Langenau Erik, Kaminsky Alexa M, Roberts Michael B
Department of Teaching Support and Professional Development, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
College of Osteopathic Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
J Osteopath Med. 2025 Jan 29;125(7):359-368. doi: 10.1515/jom-2024-0245. eCollection 2025 Jul 1.
Gun violence negatively impacts not only victims but also their families and surrounding communities. Resources and counseling services may be available to support families affected by gun violence, but the families and their clinicians may not know about these resources or how to access them.
The objective of this study was to investigate the impact of a clinician-directed educational program on patient reports of their discussions with their physician regarding gun violence, prevention, and available resources for support and treatment.
This quasi-experimental, cross-sectional, survey-based, quality-improvement study included pre-, mid-, and posttraining surveys administered to patients and clinicians participating in an educational program at two urban healthcare centers in Philadelphia. The educational program included office enhancements (handouts and posters) and lunchtime presentations for clinicians regarding gun violence prevalence, prevention strategies, local support resources, and impacts on mental health for patients and their families. The anonymous patient survey was offered to all patients seen at two urban healthcare centers in Philadelphia during three nonconsecutive weeks over 3 months.
Among 542 patients seen over the 3 weeks of survey collection, 428 completed the survey (response rate of 79 %). Sixty-four percent acknowledged being impacted by gun violence including the death of a loved one, witnessing a shooting, or being shot themselves. Over the course of the educational program, patients reported significant increases in (1) awareness of materials related to gun violence in the waiting areas, by 17.2 %, (2) discussions of gun violence with their clinician, by 12.1 %, and (3) discussions of methods to prevent gun injury, by 9.7 %. At the end of the study, 19.3 % of patients reported having discussions with their clinician about gun violence, and 14.3 % discussed strategies to prevent gun injury. Participating clinicians reported high levels of satisfaction and increased confidence when talking to patients about gun violence at the end of the program.
Providing clinician-directed education and printed materials increased the frequency with which clinicians discussed gun violence, prevention, and available resources with their patients. Increases were modest, with opportunities for improvement. A holistic and multifaceted approach is required to support families affected by gun violence, including education for clinicians and dissemination of information for families.
枪支暴力不仅会对受害者产生负面影响，还会波及他们的家人以及周边社区。可能有资源和咨询服务来支持受枪支暴力影响的家庭，但这些家庭及其临床医生可能并不了解这些资源或不知道如何获取。
本研究的目的是调查由临床医生主导的教育项目对患者报告其与医生就枪支暴力、预防以及可用的支持和治疗资源进行讨论的影响。
这项基于调查的准实验性横断面质量改进研究包括对参与费城两个城市医疗中心教育项目的患者和临床医生进行培训前、培训中和培训后的调查。教育项目包括办公室改进措施（宣传资料和海报）以及为临床医生举办的午餐时间讲座，内容涉及枪支暴力的流行情况、预防策略、当地支持资源以及对患者及其家人心理健康的影响。在3个月内的三个不连续周期间，向在费城两个城市医疗中心就诊的所有患者提供匿名患者调查。
在调查收集的3周内就诊的542名患者中，428名完成了调查（回复率为79%）。64%的患者承认受到枪支暴力的影响，包括亲人死亡、目睹枪击事件或自己被枪击。在教育项目过程中，患者报告称在以下方面有显著增加：（1）对候诊区与枪支暴力相关资料的知晓率提高了17.2%；（2）与临床医生讨论枪支暴力的比例提高了12.1%；（3）讨论预防枪支伤害方法的比例提高了9.7%。在研究结束时，19.3%的患者报告与临床医生讨论过枪支暴力，14.3%的患者讨论过预防枪支伤害的策略。参与项目的临床医生在项目结束时报告称，在与患者谈论枪支暴力时满意度很高且信心增强。
提供由临床医生主导的教育和印刷材料增加了临床医生与患者讨论枪支暴力、预防以及可用资源的频率。增幅不大，仍有改进空间。需要采取全面且多方面的方法来支持受枪支暴力影响的家庭，包括对临床医生进行教育以及为家庭传播信息。
