Date of Award

Fall 2019

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

DNP

First Advisor

Donna Pelletier

Second Advisor

Tracey Collins

Abstract

BACKGROUND

There is significant health risk associated with firearm ownership. To address this risk a primary care-based intervention was designed and implemented to screen for firearm ownership, educate patients on the risks of gun ownership, and provide patients with resources for reducing associated health risks.

METHODS

A mixed methods study design was employed. Four primary care providers (PCP) practicing in family health volunteered to participate in this intervention. Focus groups with participating PCPs were conducted prior to the intervention to solicit recommendations for intervention protocol and assess participating PCPs current understanding of the health risks of firearm ownership, and after the intervention to obtain feedback regarding intervention impact, barriers encountered, and recommendations for intervention improvement.

INTERVENTION

Based on participating PCPs’ feedback from the preintervention focus group a handout containing a firearm ownership screening questionnaire and firearm risk patient education was created. Patients presenting to an outpatient family health clinic for annual preventative health care visits between July 29, 2019 and August 30, 2019 were screened for firearm ownership and educated on health risks of firearm ownership.

RESULTS

Over a period of one month a total of 126 patients were screened for firearm ownership and educated on the risks of firearm ownership. The majority of patients who owned firearms (93.8%) and those who did not (82.0%) reported being aware of the risks of firearm ownership. In addition, the majority of patients who owned firearms (90.8%) and those who did not (96.7%) responded “No” when asked if they wanted additional information on the health risks of firearm ownership and ways to reduce this risk. Significant intervention barriers identified during the postintervention focus group were knowledge adequacy, right to privacy, right to bear arms, and fear of the government / authorities. Factors identified as perpetuating firearm ownership include pride in firearm ownership and firearms as a symbol of one’s heritage.

CONCLUSIONS

Despite the barriers encountered in the course of conducting this study in Rochester, New Hampshire, the intervention was generally well received by patients in a State which produced approximately 1/7th of all firearms manufactured in the United States in 2017. We have demonstrated that this intervention can be performed at negligible cost in terms of time and money. This intervention could be readily adapted to suit different communities, providing health care professionals across the country with a favorable cost/benefit means to address a public health crisis.

Keywords: firearms or guns, firearms ownership, risk reduction, quality improvement.

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