title: Quality of consumer-targeted internet guidance on home firearm and ammunition storage.
abstract: Four storage practices protect against unintentional and/or self-inflicted firearm injury among children and adolescents: keeping guns locked (1) and unloaded (2) and keeping ammunition locked up (3) and in a separate location from the guns (4). Our aim was to mimic common Google search strategies on firearm/ammunition storage and assess whether the resulting web pages provided recommendations consistent with those supported by the literature.
  
  
  
  We identified 87 web pages by Google search of the 10 most commonly used search terms in the USA related to firearm/ammunition storage. Two non-blinded independent reviewers analysed web page technical quality according to a 17-item checklist derived from previous studies. A single reviewer analysed readability by US grade level assigned by Flesch-Kincaid Grade Level Index. Two separate, blinded, independent reviewers analysed deidentified web page content for accuracy and completeness describing the four accepted storage practices. Reviewers resolved disagreements by consensus.
  
  
  
  The web pages described, on average, less than one of four accepted storage practices (mean 0.2 (95% CL 0.1 to 0.4)). Only two web pages (2%) identified all four practices. Two web pages (2%) made assertions inconsistent with recommendations; both implied that loaded firearms could be stored safely. Flesch-Kincaid Grade Level Index averaged 8.0 (95% CL 7.3 to 8.7). The average technical quality score was 7.1 (95% CL 6.8 to 7.4) out of an available score of 17. There was a high degree of agreement between reviewers regarding completeness (weighted κ 0.78 (95% CL 0.61 to 0.97)).
  
  
  
  The internet currently provides incomplete information about safe firearm storage. Understanding existing deficiencies may inform future strategies for improvement.
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Freundlich
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Maria Shakour
authors.initials: MS
authors.lastname: Skoczylas
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Schmidt
authors.affiliation: Michigan Institute for Clinical and Health Research (MICHR), University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Nahid R
authors.initials: NR
authors.lastname: Keshavarzi
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Bethany Anne
authors.initials: BA
authors.lastname: Mohr
mesh_terms: D000056:Accident Prevention / Q000379:methods; D054626:Consumer Health Information / Q000592:standards*; D003257:Consumer Product Safety / Q000592:standards*; D005389:Firearms; D017408:Guidelines as Topic; D006801:Humans; D020407:Internet; D010067:Ownership; D010290:Parents; D017751:Safety Management / Q000592:standards*; D014481:United States; D014948:Wounds, Gunshot / Q000517:prevention & control*