Marian E. Betz, MD, MPH; Deborah Azrael, PhD; Catherine Barber, MPA; Matthew Miller, MD, ScD
Presented in poster form at the 144th meeting of the American Public Health Association, Denver, Colorado, 29 October to 2 November 2016.
Funding Source: By the Fund for a Safer Future and the Joyce Foundation.
Disclosures: Ms. Barber reports grants from Fund for a Safer Future and Joyce Foundation during the conduct of the study. Authors not named here have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0739.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol: Available in the Appendix. Statistical code: Available from Dr. Betz (e-mail, email@example.com). Data set: Not available.
Requests for Single Reprints: Marian E. Betz, MD, MPH, Department of Emergency Medicine, University of Colorado School of Medicine, 12401 East 17th Avenue, B-215, Aurora, CO 80045; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Betz: Department of Emergency Medicine, University of Colorado School of Medicine, 12401 East 17th Avenue, B-215, Aurora, CO 80045.
Dr. Azrael: Harvard Injury Control Research Center, 677 Huntington Ave, Kresge 310, Boston, MA 02115.
Ms. Barber: Harvard Injury Control Research Center, 677 Huntington Avenue, Kresge 316, Boston, MA 02115.
Dr. Miller: Department of Health Sciences, Bouve College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA 02115.
Author Contributions: Conception and design: D. Azrael, C. Barber, M.E. Betz, M. Miller.
Analysis and interpretation of the data: D. Azrael, C. Barber, M.E. Betz, M. Miller.
Drafting of the article: D. Azrael, M.E. Betz.
Critical revision of the article for important intellectual content: D. Azrael, C. Barber, M.E. Betz, M. Miller.
Final approval of the article: D. Azrael, C. Barber, M.E. Betz, M. Miller.
Provision of study materials or patients: D. Azrael.
Statistical expertise: D. Azrael.
Obtaining of funding: D. Azrael, M. Miller.
Collection and assembly of data: D. Azrael.
Betz ME, Azrael D, Barber C, Miller M. Public Opinion Regarding Whether Speaking With Patients About Firearms Is Appropriate: Results of a National Survey. Ann Intern Med. 2016;165:543-550. doi: 10.7326/M16-0739
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Published: Ann Intern Med. 2016;165(8):543-550.
Published at www.annals.org on 26 July 2016
Health care providers have been encouraged to discuss firearms with patients; whether patients view these discussions as appropriate is unclear.
To estimate, in a national sample, the perceived appropriateness of provider discussions about firearms.
Probability-based online survey conducted in April 2015. Analyses used survey weights to generate nationally representative estimates.
3914 English-speaking adults (55% participation rate).
Participants were asked, “In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms?”
A majority (66% [95% CI, 63% to 69%]) of participants said that it is at least sometimes appropriate for providers to talk to patients about firearms. Specifically, 23% (CI, 20% to 25%) said that provider discussions about firearms were always appropriate, 14% (CI, 11% to 16%) said that they were usually appropriate, and 30% (CI, 27% to 33%) thought they were sometimes appropriate; 34% (CI, 31% to 37%) felt that such discussions were never appropriate. Views varied by firearm ownership: 54% (CI, 52% to 57%) of gun owners said that provider discussions are at least sometimes appropriate, compared with 67% (CI, 62% to 71%) of nonowners living with an owner and 70% (CI, 66% to 74%) of nonowners not living with an owner. Firearm owners who were more likely to think that firearm discussions are at least sometimes appropriate included those with children at home (62% [CI, 57% to 67%]), those who thought that having a gun at home increases suicide risk (75% [CI, 67% to 83%), and those who thought that provider discussions of seat belts are at least sometimes appropriate (73% [CI, 70% to 75%]).
The provider discussion question did not specify clinical context.
Two thirds of non–firearm owners and over one half of firearm owners in the United States believe that health care provider discussions about firearms are at least sometimes appropriate. The observed heterogeneity underscores the need to better understand assumptions that may underlie these views, particularly among firearm owners.
Fund for a Safer Future and Joyce Foundation.
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Cardiology, Coronary Risk Factors, Emergency Medicine, Ethics, Prevention/Screening.
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