Health Systems Interventions to Prevent Firearm Injuries and Death Proceedings of a Workshop (2019) / Chapter Skim
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5 Developing Health System Interventions
5 Developing Health System Interventions
Pages 37-46
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From page 37... ...
DEVELOPING A FIREARM STORAGE DECISION AID TO ENHANCE COUNSELING ON ACCESS TO LETHAL MEANS Betz began by acknowledging that she, like most every other health care provider, has complex views about firearms. On the one hand, she said, she works on the front lines as an emergency medicine specialist, and she is frustrated by the senseless injuries caused by firearms.
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From page 38... ...
This is called Counseling on Access to Lethal Means (CALM) , an intervention now recommended, especially in emergency departments and mental health settings in the context of suicide risk.
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From page 39... ...
The basic idea behind the framework is that making a high-quality decision requires knowing the options and then making a decision in line with personal values that produces the desired outcomes. In the case of firearm safety, Betz said, she and her colleagues want to know what people think about different firearm storage options and to provide them with options from which they can pick based on what is best for their particular situation.
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From page 40... ...
"I do not know what the answer is, and I do not think we know yet what drives these kind of decisions," she said, "but it would be great if we could know so that we could get people the devices they need and will use." Betz said that any actions in the realm of suicide prevention have to include language emphasizing hope and that people will get better and that these actions should also encourage patients to engage with their families or trusted loved ones. Messaging in the decision aid also normalizes the ideas that many other people go through tough times, and that temporary storage is something that many people do in the same situation.
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From page 41... ...
The working group settled on five types of firearm violence: self-directed violence, including suicide and attempted suicide; intimate partner violence; peer violence; mass violence; and unintentional injury. A literature review by the various subgroups for different types of injury generated 61 questions, after which a round-robin discussion generated 222 potential research questions.
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From page 42... ...
Working with the American Medical Association, she and her colleagues have also developed a continuing medical education module that provides advice to health care professionals.2 An example of a different type of project related to the consensus agenda is the iDOVE project, a brief intervention for violence-prone adolescents that involves automated texting. This study is ongoing, Ranney said, and its initial results were promising.
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From page 43... ...
1000 Cancer Heart Lung disease disease Liver disease Diabetes Publications, in Thousands Cerebrovascular disease 100 Hypertension Viral hepatitis Influenza and pneumonia HIV Sepsis Malnutrition Anemia Biliary tract Parkinson disease Poisoning Alzheimer disease Hernia disease Atherosclerosis Motor vehicles Intestinal infection Nephritis, nephrotic syndrome, and nephrosis Penetrating wounds Falls 10 Peptic ulcer Fires Aspiration Asphyxia Gun violence Drowning 1.0 0.8 0.4 1.0 10 100 200 Mortality Rate, per 100 000 Population FIGURE 5-2 In-hospital case fatality rate for traumatic injuries. NOTE: Unadjusted rates are the solid lines and adjusted rates are the dashed lines.
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From page 44... ...
Julie Richards from Kaiser Permanente Washington commented that in a recent training she took with social workers in her health system on safely planning with patients identified as being suicidal, she learned that
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From page 45... ...
Betz replied that the decision aid was designed to walk through the process with the patient and blend with motivational interviewing. Grossman asked the panelists if having the option of invoking an extreme risk protective order (ERPO)
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From page 46... ...
society; this does not serve the interests of the gun violence prevention movement at all, Brown said. That discovery prompted Brown and her colleagues to come up with a new term -- family fire -- for incidents that occur as a result of an improperly stored gun in the home and to d evelop a campaign focused initially on children to end family fire.
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