Wolk Courtney Benjamin, Jager-Hyman Shari, Marcus Steven C, Ahmedani Brian K, Zeber John E, Fein Joel A, Brown Gregory K, Lieberman Adina, Beidas Rinad S
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
BMJ Open. 2017 Jun 24;7(6):e014407. doi: 10.1136/bmjopen-2016-014407.
The promotion of safe firearm practices, or firearms means restriction, is a promising but infrequently used suicide prevention strategy in the USA. is an evidence-based practice for improving parental firearm safety behaviour in paediatric primary care. However, providers rarely discuss firearm safety during visits, suggesting the need to better understand barriers and facilitators to promoting this approach. This study, Adolescent Suicide Prevention In Routine clinical Encounters, aims to engender a better understanding of how to implement the three firearm components of as a suicide prevention strategy in paediatric primary care.
The National Institute of Mental Health-funded Mental Health Research Network (MHRN), a consortium of 13 healthcare systems across the USA, affords a unique opportunity to better understand how to implement a firearm safety intervention in paediatric primary care from a system-level perspective. We will collaboratively develop implementation strategies in partnership with MHRN stakeholders. First, we will survey leadership of 82 primary care practices (ie, practices serving children, adolescents and young adults) within two MHRN systems to understand acceptability and use of the three firearm components of (ie, screening, brief counselling around firearm safety and provision of firearm locks). Then, in collaboration with MHRN stakeholders, we will use intervention mapping and the Consolidated Framework for Implementation Research to systematically develop and evaluate a multilevel menu of implementation strategies for promoting firearm safety as a suicide prevention strategy in paediatric primary care.
Study procedures have been approved by the University of Pennsylvania. Henry Ford Health System and Baylor Scott & White institutional review boards (IRBs) have ceded IRB review to the University of Pennsylvania IRB. Results will be submitted for publication in peer-reviewed journals.
推广安全的枪支使用规范，即枪支限制，在美国是一种有前景但很少使用的自杀预防策略。这是一种基于证据的做法，可改善儿科初级保健中家长的枪支安全行为。然而，医疗服务提供者在就诊期间很少讨论枪支安全问题，这表明需要更好地了解推广这种方法的障碍和促进因素。这项名为“常规临床诊疗中的青少年自杀预防”的研究旨在更好地理解如何在儿科初级保健中将枪支安全的三个组成部分作为自杀预防策略来实施。
由美国国立精神卫生研究所资助的心理健康研究网络（MHRN），是一个由美国13个医疗系统组成的联盟，提供了一个独特的机会，从系统层面更好地理解如何在儿科初级保健中实施枪支安全干预措施。我们将与MHRN的利益相关者合作制定实施策略。首先，我们将对两个MHRN系统内的82家初级保健机构（即服务儿童、青少年和年轻人的机构）的领导层进行调查，以了解对枪支安全三个组成部分（即筛查、围绕枪支安全的简短咨询以及提供枪支锁）的接受程度和使用情况。然后，与MHRN的利益相关者合作，我们将使用干预映射和实施研究综合框架，系统地制定和评估一系列多层次的实施策略菜单，以促进在儿科初级保健中将枪支安全作为自杀预防策略。
研究程序已获得宾夕法尼亚大学的批准。亨利·福特健康系统和贝勒·斯科特与怀特机构审查委员会（IRB）已将IRB审查权让渡给宾夕法尼亚大学IRB。研究结果将提交至同行评审期刊发表。
