Effectiveness of Interventions to Promote Safe Firearm Storage
Abstract
Despite supportive evidence for an association between safe firearm storage and lower risk of firearm injury, the effectiveness of interventions that promote such practices remains unclear. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, we conducted a systematic review of randomized and quasi-experimental controlled studies of safe firearm storage interventions using a prespecified search of 9 electronic databases with no restrictions on language, year, or location from inception through May 27, 2015. Study selection and data extraction were independently performed by 2 investigators. The Cochrane Collaboration's domain-specific tool for assessing risk of bias was used to evaluate the quality of included studies. Seven clinic- and community-based studies published in 2000-2012 using counseling with or without safety device provision met the inclusion criteria. All 3 studies that provided a safety device significantly improved firearm storage practices, while 3 of 4 studies that provided no safety device failed to show an effect. Heterogeneity of studies precluded conducting a meta-analysis. We discuss methodological considerations, gaps in the literature, and recommendations for conducting future studies. Although additional studies are needed, the totality of evidence suggests that counseling augmented by device provision can effectively encourage individuals to store their firearms safely.
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Lethal means reduction through counseling and securing firearms with a safety device is a demonstrated, evidence-based suicide prevention strategy.
“Lethal means reduction via counseling and securing firearms with a safety device is a demonstrated, evidence-based strategy for suicide prevention [85].”
From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [85]
The review reports that interventions providing free safety devices improved safe firearm storage practices, and its Intervention characteristics section describes counseling paired with gun locks. Its Introduction links safe storage to lower observed risks of self-inflicted firearm injury, but says storage *may* reduce fatal self-harm; the Considerations for future studies section calls for studies measuring injury outcomes after storage interventions. It therefore does not establish counseling plus a safety device as a demonstrated suicide-prevention intervention. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBrief physician counseling plus a safe storage device effectively increases safe storage of home firearms.
“Studies have demonstrated that brief physician counseling, combined with provision of a safe storage device, is effective at increasing safe storage of home firearms”
From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [85]
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Self-citation
- Authors
- Rowhani-Rahbar, A., Simonetti, J. A., & Rivara, F. P.
- Affiliations
- University of Washington (US)
- Venue
- Epidemiologic Reviews
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-01-13
- Volume
- 38
- Issue
- 1
- Pages
- mxv006
- ISSN
- 0193-936X (ISSN-L)
- 1478-6729
- OpenAlex
- W2301422081
- Cited by
- 208
- References
- 69
- Citations by year
- 2026: 11 · 2025: 24 · 2024: 35 · 2023: 23 · 2022: 32 · 2021: 26 · 2020: 19 · 2019: 17 · 2018: 10 · 2017: 7 · 2016: 4
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Epidemiologic Reviews (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- University of Washington
- Topics
- Social Sciences › Health › Gun Ownership and Violence Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- firearm injury prevention, intervention effectiveness, counseling, community-based intervention, clinic-based intervention, risk of bias
- MeSH terms
- Firearms, Health Promotion, Humans, Safety, Wounds, Gunshot, Program Evaluation
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