseling with decreased likelihood for attending physicians and inter-clinic variability of 16.7%. Findings suggest that quality improvement efforts and clinician training are needed to eliminate gaps in risk-stratified screening and counseling regarding firearm safety.
AD - Departments of Internal Medicine and Pediatrics, Michigan Medicine, University of Michigan, 3116 Taubman Center, SPC 5368, 1500 E. Medical Center Drive, 48109, Ann Arbor, MI, USA. joseph.ladines-lim@pennmedicine.upenn.edu.; Division of Infectious Diseases, Department of Medicine, Penn Medicine, University of Pennsylvania, 3400 Spruce St, 3 Silverstein, Ste E, Philadelphia, PA, 19104, USA. joseph.ladines-lim@pennmedicine.upenn.edu.; University of Michigan Medical School, 1301 Catherine St, 48109, Ann Arbor, MI, USA.; Department of Pediatrics, Michigan Medicine, University of Michigan, Medical Professionals Building, 1522 Simpson Road East, 48109, Ann Arbor, MI, USA.; Michigan Medicine, University of Michigan, 1500 E Medical Center Drive, 48109, Ann Arbor, MI, USA.; Departments of Internal Medicine and Pediatrics, Michigan Medicine, University of Michigan, 3116 Taubman Center, SPC 5368, 1500 E. Medical Center Drive, 48109, Ann Arbor, MI, USA.; Institute for Firearm Injury Prevention, University of Michigan, 48109, Ann Arbor, MI, USA.; Center for Clinical Management Research at the Veterans' Affairs Ann Arbor Healthcare System, North Campus Research Complex, 2800 Plymouth Rd, Building 16, 48109, Ann Arbor, MI, USA.
AN - 40451991
BT - J Community Health
C5 - Education & Workforce
CP - 5
DA - Oct
DO - 10.1007/s10900-025-01487-1
DP - NLM
ET - 20250601
IS - 5
JF - J Community Health
LA - eng
N2 - Firearm-related injuries remain the leading cause of mortality in children in the United States. It is not well-characterized how often clinicians perform firearms access screening and safety counseling. We examined documentation of these services in a cross-sectional study of well child exams (WCEs) at a tertiary academic center in Southeast Michigan. Overall, we found that clinicians documented screening in 25,469 of 32,582 WCE encounters due to categorical Pediatrics clinicians doing so in 73.8% of encounters; Family Medicine and Internal Medicine-Pediatrics clinicians documented some form of screening in nearly all (> 99%) encounters. Clinicians documented counseling in 21.8% of encounters with Family Medicine clinicians lagging the other two specialties (8.2% versus 23.9% and 18.4% for Pediatrics and Internal Medicine-Pediatrics, respectively). Multinomial logistic regression for screening (conducted only for Pediatrics given the near universal screening by Family Medicine and Internal Medicine-Pediatrics) and counseling (conducted for all specialties) showed decreased likelihood of both screening and counseling for certain age and sociodemographic groups; however, while there was decreased likelihood for non-attending physician clinicians (i.e. advanced practice providers and resident/fellow physicians) and high inter-clinic variability (77.1%) for screening, the opposite was true for counseling with decreased likelihood for attending physicians and inter-clinic variability of 16.7%. Findings suggest that quality improvement efforts and clinician training are needed to eliminate gaps in risk-stratified screening and counseling regarding firearm safety.
PY - 2025
SN - 0094-5145 (Print); 0094-5145
SP - 959
EP - 964+
ST - Prevalence and Correlates of Firearm Screening and Safety Counseling in Pediatric Primary Care
T1 - Prevalence and Correlates of Firearm Screening and Safety Counseling in Pediatric Primary Care
T2 - J Community Health
TI - Prevalence and Correlates of Firearm Screening and Safety Counseling in Pediatric Primary Care
U1 - Education & Workforce
U3 - 10.1007/s10900-025-01487-1
VL - 50
VO - 0094-5145 (Print); 0094-5145
Y1 - 2025
ER -