266 - What Should Schools Teach About Firearm Safety? A Multidisciplinary Modified Delphi Study to Identify Firearm Safety Education Priorities

Publication Number: 2256.266

Noor Zarrinnegar, University of California, Berkeley, Hillsborough, CA, United States; Vivien K. Sun, Stanford University School of Medicine, Palo Alto, CA, United States; Helene Nepomuceno, Stanford University School of Medicine, Palo Alto, CA, United States; Stephanie Chao, Stanford University School of Medicine, Stanford, CA, United States

Background: K-12 schools in the United States are increasingly recognized as a setting for distributing firearm safety information and playing a key role in the primary prevention of firearm injuries among children. For example, recent Tennessee legislation requires schools to provide age-appropriate firearm safety education to students annually starting in 2025-2026. In California, schools must distribute annual notices to parents about the state's child access prevention laws and secure firearm storage requirements. However, there is little evidence on which firearm safety topics are most important to include in education for students and parents.

Objective: Our objective was to identify priority topics for a school-based firearm safety curriculum for high school students and parents, informed by multidisciplinary perspectives.

Design/Methods: A multidisciplinary panel of invited experts from education, public health, law enforcement, firearm safety instructors, community-based injury prevention, and parents reached consensus on key firearm safety topics for a school-based curriculum for high school students through a modified Delphi process. Panelists were recruited via snowball sampling to ensure geographic diversity and a mix of backgrounds. Panelists generated potential curriculum topics during the first teleconference call prior to ranking the topics using a 5-point scale of importance during 3 survey rounds, with 2 additional teleconference calls between surveys. Consensus was defined by >60% of panelists ranking a topic as extremely or very important (≥4) to include in a curriculum. Panelists were provided an honorarium for their participation. This study was IRB-approved.

Results: Panelists included 23 multidisciplinary experts from across the United States, with 62% of firearm owners. They reached consensus on 6 topics for high school students: suicide prevention, cardinal rules of gun safety, encountering a firearm, conflict resolution, consequences of firearm injury, and secure storage of firearms. Panelists reached consensus on 8 topics for parents: secure storage of firearms, strategies to discuss firearms with their children, secure storage methods, cardinal rules of gun safety, suicide prevention, strategies to discuss firearms with other adults, consequences of firearm injury, and legal landscape for firearms.

Conclusion(s): Multidisciplinary experts prioritized 6 topics for high schoolers and 8 topics for parents to include in a school-based firearm safety curriculum through a consensus-driven process. This can form the basis for education-related primary prevention initiatives for firearm safety.

Flow of Sessions and Topics
Table 1 represents the flow of the modified delphi process. Topics moved on if >60% votes 4 (very important) and 5 (extremely important).

Demographics of Participants
Table 2 shows participant demographics (n=21). 23 distinct experts participated in at least one expert panel session, while 2 declined to fill out our demographic survey.

Comparison of Final Curriculum Topics: Students vs. Parents
Table 3 displays the final list of topics evaluated for inclusion in a high school and parent firearm safety curriculum, along with the percentage of experts who rated each topic as either "very important" (4) or "extremely important" (5) on a 5-point Likert scale.