Neighborhood features such as community socioeconomic status, recreational facilities, and parks have been correlated to the health outcomes of the residents living within those neighborhoods, especially with regard to health-related quality of life, body mass index, and physical activity. The interplay between one’s built environment and one’s perceptions may affect physical health, well-being, and pain experiences. In the current study, neighborhood characteristics and attitudes about physical activity were examined in a high-risk (youths with a parent with chronic pain) and low-risk (youths without a parent with chronic pain) adolescent sample. There were significant differences in neighborhood characteristics between the high-risk (n = 62) and low-risk (n = 77) samples (ages 11–15), with low-risk participants living in residences with more walkability, closer proximity to parks, and higher proportion of neighborhood residents having college degrees. Results indicate that neighborhood features (e.g., walkability and proximity to parks), as well as positive attitudes about physical activity were correlated with lower levels of pain and pain-related disability, and higher performance in physical functioning tests. These findings suggest that the built environment may contribute to pain outcomes in youth, above and beyond the influence of family history of pain.

Introduction: The American College of Emergency Physicians supports community- and hospital-based programs that intervene to prevent firearm-related injury. To this end, the distribution of firearm locks or storage devices in the emergency department (ED) may help achieve this target. To inform secure firearm storage programs for households with children and firearms, we examined firearm storage practices, device preferences, and cost tolerance among parents/caregivers of children. Methods: Between April 2018–November 2019, we conducted and analyzed an in-person survey of 294 caregivers, aged ≥18, with both children and firearms in the home. Surveys assessed reasons for firearm ownership, storage practices and device preferences among five storage-device options, and prices participants were willing to pay for devices. Practices and preferences were examined by participant characteristics. We used logistic regression to estimate odds ratios and 95% confidence intervals for associations of interest. Results: Most participants (73%) reported personal protection as a reason for owning firearms, and nearly 80% owned at least one firearm storage device. Over half (55%) owned cable locks, but only 36%of owners reported regularly using them. Rapid-access devices (electronic and biometric lockboxes) were less commonly owned (26%) but more likely to be regularly used (73%). The most highly rated storage device features were the following: the ability to store the firearm unloaded (87.3%); the ability to store the firearm loaded (79.1%); and device affordability (65%). Most participants (78%) preferred rapid-access devices over other options. Participants were willing to pay more for products that afforded rapid access to the firearm. Participants reported they would pay a median of $100 for a pushbutton rapid-access product ($80 retail), and $150 for a biometric lockbox ($210 retail). Conclusion: Understanding the storage practices and preferences among firearm-owning households with children can help inform ED injury-prevention screening and firearm safety practice implementation. Our results suggest that rapid-access devices may be the most preferable firearm storage devices for distribution by secure storage programs, and costs are likely minimal given parental/caregiver willingness to pay.