Appalachian Caregiver Perspectives on Childhood Gun Safety in the Home

Background: Childhood gun injuries pose a critical public health challenge. For children, unintentional gun injury deaths primarily occur in the home where parents or other adult guardians, referred to as caregivers hereafter, are responsible for safety. While the American Academic of Pediatrics recommends not having guns in areas where children live and play, firearms are often viewed as normative and fill an important role in many homes. This is particularly true in more rural areas, such as Appalachia, where there is a high density of gun ownership. Additional research is needed to understand rural caregivers’ current gun safety practices in the home. Purpose: The purpose of this study was to gain an understanding of Appalachian caregivers’ gun safety practices, perspectives, and attitudes to assist public health professionals develop more effective interventions and targeted messaging. Methods: Ten Appalachian caregivers were interviewed for a qualitative, phenomenologic study designed to elicit an in-depth understanding of firearm safety strategies in the home. An inductive analytic approach to coding and analysis was used to identify main themes and ideas. Results: Current attitudes, practices, and perspectives focused on the primary childhood injury prevention strategies of education, environmental change, and supervision. Findings matched and expanded upon previous literature in the field. Implications: Cross-cutting themes were identified that have practical implications for the development of public health interventions and messaging for this at-risk population

Leveraging Electronic Health Records Data for Enhanced Colorectal Cancer Screening Efforts

Introduction: Colorectal cancer is the third most common type of cancer in the United States for men and women combined. While the current threat of disease nationally is significant, the majority of colorectal cancer cases and deaths could be prevented through established screening tests and guidelines. Within the Appalachian region and West Virginia in particular, colorectal cancer is a significant public health problem. A more systematic, comprehensive approach to preventing and controlling cancer is essential. Methods: Through the West Virginia Program to Increase Colorectal Cancer Screening, primary care systems across the state received data-informed practice facilitation designed to increase screening rates. Results: Year-1 cohort health systems had an overall baseline screening rate of 28.4% during calendar year 2014. This rate increased and remained steady during the three follow-up measurement time periods, with a rate of 49.5% during calendar year 2018. This increase is notably greater than comparable health systems not part of the initiative. Implications: Lessons learned in increasing colorectal cancer screening rates are applicable to other priority health needs as well