PEDIATRICS Vol. 108 No. 3 September 2001, pp. 823-823

Gun StorageWho's the Right Target?

To the Editor.

We applaud Azrael and colleagues' recent article,¹ which addressed differential reporting on firearm storage patterns by which adult was the respondent. The article highlighted what can be described as the "safe gun storage promotion paradox." Studies, including Azrael's, show that in households with multiple adults, one adult usually has more knowledge and more control over the number, type, and storage patterns of guns in the home. That particular individual, usually the adult male, is typically not the one who is exposed to gun safe storage promotion campaigns in the form of anticipatory guidance by physicians. This is of concern because physicians tend to use fear appeals (ie, the image of a child having a serious gun-related unintentional injury, or a teen committing suicide) to persuade individuals to comply with gun storage recommendations. A basic tenet of health communication is that fear appeals are most effective when individuals are able to manage the fear through compliance with recommendations.² Women who are not in control of the firearms in their household environments may not be or feel able to reduce the threat of a serious injury to a child through compliance with safe storage recommendations. Thus, it is important to develop safe storage promotion strategies in addition to anticipatory guidance by pediatricians.

For safe storage promotion efforts to be successful in the future, 3 things are needed. The first, and most important, is a promotion campaign that reaches gun-owning adults. Mass media, workplaces, and communities are possible channels/settings for such a campaign. We conducted a community-based firearm safety education and media campaign that included the distribution of keyed cable gun locks. We specifically targeted registered gun owners to participate by sending them letters describing the event. As it turned out, the majority of the participants were male gun owners. In addition to the letters, we believe that gun owners were successfully recruited to our program because of its mass media exposure, because we were giving away free gun locks, and because the event was held on the weekend in an easily accessible location (a local shopping center).

A second need in safe storage promotion is for physicians to talk to women about the degree to which they feel they can discuss firearm issues with their partners, and then tailor counseling strategies accordingly. For those women who feel powerless to change the firearm storage practices in their home, physicians may want to consider determining if it is possible to talk with the gun owner in the context of a clinical visit where other injury prevention behaviors are discussed. Finally, research describing how couples negotiate (or do not negotiate) gun storage practices is necessary to make promotion campaigns more effective, especially if we continue to reach only one adult in the household.

Tamera Coyne-Beasley, MD, MPH
Departments of Pediatrics and Internal Medicine
UNC Chapel Hill School of Medicine
Chapel Hill, NC 27599-7225

Renee M. Johnson, MPH
Department of Health Behavior and Health Education
UNC Chapel Hill School of Public Health
Chapel Hill, NC 27599-7225

REFERENCES

1. Azrael D, Miller M, Hemenway D. Are household firearms stored safely? It depends on whom you ask. Pediatrics. 2000;106(3). Available at: http://www.pediatrics.org/cgi/content/full/106/3/e31
2. Job RFS Effective and ineffective use of fear in health promotion campaigns. Am J Public Health. 1988; 78:163-167 [Abstract/Free Full Text]