Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. e654-e661 (doi:10.1542/peds.2004-1625)

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ELECTRONIC ARTICLE

Evaluation of a Community-Based Handgun Safe-Storage Campaign

Elanor A. Sidman, MS^*,, David C. Grossman, MD, MPH^*,,||, Thomas D. Koepsell, MD, MPH^*,,, Luann D'Ambrosio, MEd^*, John Britt, RN, MPH^*, Evan S. Simpson, MPH^*, Frederick P. Rivara, MD, MPH^*,,|| and Abraham B. Bergman, MD^*,||

^* Harborview Injury Prevention and Research Center and Departments of
Epidemiology
Health Services
^|| Department of Pediatrics, University of Washington, Seattle, Washington

Objective. Safe storage of firearms has been recommended as a means of preventing gun-related pediatric injuries, yet few interventions have led to significant improvements in storage practices. This study examined a multifaceted community education campaign to promote safe handgun storage and the campaign's impact on firearm locking and loading practices in households with children.

Methods. Beginning in 1997, a safe-storage campaign consisting of television and radio announcements, educational materials, billboards, and discount coupons for lock boxes was conducted in King County, Washington. The campaign evaluation used a quasi-experimental design and compared the intervention site with 9 control counties outside Washington State and west of the Mississippi River. Cross-sectional, random-digit-dial telephone surveys of handgun-owning households with children were conducted in all study counties both before the intervention in 1996 (n = 302) and again in 2001 (n = 255). The main analyses assessed whether greater improvements in household firearm-storage practices occurred between 1996 and 2001 in the intervention, compared with the control, counties. Primary outcomes were based on up to 3 handguns per household and included (1) all stored with trigger locks, lock boxes, or gun safes (formal locking devices), (2) all stored in lock boxes or gun safes, (3) any stored loaded, (4) any stored loaded without a formal locking device, and (5) any stored loaded and not in a lock box or gun safe. Data were also collected on up to 1 long gun per household; long-gun outcomes included (1) stored with a trigger lock or gun safe and (2) stored loaded.

Results. Overall, handguns and long guns were generally more likely to be stored locked and less likely to be loaded in 2001 compared with 1996, with these trends seeming to be more consistent in the intervention county. Even so, more than one quarter of households with children and handguns in 2001 failed to store all of their handguns with a formal locking device, and up to 8% continued to possess at least 1 loaded handgun that was not stored with a formal device. The majority of households that stored their handguns with formal devices used lock boxes or gun safes. Storage of handguns in lock boxes or gun safes became more common in both the intervention (adjusted odds ratio [aOR]: 1.71; 95% confidence interval [CI]: 1.03–2.84) and control households (aOR: 1.66; 95% CI: 1.01–2.72) between 1996 and 2001. None of the other measured changes reached statistical significance, such as storing any household handgun loaded (aOR: 0.71; 95% CI: 0.35–1.42 [intervention]; aOR: 1.08; 95% CI: 0.58–2.00 [control]) or keeping any household handgun loaded and not stored in a lock box or gun safe (aOR: 0.59; 95% CI: 0.22–1.55 [intervention]; aOR: 0.67; 95% CI: 0.30–1.49 [control]). Moreover, the intervention county did not experience significantly greater overall improvements in household storage practices for handguns or long guns than did control counties.

Conclusions. In both the intervention and control counties, households were more likely to lock all handguns in 2001 compared with 1996. After accounting for temporal trends, this educational campaign, combined with economic incentives to purchase lock boxes, did not seem to significantly change safe storage practices in households with handguns and children. Even if the campaign did result in small improvements in firearm safe storage, simultaneous national and state-specific gun-safety activities or legislative efforts may have drawn increasing attention to gun-related issues in the control counties, thereby making it more difficult to identify effects of our specific handgun storage intervention.

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Key Words: firearms • program evaluation • injury prevention and control • community health education • health promotion

Abbreviations: CAP, Child Access Prevention • OR, odds ratio • CI, confidence interval

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Accepted Dec 16, 2004.

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