Table 2.

Quotes from Qualitative Interviews by Theme

Theme	Example Quotes
Acceptability	“Coaching is fine, but the questions of what you have and what you don’t have is no one’s business.”
	“As soon as my pediatrician starts asking me about guns in my home, I’m like uh oh, here we go. Now my pediatrician’s office is all about this’”
	“Bundling it in with other questions… that pertains [sic] to child safety, just throwing it kind of in the middle… that’s a better way to do it because it’s a soft blow. It’s not like hitting them right in the forehead kind of thing.”
	“I think that’s the way a good intervention is set up. So you screen to see if it’s pertinent and then, if it is, then you counsel them on it, and then if…you know after you’ve done the counseling, to actually give them something that’s useful to help drive that home of a gun lock is, I mean, the way it should be. So I wouldn’t make any changes [to the intervention].”
	“Any vehicle that will give out gun locks to people, especially anonymously, to people that need a gun lock, want a gun lock, I applaud that so much.”
	“You’d be surprised at how many people, before they leave my shop, take the lock out of the box and throw it on the counter and say “throw this away’.”
	“There’s nothing new and unique about asking the question “Are your guns properly secured?” And if you need a gun lock just check with the nurse’s station on the way up.”
	“If you have guns in the home, are they properly locked up? Are they properly secured?” That’s a yes or no. And I think that part would be well received because it’s already out there. It’s already common knowledge to gun owners.”
Responsibility	“The highest responsibility of any firearms owner, if you choose to own it, is you have to prevent unauthorized access to your firearm and that’s a broad sweeping comment, which we go on to define as unauthorized access to your firearm means don’t let somebody steal it. It means don’t let your kids find it and have an accident with a gun. Don’t let a distraught family member or somebody who is addicted to drugs or alcohol or somebody in a drunken stupor access this. Don’t let, you if you have an anger management problem with you know the wife, the husband, the daughter, the son whoever...basically it comes down to if you’re going to have the gun, no unauthorized use should have access to it, so whatever it takes to make sure that that doesn’t happen, is completely part of when you make the decision to purchase it you have to...that has to be part of your plan.”
	“I do not believe that it is the pediatrician or medical doctors’ responsibility, nor is it any of their business, if someone owns or possess firearms…”
	“Well, I think that it’s important to talk to the patient but it is also important to talk to those around the patient. Whether it’s a parent or whether it’s loved ones or siblings. When you know that there’s potential for self-harm, it should be one of the topic areas that is addressed in briefing the family numbers that “Hey, this is something that you must look into and this is something that you must make safe in your home.” And you can suggest whether it’s locking up the weapons or getting rid of the weapons or those kind of recommendations. Ultimately, it’s up to the parent or family member to do this or not do it, but I think it’s very important for the clinician to infer the consequence if you don’t.”
	“I think gun owners are actually the experts in firearm storage and accident prevention. If you want to fix a car, you go to a mechanic. If you want to talk about firearms, you go talk to somebody who owns firearms.”
	“So far as suicide prevention, it is not really in our belly work… other than to be responsible, take responsibility, and secure them [firearms] properly. None of us are psychologists.”
Lack of trust	“The huge thing is that people are worried about being put into a database. Anyone that they associate with a database, like law enforcement or medical, they’re probably not going to answer honestly to, I’m assuming[…]”
	“… if the [name of government agency redacted for publication] were not so anti, and they have proven in the past that they are anti-gun ownership, that’s why I question their metrics, I question their data[...]”
	“Well I think right now our country is split between those that interpret that they need to have their weapons to protect themselves and their property versus those that see the potential harm that weapons can do and I think that our legislatures are not doing enough [...]”
	“The [medical association redacted for publication], in general, on anything promulgate has not been particularly sympathetic with gun ownership. As a matter of fact. I think it viewed gun ownership as a positive evil”.
	“I know many physicians that do own firearms that aren’t open about it because they will be tagged which is why I do not want private citizens to also tag it themselves in that same way because then things will get recorded, HIPAA rules go out the window and the federal government comes in.”
Suggested approaches	“So for example, imagine the following scenario. A little pamphlet stand in the pediatrician’s office that says ‘Own a gun? If so, get training and learn about safety. Here are 5 [name of firearm organization redacted for publication] certified instructors that are available within 5 miles of this office and this contact info for them.’ So you’re not saying guns are good, guns are bad, you’re saying “do you have one of these things? Why don’t you get some training? Here’s some people who can help you get that training”
	“A better program I think would be maybe, if the doctor wanted to do it, is to refer to somebody in the community if they can find it because there’s plenty of us that are trained by the [name of firearm organization redacted for publication]…to show them how to be safe and handle [their guns]. The doctors already have enough to do, especially pediatricians. I see their workload; it’s just incredible.”
	“It would be useful if gun safety, taught by a certified instructor, became part of the public school curriculum. This is the best play that I can think of to reach youngsters…to teach them about the dangers of mishandling firearms and benefits of safe handling firearms.”
	“You cannot do that [develop an intervention to promote firearm safety and suicide prevention] without the gun owners. You’ve got to make them part of the equation because if you exclude the gun owners, you’re not going to get anywhere with your program.”
	“It’s good to speak to someone that’s wanting to, really wanting to help without telling me I shouldn’t have a gun.”
	“I do think there would be some benefit to it [collaborative approach with pediatricians and gun advocates] where doctors and instructors could get together every so often and try to get their parents and their kids in some kind of educational…seminar. It wouldn’t take long, an hour or less would do it. It’s not a lot of time to spend to help protect against the accidents and mental problems.”
	“I think that gun locks are probably the best option, but I’m not sure how many people would be willing to actually go for it.”
	“Why don’t we try engagement? Why don’t we try to find a way where we get on the same side of this issue, leverage our training and safety infrastructure, review the content, make sure it’s consistent with the message you’re trying to deliver, and see if in some small geography, we can lever it and study it.”