Content assessment and readability of online injury prevention resources on firearm safety: a cross-sectional analysis of hospital and national injury prevention literature

Abstract

Background: Firearm-related injuries are a preventable public health epidemic and the leading cause of pediatric death in America. Online injury prevention resources (OIPRs) offer potential for educating the public on firearm safety. National public health organizations recommend a sixth-grade reading level for these resources. We hypothesize that OIPRs for firearm safety may not meet this standard and are inconsistent in content.

Methods: We analyzed firearm injury OIPRs from three sources: verified trauma centers (TCs), national health organizations, and gun violence prevention advocacy groups. We assessed readability using reading time, Flesch-Kincaid grade level, and Flesch reading ease. We also assessed whether OIPRs included child safety, safe handling, and safe storage of firearms.

Results: Among 587 TCs, 105 had publicly accessible OIPRs. After removing duplicates, we analyzed 53 unique hospital OIPRs, 25 from national organizations, and 8 from advocacy groups. The mean reading time of hospital-based OIPRs was 2 min and 49 s, and 5 min and 30 s for advocacy organizations. The average Flesch-Kincaid Grade Level for hospital OIPRs was 8.2, national organizations 8.4, and advocacy groups 9.7. Only 21% of hospital and 22% of national OIPRs met the sixth-grade level; none of the advocacy groups met this standard. 79% of hospital-based OIPRs content related to child safety, compared with 44% of national organizations and none of the advocacy groups. Only 21% of TCs and no advocacy groups provided information on safe handling practices.

Conclusion: Few OIPRs meet recommended readability guidelines and often fail to address key topics such as child safety or safe handling of firearms. This gap in accessible educational information highlights the need for standardized resources to reduce firearm injury. Future research should aim to improve these resources to ensure usability and effective outreach to our communities.

Keywords: Accident Prevention; Firearms; Health literacy; patient education.

Figure 1. Readability Rtatistics, by Resource Type. a: Mean Reading Time of OIPRs by Group, b: Average Flesch Kincaid Ease of OIPRs by Group, c: Average FK Reading Ease of OIPRs by Group.