Statement of Purpose ‘Behavioral bundling’, a theory that explains how some health behaviors reinforce one another, may provide valuable insight into firearm storage behaviors. The purpose of this study is to estimate the association between five preventive health behaviors (PHBs) and safe firearm storage.

Methods/Approach Using 2017 Behavioral Risk Factor Surveillance Survey data, we selected 5 PHBs: seatbelt use, primary care visits, physical activity, cholesterol screening, and flu shot. We defined safe firearm storage as storing a firearm unloaded or locked but loaded. We estimated the association between engagement in five PHBs as a composite score and individually with safe firearm storage, adjusting for age, sex, and presence of children in the home using Poisson regression.

Results Of 14,447 firearm owners, 78% stored their firearms safely. Safe firearm storage was more prevalent among those with satisfactory (vs. unsatisfactory) engagement in all PHBs except flu shot: 78% (vs. 70%) for seatbelt use, 55% (vs. 25%) for primary care visits, 43% (vs. 38%) for physical activity, 68% (vs. 12%) for cholesterol screening, and 36% (vs. 45%) for flu shot. There were weak positive associations between engagement in PHBs and safe firearm storage. We found a suggestion of a positive trend between number of PHBs engaged with and safe firearm storage.

Conclusion The results suggest that safe firearm storage occurs at similar rates among individuals engaged and disengaged in these five PHBs.

Significance This study laid a foundation for assessing behavioral bundling in the context of safe firearm storage.