Lock Up Those Guns!

Source: Grossman DC, Stafford HA, Koepsell TD, et al. Improving firearm storage in Alaska native villages: a randomized trial of household gun cabinets. Am J Public Health 102 Suppl 2:S291-7. doi:10.2105/AJPH.2011.300421.  See AAP Grand Rounds commentary by Dr. Eliot Nelson (subscription required).

PICO
Question: Among households with guns, does the installation of gun cabinets improve the safe storage of guns and ammunition?
Question type: Prevention
Study design: Wait list, randomized controlled trial

It's unfortunate that gun safety has become so politicized that it sometimes becomes difficult to discuss outside of this realm.  This study surmounts those obstacles, as well as demonstrates some successful approaches to community-based research.

Investigators chose six villages in rural Alaska based on population size and accessibility to air transportation, so that portion of the study wasn't randomized.  However, within these communities, half of the households were chosen at random to receive gun cabinets for firearm storage at baseline.  The remaining half were on a "wait list" and received their cabinets 12 months later.  Follow-up survey data was collected at the 12- and 18-month post-baseline times.  Bottom line: both groups showed improved rates of guns and ammunition being locked up at 18 months, with (not surprisingly) far better results at 12 months in the early intervention group. 

It's great that the investigators could show a sustained improvement after the intervention.  Of course, the outcomes being measured are not necessarily outcomes of greatest interest.  What we really would like to know is whether these interventions prevent firearm injuries and deaths; use of gun cabinets is at best a "surrogate" for these more important outcomes.  Also, because the households involved in this study were comprised primarily of Native Alaskans who owned mostly long guns rather than handguns, it remains to be seen whether similar results can be attained in other settings. 

As an aside, the National Rifle Association recently posted an article on safe gun storage.  Maybe this is an issue all can agree upon!