ABSTRACT. Objective. Safe storage of firearms has been recommended as a means of preventing gun-related pediatric injuries, yet few interventions have led to significant improvements in storage practices. This study examined a multifaceted community education campaign to promote safe handgun storage and the campaign's impact on firearm locking and loading practices in households with children.Methods. Beginning in 1997, a safe-storage campaign consisting of television and radio announcements, educational materials, billboards, and discount coupons for lock boxes was conducted in King County, Washington. The campaign evaluation used a quasi-experimental design and compared the intervention site with 9 control counties outside Washington State and west of the Mississippi River. Cross-sectional, random-digit-dial telephone surveys of handgun-owning households with children were conducted in all study counties both before the intervention in 1996 (n ؍ 302) and again in 2001 (n ؍ 255). The main analyses assessed whether greater improvements in household firearm-storage practices occurred between 1996 and 2001 in the intervention, compared with the control, counties. Primary outcomes were based on up to 3 handguns per household and included (1) all stored with trigger locks, lock boxes, or gun safes (formal locking devices), (2) all stored in lock boxes or gun safes, (3) any stored loaded, (4) any stored loaded without a formal locking device, and (5) any stored loaded and not in a lock box or gun safe. Data were also collected on up to 1 long gun per household; long-gun outcomes included (1) stored with a trigger lock or gun safe and (2) stored loaded.Results. Overall, handguns and long guns were generally more likely to be stored locked and less likely to be loaded in 2001 compared with 1996, with these trends seeming to be more consistent in the intervention county. Even so, more than one quarter of households with children and handguns in 2001 failed to store all of their handguns with a formal locking device, and up to 8% continued to possess at least 1 loaded handgun that was not stored with a formal device. At least 4 nonfatal gunshot wounds are treated in emergency departments for every fatal firearm injury in children and young adults. 2,3 Attempts to prevent firearm injuries by altering storage methods may have broader support than efforts to remove firearms from households. [4][5][6][7][8][9] The elevated risks of homicide and suicide associated with household availability or purchase of firearms 10-17 seem to be strongest for handguns and when guns are stored loaded or unlocked. 13,14,17 by guest on May 9, 2018 http://pediatrics.aappublications.org/ Downloaded from use of accessible, loaded guns owned by adults and stored at their residences. [17][18][19][20][21] State Child Access Prevention (CAP) laws instituting criminal penalties if a child gains access to improperly stored firearms have been associated with reductions in children's unintentional shooting deaths. 22,23 More than one third of US ho...