Physicians’ perspectives on Extreme Risk Protection Orders (ERPOs) in the clinical setting: Challenges and opportunities for gun violence prevention

Background Firearm-related injuries remain a heavy public health and clinical burden in the United States. Extreme Risk Protection Order (ERPO) laws, which create a path through a civil court process to temporarily remove firearms from individuals deemed to be at risk of harming themselves or others...

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Veröffentlicht in:PloS one 2022-09, Vol.17 (9), p.e0274489-e0274489
Hauptverfasser: Hollo, Ashley, VanderStoep, Amy, Frattaroli, Shannon
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Frattaroli, Shannon
description Background Firearm-related injuries remain a heavy public health and clinical burden in the United States. Extreme Risk Protection Order (ERPO) laws, which create a path through a civil court process to temporarily remove firearms from individuals deemed to be at risk of harming themselves or others and are one strategy designed to reduce firearm violence. Maryland was the first state to authorize clinicians as ERPO petitioners. Objective We aim to document a sample of Maryland physicians' perspectives about the utility of, any barriers to, and other thoughts on clinicians as ERPO petitioners. Design A series of semi-structured interviews with Maryland physicians identified through a combination of purposive and snowball sampling. We coded the transcribed interviews and analyzed the coded transcripts for themes using deductive content analysis. Setting/Participants 13 Maryland-based physicians interviewed over Zoom in and around Baltimore City, Maryland. Results The interviewees had overall positive feedback about ERPO as a gun violence prevention tool in the clinical setting. They identified several barriers to effective implementation such as time spent on paperwork and in court, a lack of awareness among clinicians about ERPO, threats to therapeutic alliance, and a sense of futility in a culture where firearms are easy to obtain. Solutions such as providing clinician education about ERPO laws, allowing for virtual court testimony, and creating a consult service with ERPO specialists to manage ERPO petitions were discussed. Limitations This study includes a small sample of Maryland-based physicians. Conclusions The physicians we interviewed expressed interest in knowing more about ERPO laws and emphasized education as an important tool for improving implementation. Addressing physicians' concerns about ERPO implementation will improve their ability to be effective and efficient petitioners.
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Extreme Risk Protection Order (ERPO) laws, which create a path through a civil court process to temporarily remove firearms from individuals deemed to be at risk of harming themselves or others and are one strategy designed to reduce firearm violence. Maryland was the first state to authorize clinicians as ERPO petitioners. Objective We aim to document a sample of Maryland physicians' perspectives about the utility of, any barriers to, and other thoughts on clinicians as ERPO petitioners. Design A series of semi-structured interviews with Maryland physicians identified through a combination of purposive and snowball sampling. We coded the transcribed interviews and analyzed the coded transcripts for themes using deductive content analysis. Setting/Participants 13 Maryland-based physicians interviewed over Zoom in and around Baltimore City, Maryland. Results The interviewees had overall positive feedback about ERPO as a gun violence prevention tool in the clinical setting. They identified several barriers to effective implementation such as time spent on paperwork and in court, a lack of awareness among clinicians about ERPO, threats to therapeutic alliance, and a sense of futility in a culture where firearms are easy to obtain. Solutions such as providing clinician education about ERPO laws, allowing for virtual court testimony, and creating a consult service with ERPO specialists to manage ERPO petitions were discussed. Limitations This study includes a small sample of Maryland-based physicians. Conclusions The physicians we interviewed expressed interest in knowing more about ERPO laws and emphasized education as an important tool for improving implementation. Addressing physicians' concerns about ERPO implementation will improve their ability to be effective and efficient petitioners.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0274489</identifier><identifier>PMID: 36099263</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Aggression ; Causes of ; Content analysis ; Court hearings &amp; proceedings ; Data collection ; Domestic violence ; Education ; Emergency medical care ; Engineering and Technology ; Firearm laws &amp; regulations ; Firearms ; Gun violence ; Health risks ; Implementation ; Influence ; Injuries ; Injury prevention ; Interviews ; Medicine and Health Sciences ; Pediatrics ; People and Places ; Physicians ; Positive feedback ; Prevention ; Protection ; Public health ; Qualitative research ; Risk ; Small arms ; Snowball sampling ; Social Sciences ; Specialists ; Suicidal behavior ; Testimony ; Violence ; Wounds and injuries</subject><ispartof>PloS one, 2022-09, Vol.17 (9), p.e0274489-e0274489</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Hollo et al. 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Extreme Risk Protection Order (ERPO) laws, which create a path through a civil court process to temporarily remove firearms from individuals deemed to be at risk of harming themselves or others and are one strategy designed to reduce firearm violence. Maryland was the first state to authorize clinicians as ERPO petitioners. Objective We aim to document a sample of Maryland physicians' perspectives about the utility of, any barriers to, and other thoughts on clinicians as ERPO petitioners. Design A series of semi-structured interviews with Maryland physicians identified through a combination of purposive and snowball sampling. We coded the transcribed interviews and analyzed the coded transcripts for themes using deductive content analysis. Setting/Participants 13 Maryland-based physicians interviewed over Zoom in and around Baltimore City, Maryland. Results The interviewees had overall positive feedback about ERPO as a gun violence prevention tool in the clinical setting. 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Extreme Risk Protection Order (ERPO) laws, which create a path through a civil court process to temporarily remove firearms from individuals deemed to be at risk of harming themselves or others and are one strategy designed to reduce firearm violence. Maryland was the first state to authorize clinicians as ERPO petitioners. Objective We aim to document a sample of Maryland physicians' perspectives about the utility of, any barriers to, and other thoughts on clinicians as ERPO petitioners. Design A series of semi-structured interviews with Maryland physicians identified through a combination of purposive and snowball sampling. We coded the transcribed interviews and analyzed the coded transcripts for themes using deductive content analysis. Setting/Participants 13 Maryland-based physicians interviewed over Zoom in and around Baltimore City, Maryland. Results The interviewees had overall positive feedback about ERPO as a gun violence prevention tool in the clinical setting. They identified several barriers to effective implementation such as time spent on paperwork and in court, a lack of awareness among clinicians about ERPO, threats to therapeutic alliance, and a sense of futility in a culture where firearms are easy to obtain. Solutions such as providing clinician education about ERPO laws, allowing for virtual court testimony, and creating a consult service with ERPO specialists to manage ERPO petitions were discussed. Limitations This study includes a small sample of Maryland-based physicians. Conclusions The physicians we interviewed expressed interest in knowing more about ERPO laws and emphasized education as an important tool for improving implementation. Addressing physicians' concerns about ERPO implementation will improve their ability to be effective and efficient petitioners.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>36099263</pmid><doi>10.1371/journal.pone.0274489</doi><orcidid>https://orcid.org/0000-0002-0975-9713</orcidid><oa>free_for_read</oa></addata></record>
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subjects Aggression
Causes of
Content analysis
Court hearings & proceedings
Data collection
Domestic violence
Education
Emergency medical care
Engineering and Technology
Firearm laws & regulations
Firearms
Gun violence
Health risks
Implementation
Influence
Injuries
Injury prevention
Interviews
Medicine and Health Sciences
Pediatrics
People and Places
Physicians
Positive feedback
Prevention
Protection
Public health
Qualitative research
Risk
Small arms
Snowball sampling
Social Sciences
Specialists
Suicidal behavior
Testimony
Violence
Wounds and injuries
title Physicians’ perspectives on Extreme Risk Protection Orders (ERPOs) in the clinical setting: Challenges and opportunities for gun violence prevention
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