Early Adolescents' Knowledge and Behavior with Firearms: How Experience, Parents, and Safety Training Contribute to Behavior.

Unintentional pediatric firearm-related injuries constitute a public health challenge. This cross-sectional research study examines how children's experience with firearms, parent-level supervision and training, and youth exposure to firearms is associated with youths' knowledge about and behavior with firearms. One hundred sixty-three children aged 10-12, all with firearm exposure, and their parents participated. Self-report data from youth and parents on youth firearm experience and knowledge; family firearm use and storage; and how children were supervised and trained to use firearms served as independent variables in age- and sex-adjusted generalized linear models. Children's knowledge about firearm safety, intended behavior in response to stories, and simulated behavior in both hunting and shooting range scenarios were outcome variables. Children who reported their families owned firearms for shooting had higher firearm safety knowledge (p = 0.01) and made safer clothing choices in simulation scenarios (OR = 2.30, p = 0.02). Family lessons about firearm safety were associated with safer clothing choices and fewer unsafe shots in simulation (p = 0.01). Children who self-reported experience hunting without adult supervision had increased time unsafe in hunting simulation (MD = 5.09, p = 0.02). Parent-reported data showed similar patterns. Additionally, per parent report, children with more firearm experience displayed greater knowledge about safety (p = 0.01) and increased safe clothing selection in simulations. Children with more firearm experience generally demonstrated more knowledge and safer simulated behavior. Youth who self-reported hunting without adult supervision took more risks in hunting simulations. Multifaceted strategies that include increased adult supervision and youth safety training could reduce unintentional youth firearms injuries.