NATIONAL TRENDS IN PEDIATRICIANS? EXPERIENCES TREATING GUN INJURIES AND PROVIDING PREVENTIVE COUNSELING Lynn M. Olson, Kathy Kaufer Christoffel, Karen G. O'Connor Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL; General/Emergency Pediatrics, Children's Memorial Hospital, Chicago, IL

OBJECTIVE: To assess trends in pediatricians': a) experiences treating gun injuries, b) current practices regarding gun injury prevention counseling, and c) attitudes toward their roles in gun injury prevention and legislation.

DESIGN/METHODS: National random sample, mailed Periodic Surveys of American Academy of Pediatric (AAP) members: a) 1994 (response rate = 68.9%, n = 982) and b) 2000 (response rate = 62.4%, n = 912). In addition, a 1988 Periodic Survey (response rate = 78.7%, n = 644) provides data on gun injuries treated. Chi-square tests are used to assess bivariate relationships and logistic regression to assess multivariate relationships.

RESULTS: The percentage of pediatricians reporting they treated a gun injury in the prior 12 months increased from 15.2% in 1988 to 19.8% in 1994; it then decreased to 12.7% in 2000. Equally large proportions of respondents in 1994 and 2000 believe violence prevention should be a priority issue for pediatricians (91.4% and 92%), and believe anticipatory guidance can help reduce risk of gun injury or death (82.4% and 82.7%). Between 1994 and 2000 there was a significant increase in the reported rate of firearm safety counseling during health supervision visits. For example, the proportion of pediatricians who report they always or sometimes recommend to families who have handguns their removal from the home increased from 46.2% to 55.9% (p<.001). Based on logistic regression, in both 1994 and 2000 the likelihood of counseling on handgun removal was positively related to: recent experience treating a gun injury, age under 45, female gender, and not owning a gun. Gun ownership among pediatricians continues to drop: 25.7% (1988), 15.7% (1994), and 13.2% (2000). In both 1994 and 2000 large majorities agreed that gun control legislation or regulations would reduce injury and death, 86.2% and 84.0%. In this period, support for policy approaches to gun injury reduction remains high, though there has been a somewhat diminished support for some specific measures.

CONCLUSIONS: Ongoing monitoring of pediatricians' attitudes and practices related to firearm injury prevention documents: falling rates of injury treatment (consistent with national injury data), strong support for patient counseling and related legislation, and rising rates of actual counseling.