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By Carole H. Stipelman, Greg Stoddard, Kyle Bata, et al., JAMA Pediatrics, October 28, 2019

Firearms are a leading cause of death in US children, and the rate of suicide by firearms in people aged 10 to 19 years has increased since 2008.1 In the United States, 4.6 million children (approximately 7%) live in households with at least 1 gun that is stored loaded and unlocked.2

Safe storage of guns and ammunition may decrease the occurrence of self-inflicted or unintentional firearm injury to children, and interventions by pediatricians may increase safe firearm storage.3 Although several states have introduced legislation to restrict physicians from discussing guns,4 pediatric and adult physician organizations encourage physician discussion with patients about firearm risk.5 However, most physicians do not ask patients whether they have guns in their households.6

We added questions about gun storage and smoke alarm safety in patient households to an electronic health record (EHR) well-child visit (WCV) encounter form. We evaluated the association of these questions and recent mass shootings with pediatric primary care physician documentation of gun storage and smoke alarm safety in patient households over time.

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