Trial reportBMC pediatrics2026
Pediatric healthcare worker perspectives on implementation of a secure firearm storage program: a qualitative study.
Trial report in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04844021 (A Comparative Effectiveness Trial of Strategies to Implement Firearm Safety Promotion as a Universal Suicide Prevention Strategy in Pediatric Primary Care), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Comparative Effectiveness Trial of Strategies to Implement Firearm Safety Promotion as a Universal Suicide Prevention Strategy in Pediatric Primary Care
Who cites it
1 citing paper in PubMed.
- A mixed methods evaluation of mechanisms for facilitation in pediatric primary care.Implementation science communications · 2026Article
Corrections and comments
- Update of
Authors and funding
20 authors.
Funding
Abstract
objectivePrimary care-based secure firearm storage programs are well-positioned to prevent firearm-related injury, the leading cause of death for young people in the United States. While recommended by the American Academy of Pediatrics and US Surgeon General, these programs have yet to become routine practice. Our cluster randomized hybrid effectiveness-implementation trial studied implementation of a universal evidence-based secure firearm storage program, S.A.F.E. Firearm (Suicide and Accident Prevention through Family Education) across 30 clinics in two large health systems. S.A.F.E. Firearm includes a brief discussion between a clinician and parent on secure firearm storage and an offer of free cable locks at pediatric well-child visits for youth ages 5-17. The ASPIRE trial demonstrated meaningful clinician behavior change, with S.A.F.E. Firearm delivered to 49% of patient families in the clinics that received both trial implementation strategies. The present study qualitatively explores factors broadly influencing the successful implementation of S.A.F.E. Firearm, centering healthcare worker (HCW) perspectives.
methodsSemi-structured qualitative interviews were conducted with leaders, clinic change agents, and clinicians involved in implementation from 2023 to 2024 (N = 38). The interview guide was informed by the original and updated Consolidated Framework for Implementation Research. Interviews were coded and analyzed using an abductive, integrated (i.e., deductive and inductive) approach. Inter-rater reliability (Kappa = 0.87) was strong.
resultsInterviews elucidated four interconnecting themes. HCWs unanimously expressed pediatric HCWs' responsibility to promote firearm safety (role of pediatrics in firearm safety) across heterogeneous community and healthcare firearm cultures. By preserving families' autonomy and privacy around firearms, S.A.F.E. Firearm's nonjudgemental and universal approach promoted program acceptability and delivery. Consequently, HCWs' understanding versus confusion around this universal, privacy-focused harm reduction approach was foundational to implementation.
conclusionHealth systems can harness HCWs' shared commitment to firearm safety by deploying brief programs that preserve recipient autonomy and privacy. To scale these evidence-based approaches, we recommend offering clear, simple trainings and collaboratively adapting programs to meet the needs of HCWs and recipients.
trial registrationRegistry https://clinicaltrials.gov/study/NCT04844021 , TRN NCT04844021, first registered on April 14, 2021.
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