Gun Safety Program at CHOP
The prevalence of guns in the U.S. is staggering, particularly when considering health and safety implications for children and families – firearms are the leading cause of death for children and teens ages 1-19 and approximately 4.6 million children and teens live in a home with a loaded, unlocked gun. Research has shown that three out of four kids ages 5–14 know where guns are kept in the home.
To ensure optimal safety for children who live or spend time in homes with guns, experts at Children’s Hospital of Philadelphia (CHOP) have integrated firearm safety counseling and resource distribution into clinical care at a range of care locations throughout CHOP. This initiative supports and encourages healthcare providers to have nonjudgmental conversations with families about guns and, if appropriate, offer education and gun safety devices at no cost.
An Evidence-based Approach
CHOP’s approach is research-driven; prior studies in both pediatric practices and community settings have shown that providing firearm safety counseling combined with a safe storage device improves safe storage practices within the home, as opposed to providing safety counseling alone.
CHOP-involved research has sought out both provider and caregiver perspectives; a study co-authored by CHOP’s Center for Violence Prevention co-director and emergency medicine physician Joel Fein, MD, MPH assessed the needs of stakeholders who would be involved in implementing an evidence-based approach to firearm safety promotion in pediatric primary care settings. The study revealed firearm safety promotion is a health system priority, and identified important facilitators and barriers that have informed program design. Ongoing implementation surveys continue to demonstrate high levels of acceptability among healthcare providers across a range of inpatient and ambulatory care settings.
Surveys and qualitative interviews among families receiving care in the Emergency Department and Pediatric Intensive Care Unit also demonstrate widespread acceptability of firearm safety counseling in the healthcare setting. A key suggestion among children’s caregivers has been to make the safety device distribution universal – meaning offering gun locking devices and safe storage education to all families, regardless of disclosure of firearms in the home. Universal offering is now a primary component of this initiative.
CHOP's gun safety tips fact sheet is available for download in English and Spanish.
Current Work
Gun safety device distribution is currently underway across a range of care settings at CHOP. These include two Emergency Departments, five primary care practices, all ambulatory mental health practices, the recently opened Behavioral Health and Crises Center, several subspecialty practices, Security hubs and two inpatient units. All families, regardless of firearm ownership, are offered free gun cable locks that have been supplied by CHOP’s Center for Violence Prevention, counseling regarding best practices for safe firearm storage, resources for asking about firearms in other places children spend time, and an educational handout.
Ongoing expansion of this initiative is underway, including dissemination to all 31 of CHOP’s primary care practices, and implementation in the inpatient setting through the Uniting Pediatric Nurses as Leaders in Firearm Injury Prevention (UPLIFT) trial. This trial, made possible through a 5-year grant from the National Institute of Nursing Research, will adapt an evidence-based safe firearm storage intervention for the inpatient setting through nurse-led delivery of free gun locking devices and safe storage education.
Ongoing evaluation of our efforts are critical. Caregivers in a subset of settings are currently being surveyed about their intent to use the lock and/or change their firearm safety practices, and a follow-up study exploring changes in safe storage practices is underway. Heath care providers are also asked to give feedback on the initiative overall, including both the education and device delivery components. Long term goals of this collaborative project include reducing the risk of pediatric firearm injury and mortality through integration of firearm safety counseling and locking device distribution into routine pediatric care, and developing a model that can be used across a variety of pediatric healthcare settings.
- Completed Research Projects
Addressing unsafe firearm storage is essential to preventing suicide and unintentional firearm injury. For patients presenting to CHOP's pediatric emergency department (ED) with behavioral health (BH) needs, researchers implemented a standardized approach to screening for exposure to unsafely stored firearms and offering firearm storage devices and educational resources to the families of patients presenting with BH concerns. Using quality improvement methodology, researchers identified electronic medical record (EMR) documentation and availability of firearm safety resources (gun locks and firearm safety handouts) as areas for improvement. At the completion of the QI process, 85% of the patients who identified they had unsafely stored firearms at home received safety resources. The study found that incorporating firearm safety questions into the EMR and maintaining a supply of firearm safety resources in the ED is an effective and sustainable approach to enhancing firearm safety for high-risk BH patients.
Read a press release about the study.
Neighborhood Firearm Violence, Psychosocial Risks, and Youth Firearm Perception
In collaboration with the University of Pennsylvania School of Nursing, CVP researchers examined 23,334 emergency department visits between 2013 and 2024 by teenagers aged 14-18 who underwent behavioral health screening. Findings document a substantial link between exposure to neighborhood firearm violence, participation in fighting, and an adolescent's perceived ability to acquire a firearm outside their homes. This study illustrates that emergency departments can gather information that can lead to crucial intervention points for firearm injury in youth. The authors recommend that EDs universally screen not only for firearm possession but also for perceived firearm access and past fighting behavior.
Read a CHOP news brief about the study
Counseling on Gun Safety In The Home
Learn more about counseling on gun safety in the home.
Philadelphia Gun Violence Victims Memorial at CHOP
In 2022, CVP partnered with Moms Demand Action – Philadelphia Region to open the Philadelphia Gun Violence Victims Memorial, a community space at The Garden at Karabots where gun violence survivors – family, friends, and community members – can visit and reflect. One of the first spaces of its kind in our city, the space is dedicated to honor those who have lost their lives to gun violence in Philadelphia. In addition to Moms Demand Action, the memorial space was created in conjunction with gun violence prevention groups National Homicide Justice Alliance, Mothers in Charge, EMIR Healing Center, and D.I.V.A.S. Ministry.
Hours
The Memorial and Garden are open to the public during Karabots Pediatric Care Center operating hours:
Sunday: Closed
Monday: 8:30am-7:00pm
Tuesday: 8:30am-7:00pm
Wednesday: 8:30am-7:00pm
Thursday: 8:30am-7:00pm
Friday: 8:30am-5:00pm
Saturday: 9:00am-2:00pm
Location
The Garden at Karabots Pediatric Care Center
4865 Market Street
Philadelphia, PA
Read a WHYY article about the opening of the Memorial.
View a recording of the opening ceremony.
