Introduction
The growing interest in incorporating prevention into emergency health care make it
timely to examine the use of computer technology to efficiently deliver effective
education in this setting.
Study design
This RCT compared results from an intervention group (n=367) that received child passenger safety information, to an attention-matched control
(n=375). A baseline survey and two follow-up surveys at 3 and 6 months were conducted.
Setting/participants
Data were collected from June 2014 to September 2016 from a sample of parents with
children aged 4–7 years recruited from a pediatric emergency department in an East
Coast urban area and one in a Midwest semi-rural area.
Intervention
A theory-based, stage-tailored educational program, Safety in Seconds v2.0TM, delivered on a mobile app.
Main outcome measures
Four car seat behaviors: (1) having the correct restraint for the child’s age and
weight; (2) having the child ride in the backseat all the time; (3) buckling up the
child all the time; and (4) having the child’s restraint inspected by a child passenger
safety technician.
Results
At 3 months, adjusting for baseline behaviors and attrition, the odds of reporting
the correct behavior by the intervention group relative to the control group was 2.07
(p<0.01) for using the correct car seat; 2.37 (p<0.05) times for having the child ride in the back seat; 1.04 (nonsignificant) for
riding buckled up all the time; and 1.99 (p<0.01) times for having the car seat inspected. At 6 months, there were statistically
significant effects for reporting use of the correct car seat (OR=1.84, p<0.01) and having the car seat inspected (OR=1.73, p<0.01).
Conclusions
Mobile apps hold promise for reaching large populations with individually tailored
child passenger safety education.
Trial registration
Clinical Trial Registration # NCT02345941.
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References
Centers for Disease Control and Prevention (CDC). Injury prevention and control: data and statistics (WISQARS). www.cdc.gov/injury/wisqars/.
- Committee on Injury, Violence, and Poison Prevention. Child passenger safety. Technical report.Pediatrics. 2011; 127: e1050-e1066https://doi.org/10.1542/peds.2011-0213
- Motor Vehicle Occupant Protection Facts—Children, Youth, Young Adults (Fact Book).National Highway Traffic Safety Administration, Washington, DCMarch 2016 (Report No.: DOT HS 812 251)
- The 2013 National Survey of the Use of Booster Seats.National Highway Traffic Safety Administration, Washington, DCJune 2014 (Report No.: DOT HS 812 037)
- Results of the National Child Restrain Use Special Study.National Highway Traffic Safety Administration, Washington, DCMay 2015 (Report No.: DOT HS 812 142)
- Providing car seat checks with well-child visits at an urban health center: a pilot study.Inj Prev. 2007; 13: 352-354https://doi.org/10.1136/ip.2006.015099
- A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change.Inj Prev. 2017; 23: 138-146https://doi.org/10.1136/injuryprev-2015-041740
- Using a computer kiosk to promote child safety: results of a randomized, controlled trial in an urban pediatric emergency department.Pediatrics. 2007; 120: 330-339https://doi.org/10.1542/peds.2006-2703
- Using the pediatric emergency department to deliver tailored safety messages: results of a randomized controlled trial.Pediatr Emerg Care. 2013; 29: 628-634https://doi.org/10.1097/PEC.0b013e31828e9cd2
- Dog bites: an opportunity for parent education in the pediatric emergency department.Pediatr Emerg Care. 2012; 28: 966-970https://doi.org/10.1097/PEC.0b013e31826c6c13
- Improving pediatric prevention via the internet: a randomized, controlled trial.Pediatrics. 2006; 118: 1157-1166https://doi.org/10.1542/peds.2006-0209
- A computerized kiosk to teach injury prevention: is it as effective as human interaction?.J Trauma Acute Care Surg. 2014; 77: S2-S7https://doi.org/10.1097/TA.0000000000000317
- Baby, Be Safe: the effect of tailored communications for pediatric injury prevention provided in a primary care setting.Patient Educ Couns. 2002; 46: 175-190https://doi.org/10.1016/S0738-3991(01)00211-7
- Preventing unintentional pediatric injuries: a tailored intervention for parents and providers.Health Educ Res. 2008; 23: 656-669https://doi.org/10.1093/her/cym041
- Effectiveness of web-based tailored advice on parents’ child safety behaviors: randomized controlled trial.J Med Internet Res. 2014; 16: e17https://doi.org/10.2196/jmir.2521
- Evaluation of kiosk-based tailoring to promote household safety behaviors in an urban pediatric primary care practice.Patient Educ Couns. 2005; 58: 168-181https://doi.org/10.1016/j.pec.2004.08.015
White A. U.S. Smartphone use in 2015. Pew Research Center on Internet and Technology. www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/. Accessed April 1, 2015.
- Evaluating a smartphone application to improve child passenger safety and fire safety knowledge and behaviour.Inj Prev. 2017; 23: 58https://doi.org/10.1136/injuryprev-2016-042161
Shields WC, Perry EM, McDonald EM, et al. Cell phone use among parents visiting an urban pediatric emergency department. Pediatr Emerg Care. In press.
- An emergency department intervention to increase booster seat use for lower socioeconomic families.Acad Emerg Med. 2006; 13: 396-400
- Preventive care in the emergency department, part I: clinical preventive services—Are they relevant to emergency medicine?.Acad Emerg Med. 2008; 7: 1036-1041https://doi.org/10.1111/j.1553-2712.2000.tb02097.x
- A systematic review of emergency department technology-based behavioral health interventions.Acad Emerg Med. 2012; 19: 318-328https://doi.org/10.1111/j.1553-2712.2012.01299.x
American College of Surgeons Committee on Trauma. Resources for the Optimal Care of the Injured Patient 2014. www.facs.org/quality-programs/trauma/vrc/resources. Published 2014.
- A smartphone app to communicate child passenger safety: an application of theory to practice.Health Educ Res. 2015; 30: 683-692https://doi.org/10.1093/her/cyv035
- The elaboration likelihood model of persuasion.Communication and Persuasion. Springer, New York, NY1986: 1-24https://doi.org/10.1007/978-1-4612-4964-1
- The precaution adoption process.Health Psychol. 1988; 7: 355-386https://doi.org/10.1037/0278-6133.7.4.355
- An introduction to propensity score methods for reducing the effects of confounding in observational studies.Multivariate Behav Res. 2011; 46: 399-424https://doi.org/10.1080/00273171.2011.568786
- A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study.Stat Med. 2007; 26: 734-753https://doi.org/10.1002/sim.2580
- Reducing bias in observational studies using subclassification on the propensity score.J Am Stat Assoc. 1984; 79: 516-524https://doi.org/10.1080/01621459.1984.10478078
- Evaluation of Safe Kids Week 2004: age 4 to 9? It’s booster seat time!.Inj Prev. 2006; 12: 316-319https://doi.org/10.1136/ip.2006.012138
- Legislating child restraint usage—its effect on self-reported child restraint use rates in a central city.J Safety Res. 2010; 41: 47-52https://doi.org/10.1016/j.jsr.2009.12.004
- Effects of booster seat education and distribution program in child care centers on child restrain use among children aged 4 to 8 years.Arch Pediatr Adolesc Med. 2008; 163: 261-267https://doi.org/10.1001/archpediatrics.2008.564
- Booster seat use in an inner-city day care center population.Traffic Inj Prev. 2008; 9: 238-242https://doi.org/10.1080/15389580801958471
- Developing computerized tailored health messages.in: Bensley R.J. Brookins-Fisher J. Community Health Education Methods: A Practical Guide. 2nd ed. Jones and Bartlett Publishers, Boston, MA2003: 255-289
- Carpooling and booster seats: a national survey of parents.Pediatrics. 2012; 129: 290-298https://doi.org/10.1542/peds.2011-0575
- Disparities in age-appropriate child passenger restraint use among children aged 1 to 12 years.Pediatrics. 2014; 133: 262-271https://doi.org/10.1542/peds.2013-1908
- Validation of two child passenger safety questionnaires.Inj Prev. 2010; 16: 343-347https://doi.org/10.1136/ip.2009.022681
Article Info
Publication History
Published online: April 12, 2018
Identification
Copyright
© 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
