Results of an RCT in Two Pediatric Emergency Departments to Evaluate the Efficacy of an m-Health Educational App on Car Seat Use


      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.


      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.


      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.


      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).


      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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