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Popa Ș, Ciongradi CI, Sârbu I, Bîcă O, Popa IP, Bulgaru-Iliescu D. Traffic Accidents in Children and Adolescents: A Complex Orthopedic and Medico-Legal Approach. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1446. [PMID: 37761407 PMCID: PMC10527870 DOI: 10.3390/children10091446] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
Traffic accidents involving children and adolescents present complex challenges from both the medico-legal and orthopedic standpoints. Despite the implementation of road traffic safety laws, pediatric road traffic injuries continue to be a significant contributor to mortality rates, physical harm, and hospitalization on a global scale. For children and young people, automobile accidents are considered to be the primary culprit of mortality in developed nations. Even in highly developed nations, trauma is a significant factor in infant mortality. Each age category, from childhood to young adulthood, has its fracture patterns, as their skeletons are considerably different from those of adults. The consequences of traffic accidents extend beyond the immediate physical trauma. The medico-legal aspects surrounding these incidents add another layer of complexity, as legal repercussions may affect the responsible adult or parent, particularly in cases involving child fatalities. To effectively address traffic accidents in children and adolescents, a comprehensive approach is necessary. This approach should involve not only medical professionals but also legal experts and policymakers. Collaboration between orthopedic specialists, medico-legal professionals, law enforcement agencies, and relevant government bodies can facilitate the development and implementation of strategies aimed at prevention, education, the enforcement of traffic laws, and improved infrastructure. By addressing both the medical and legal aspects, it is possible to enhance road safety for children and adolescents, reducing the incidence of injuries and their associated long-term consequences. In this review, we aimed to summarize traffic accidents in children and adolescents from a complex orthopedic and medico-legal approach.
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Affiliation(s)
- Ștefan Popa
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Carmen Iulia Ciongradi
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Ioan Sârbu
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Ovidiu Bîcă
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Irene Paula Popa
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Diana Bulgaru-Iliescu
- 3rd Department of Medical Specialities–Legal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
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Stehr P, Reifegerste D, Rossmann C, Caspar K, Schulze A, Lindemann AK. Effective communication with caregivers to prevent unintentional injuries in children under seven years. A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:2721-2730. [PMID: 35537900 DOI: 10.1016/j.pec.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This review systematically examines the theory base and effectiveness of communication strategies (i.e., message content, message attributes, communication channels, and communicators) of interventions for caregivers to prevent unintentional child injuries. METHODS Relevant articles were searched in the databases Communication and Mass Media Complete, PsycInfo, Pubmed, and Google Scholar, the journal Injury Prevention, and the literature of included studies. A total of 71 articles reporting 67 different studies were included and fully coded. Quality was assessed using the Mixed Methods Appraisal Tool. Coded categories and their frequencies are described, and the effectiveness of different communication strategies is explored with crosstabs. RESULTS Only 17 studies stated the use of a specific theory base; Precaution Adoption Process-Model, Theory of Planned Behavior, and Health Belief Model were most often used. The message content of most studies aimed at knowledge dissemination; however, addressing behavioral determinants, such as risk perception and self-efficacy, was more effective. About half of the studies did not elaborate on message attributes; calls to action, exemplars, and tailoring were most often used, the latter being most effective. Communication channels ranged from printed products to face-to-face communication and digital media. In addition, studies specifying interpersonal communicators were highly effective. CONCLUSION The results of the review suggest that the following aspects can contribute to effective communication in child injury prevention: theory-based communication, addressing broad knowledge and further behavioral determinants, digital tailoring, and health professionals as communicators. However, a conclusive statement on the effectiveness of different communication strategies is hampered by the fact that they are not specified and/or confounded in many studies. PRACTICE IMPLICATIONS Communication strategies should be theory based and address, in addition to knowledge, behavioral determinants such as risk perception and self-efficacy. Moreover, digital tailoring is an advanced way of enhancing effectiveness and health professionals, such as pediatricians and clinic staff, are important multipliers.
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Affiliation(s)
- Paula Stehr
- Department of Media and Communication, LMU Munich, Munich, Germany.
| | | | | | - Katja Caspar
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Annett Schulze
- Department Risk Communication, Federal Institute for Risk Assessment, Berlin, Germany
| | - Ann-Kathrin Lindemann
- Department Risk Communication, Federal Institute for Risk Assessment, Berlin, Germany
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3
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Alghnam S, Alshehri F, Alnjeidi Z, Al-Saud N, Alqahtani M, Al-Eissa M. The impact of car seat giveaways on compliance among newborns in Saudi Arabia. Public Health 2022; 206:77-82. [DOI: 10.1016/j.puhe.2022.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/29/2021] [Accepted: 01/23/2022] [Indexed: 10/18/2022]
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Bou-Karroum L, El-Jardali F, Jabbour M, Harb A, Fadlallah R, Hemadi N, Al-Hajj S. Preventing Unintentional Injuries in School-Aged Children: A Systematic Review. Pediatrics 2022; 149:186944. [PMID: 35503333 DOI: 10.1542/peds.2021-053852j] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Unintentional injuries constitute the leading causes of death and long-term disabilities among children aged 5 to 15 years. We aimed to systematically review published literature on interventions designed to prevent unintentional injuries among school-aged children. METHODS We searched MEDLINE, PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO and screened the reference lists of included studies and relevant reviews. We included randomized controlled trials, controlled before-and-after studies, and interrupted time series studies. The focus of included studies was on primary prevention measures. Two reviewers collected data on type of study design, setting, population, intervention, types of injuries, outcomes assessed, and statistical results. RESULTS Of 30 179 identified studies, 117 were included in this review. Most of these studies were conducted in high-income countries and addressed traffic-related injuries. Evidence from included studies reveals that multicomponent educational interventions may be effective in improving safety knowledge, attitudes, and behaviors in school-aged children mainly when coupled with other approaches. Laws/legislation were shown to be effective in increasing cycle helmet use and reducing traffic-related injury rates. Findings reveal the relevance of infrastructure modification in reducing falls and improving pedestrian safety among children. CONCLUSIONS Additional studies are needed to evaluate the impact of unintentional injury prevention interventions on injury, hospitalizations, and mortality rates and the impact of laws and legislation and infrastructure modification on preventing unintentional injuries among school-aged children.
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Affiliation(s)
- Lama Bou-Karroum
- Department of Health Management and Policy.,Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut
| | - Fadi El-Jardali
- Department of Health Management and Policy.,Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mathilda Jabbour
- Department of Health Management and Policy.,Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut
| | - Aya Harb
- Department of Health Management and Policy.,Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut
| | - Racha Fadlallah
- Department of Health Management and Policy.,Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut
| | - Nour Hemadi
- Department of Health Management and Policy.,Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut
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Urrechaga EM, Cioci AC, Allen MK, Saberi RA, Gilna GP, Turpin AG, Perez EA, Ford HR, Sola JE, Thorson CM. Improper Restraint Use in Pediatric Patients Involved in Motor Vehicle Collisions. J Surg Res 2022; 273:57-63. [PMID: 35030430 DOI: 10.1016/j.jss.2021.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/25/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Motor vehicle collisions (MVCs) are the leading cause of unintentional death among children and adolescents; however, public awareness and use of appropriate restraint recommendations are perceived as deficient. We aimed to investigate the use of child safety restraints and examine outcomes in our community. METHODS We retrospectively queried a level 1 trauma registry for pediatric (0-18 y) MVC patients from October 2013 to December 2018. Demographic and clinical variables were recorded. Data regarding appropriate restraint use by age group were examined. RESULTS Four hundred thirty-four cases of pediatric MVC were identified. Overall, 53% were improperly restrained or unrestrained. Sixty-two percent of car seat age and 51% of booster age children were improperly restrained or unrestrained altogether. Fifty-nine percent of back seat riding, seatbelt age were improperly restrained/unrestrained, with 26% riding in the front. Fifty-one percent of seatbelt-only adolescents were not belted. Black, non-Hispanic children were more often improperly restrained/unrestrained compared to Hispanics (63% versus 48%, P = 0.001). Improperly restrained/unrestrained children had higher injury severity (10% versus 4% Injury Severity Score > 25, P = 0.021), require operative/interventional radiology (33% versus 19%, P = 0.001), and be discharged to rehabilitation or skilled nursing facility (5.2% versus 1.5%, P = 0.033). Mortality in adolescents was higher among those unrestrained (5.2% versus 0.8%, P = 0.034). CONCLUSIONS Although efforts to improve adherence to restraint regulations have greatly increased in the last decade, more than half of children in MVC are still improperly restrained. Injury prevention services and community outreach is essential to educate the most vulnerable populations, especially those with infants and toddlers, on adequate motor vehicle safety measures in our community.
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Affiliation(s)
- Eva M Urrechaga
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alessia C Cioci
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Megan K Allen
- University of Miami Miller School of Medicine, Miami, Florida
| | - Rebecca A Saberi
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Gareth P Gilna
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alexa G Turpin
- University of Miami Miller School of Medicine, Miami, Florida
| | - Eduardo A Perez
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Henri R Ford
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan E Sola
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Chad M Thorson
- Dewitt-Daughtry Family Department of Surgery. Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, Florida.
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Núñez-Samudio V, Mayorga-Marín F, López Castillo H, Landires I. Epidemiological Characteristics of Road Traffic Injuries Involving Children in Three Central American Countries, 2012-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010037. [PMID: 33374643 PMCID: PMC7793503 DOI: 10.3390/ijerph18010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
Although motor vehicle collisions (MVCs) are a worldwide public health concern due to their high injury, mortality, and fatality rates, few studies have addressed the epidemiologic behavior of MVCs in Latin American youth. Thus, this study was aimed at describing and comparing the characteristics of MVCs involving 0 to 14-year-olds in Costa Rica, Guatemala, and Panama. A secondary aim was to estimate the crude MVC-related injury, fatality, and mortality rates and their trends over time. We conducted a descriptive, retrospective study using publicly available data for Costa Rica, Panama, and Guatemala between 2012 and 2015. We examined the reported MVC cases and calculated the crude injury, fatality, and mortality rates and their trends over time (α = 0.05). Publicly available data reported 12,020 MVC-related injuries and 431 MVC-related deaths involving 0 to 14-year-olds. The most frequent mechanisms involved 0 to 14-year-olds as passengers or pedestrians in MVCs (>85% of all cases). The highest crude MVC-related injury and mortality rates were reported for Panama (119.35 and 2.14 per 100,000 population, respectively, in 0 to 14-years-olds), while Guatemala had the highest median MVC-related fatality rate (8.84 per 100,000 events; χ2 [2] = 377.8; p < 0.001) with a statistically significant trend increasing over time (r = 0.947; p = 0.027). Although several factors play a role in the prevention of MVCs among 0 to 14-year-olds, we found that Costa Rica was the only country that implemented a policy on child restraint systems resulting in the lowest rates of MVC-related injury, mortality, and fatality. These results could be used by decision makers from the aforementioned Central American countries to develop adequate policies addressing MVC preventative strategies to protect Central American infants and children.
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Affiliation(s)
- Virginia Núñez-Samudio
- Instituto de Ciencias Médicas, Las Tablas, Los Santos 0701, Panama;
- Sección de Epidemiología, Departamento de Salud Pública, Región de Salud de Herrera, Ministry of Health, Chitré, Herrera 0601, Panama
| | - Francisco Mayorga-Marín
- Centro de Investigaciones y Estudios de la Salud, Universidad Nacional Autónoma, Managua 10000, Nicaragua;
| | - Humberto López Castillo
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida (UCF), Orlando, FL 32816, USA;
- Department of Population Health Sciences, College of Medicine, UCF, Orlando, FL 32827, USA
| | - Iván Landires
- Instituto de Ciencias Médicas, Las Tablas, Los Santos 0701, Panama;
- Centro Regional Universitario de Azuero (CRUA), Universidad de Panamá, Chitré, Herrera 0601, Panama
- Hospital Joaquín Pablo Franco Sayas, Región de Salud de Los Santos, Ministry of Health, Las Tablas, Los Santos 0701, Panama
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Tan RMR, Dong C, Shen GQ, Feng JXY, Piragasam R, Tyebally A, Chong SL. Parental knowledge and beliefs on the use of child car restraints in Singapore: a qualitative study. Singapore Med J 2019; 61:102-107. [PMID: 30773603 DOI: 10.11622/smedj.2019023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Road traffic injuries and fatalities represent a significant public health problem. In Singapore, compliance with appropriate child car restraints (CCRs) is poor. We aimed to understand parental knowledge, beliefs and barriers regarding the use of CCRs. METHODS In this qualitative study, we conducted five focus group discussions with parents who drive with their children in private cars. Participants were recruited using the KK Women's and Children's Hospital's social media page. Guiding questions were derived by consensus following literature review and adaptation to the Singapore context, exploring parental perceptions of CCR use. Focus group interviews were then transcribed and analysed. RESULTS 33 participants were recruited, with an age range of 28‒46 (mean age 35.5) years. They had a total of 46 children with ages ranging from 2.5 months to 14 years (mean age 4.2 years). Three key themes were identified: parental knowledge regarding CCRs, barriers to CCR use, and suggestions to increase CCR compliance. Barriers to compliance included lack of knowledge, difficult child behaviour and cultural norms. A multipronged approach was proposed to increase CCR use, including educating the public, reinforcing positive behaviour, legal enforcement as a deterrent to non-compliance, increasing CCR installation services, providing CCRs for taxi users and offering financial incentives. CONCLUSION Non-compliance to CCR use is multidimensional, including multiple potentially modifiable factors. This study could inform ongoing collaborative injury prevention efforts among healthcare professionals, industry partners and the traffic police, using public education and outreach to reduce the burden of road traffic injuries.
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Affiliation(s)
- Ronald Ming Ren Tan
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Chaoyan Dong
- Department of Education, Sengkang General Hospital, Singapore
| | - Germac Qiaoyue Shen
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Jasmine Xun Yi Feng
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Rupini Piragasam
- KK Research Centre, KK Women's and Children's Hospital, Singapore
| | - Arif Tyebally
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
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Asbridge M, Ogilvie R, Wilson M, Hayden J. The impact of booster seat use on child injury and mortality: Systematic review and meta-analysis of observational studies of booster seat effectiveness. ACCIDENT; ANALYSIS AND PREVENTION 2018; 119:50-57. [PMID: 29990613 DOI: 10.1016/j.aap.2018.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/19/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine through systematic review and meta-analysis of observational studies if booster seats, compared to seatbelts alone, reduce injury and mortality from motor vehicle collisions among child passengers four to eight years of age. METHODS A comprehensive search of several data sources (including Medline, Embase, and PsycINFO) was conducted from inception to December 2016, to retrieve relevant publications in any language and from any geographic region. Data extraction was completed by two independent reviewers, capturing: study details, population characteristics, exposure (booster seat compared to seat belt use), outcomes (injury and fatality), and all associations reported between the exposure and outcomes. Risk of bias assessment was completed by two reviewers using the QUIPS tool. Meta-analysis of sufficiently similar studies was conducted using random effects models. RESULTS Eleven observational studies were included in qualitative syntheses. The systematic review and meta-analysis found no association between booster seat use, compared to seatbelts, and reduced injury (4 studies, OR 1.03; 95% CI 0.53-1.99) or fatality (2 studies, OR 0.91; 95% CI 0.73-1.13). CONCLUSIONS Evidence on booster seat effectiveness to protect against injury and mortality in real-world conditions is limited. This review identified the need for high quality studies assessing the effects of different models of booster seats on children of varying ages and weights.
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Affiliation(s)
- Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Rachel Ogilvie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Maria Wilson
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jill Hayden
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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Kuroiwa E, Ragar RL, Langlais CS, Baker A, Linnaus ME, Notrica DM. Car seat education: A randomized controlled trial of teaching methods. Injury 2018; 49:1272-1277. [PMID: 29739654 DOI: 10.1016/j.injury.2018.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 04/08/2018] [Accepted: 05/02/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if a less labor-intensive video-based program for teaching car seat installation can be as effective as the traditional didactic lecture component. METHODS This is a randomized controlled trial of caregivers seeking car seat education. Caregivers were assigned to didactic or video-based social learning classes. The didactic class involved live lecture; the social learning class included a brief lecture and the video, Simple Steps to Child Passenger Safety, utilizing social learning principles. Proficiency in child passenger safety was evaluated pre- and post-class via: (1) 5-question confidence assessment; (2) 15-question knowledge test; and (3) 5-part car seat installation demonstration. Data were analyzed to compare post-class assessment scores between teaching modalities using pre-test scores as covariates, and correlation of participant confidence and knowledge with installation ability. RESULTS 526 individuals registered and were randomized. A total of 213 arrived for class with 103 randomized to didactic teaching and 111 to social learning. Didactics and social learning groups showed similar increases in post-class confidence, knowledge, and installation ability. In the pre-class assessment, 16% of participants in each group installed the car seat correctly. After controlling for baseline installation ability, correct post-class car seat installation did not vary between groups (mean difference = 0.001; p = 0.964). Among participants with high scores on the knowledge assessment, only 57% could demonstrate correct car seat installation (rs = 0.160, p = 0.023). CONCLUSION Video-based social learning methodology, which requires less time and resources, was as effective in teaching child passenger safety as didactic lecture. Both teaching methods significantly improved proficiency in child passenger restraint. Car seat installation knowledge is only weakly correlated with proper installation ability and proper installation remains a challenge, even after education.
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Affiliation(s)
- Erin Kuroiwa
- Center for Injury Prevention and Level 1 Pediatric Trauma Center, Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Rebecca L Ragar
- Center for Injury Prevention and Level 1 Pediatric Trauma Center, Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Crystal S Langlais
- Center for Injury Prevention and Level 1 Pediatric Trauma Center, Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Angelica Baker
- Center for Injury Prevention and Level 1 Pediatric Trauma Center, Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Maria E Linnaus
- Center for Injury Prevention and Level 1 Pediatric Trauma Center, Phoenix Children's Hospital, Phoenix, AZ, United States; Mayo Clinic Department of Surgery, Phoenix, AZ, United States
| | - David M Notrica
- Center for Injury Prevention and Level 1 Pediatric Trauma Center, Phoenix Children's Hospital, Phoenix, AZ, United States; Mayo Clinic Department of Surgery, Phoenix, AZ, United States; University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States.
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Abstract
Education is ubiquitous with clinical care. However, not all education supports behavioral change. Education is a broad term that encompasses the process of obtaining general knowledge, personal awareness, and skills training. Although not sufficient, education is a necessary component for behavior change. This article outlines the role of education in behavior change and offers practical suggestions for how clinicians can provide education to their patients to help them change behavior.
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Affiliation(s)
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, Texas
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Stéphane Grenier, Laurence Hamel-Charest, Suzanne McMurphy, G. Brent Angell. Être bien attaché à la vie : sécurité routière dans les familles anicinabek. ENFANCES, FAMILLES, GÉNÉRATIONS 2016. [DOI: 10.7202/1039505ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
La sous-utilisation des sièges d’auto pour enfants par les Autochtones du Canada pourrait nous laisser penser que les parents autochtones se préoccupent peu de la sécurité de leurs enfants. Nous déconstruisons cette hypothèse en analysant la constitution de programmes d’intervention visant l’amélioration de la sécurité routière dans deux communautés anicinabek du Québec, Lac-Simon et Kitcisakik. Les préoccupations des membres de ces communautés et les angles d’intervention qu’ils désiraient privilégier afin de réduire les risques de blessures causées par des accidents de véhicules motorisés montrent que les enfants occupent un espace symbolique important. Plutôt qu’un résultat de la négligence parentale, la sous-utilisation de sièges d’auto pour enfants semble notamment due à la pauvreté dans laquelle vivent plusieurs familles autochtones. De plus, la sécurité de la jeunesse semble être une motivation amenant les communautés et leurs membres vers un processus de transformation. Cet article nous renseigne aussi sur le type d’éducation ainsi que sur la conception de la famille privilégiée par les Anicinabek. Tenir compte de ces éléments culturels dans le développement des programmes d’intervention permet d’adapter l’action au contexte local.
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Affiliation(s)
- Stéphane Grenier
- Professeur agrégé, Unité d’enseignement et de recherche en sciences du développement humain et social, Université du Québec en Abitibi-Témiscamingue, Canada,
| | | | - Suzanne McMurphy
- Professeure associée, Département de sociologie, d’anthropologie et de criminologie, University of Windsor, Canada,
| | - G. Brent Angell
- Professeur agrégé, Département de travail social, University of Windsor , Canada,
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Pankratz C, Warda L, Piotrowski C. Challenges in the Accurate Surveillance of Booster Seat and Bicycle Helmet Usage by Children: Lessons from the Field. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070658. [PMID: 27399749 PMCID: PMC4962199 DOI: 10.3390/ijerph13070658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 06/06/2023]
Abstract
Motor vehicle collisions and bicycle collisions and falls are a leading cause of death by preventable injury for children. In order to design, implement and evaluate campaigns and programs aimed at improving child safety, accurate surveillance is needed. This paper examined the challenges that confront efforts to collect surveillance data relevant to child traffic safety, including observation, interview, and focus group methods. Strategies to address key challenges in order to improve the efficiency and accuracy of surveillance methods were recommended. The potential for new technology to enhance existing surveillance methods was also explored.
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Affiliation(s)
- Curt Pankratz
- Department of Sociology, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada.
| | - Lynne Warda
- Injury Prevention and Child Public Health Program, Winnipeg Regional Health Authority, Winnipeg, MB R3A 1S1, Canada.
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada.
| | - Caroline Piotrowski
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
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Nuñez-Samudio V, Jaramillo-Morales J, Landires I. Prevalence and characteristics of child victims in motor vehicle collisions in Panama. TRAFFIC INJURY PREVENTION 2016; 17:391-393. [PMID: 26508173 DOI: 10.1080/15389588.2015.1092524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Fatalities from motor vehicle collisions are one of the leading causes of death among children in developed countries. Previous publications have shown that the rate is approximately 4 times higher in Latin American countries. We aimed to determine the prevalence and characteristics of child victims of motor vehicle collisions in Panama and to compare them with data from a more developed country. In this study, Spain was the country chosen for such comparison. METHODS A descriptive and retrospective study on the prevalence and characteristics of child victims from motor vehicle collisions that occurred from 2005 to 2012 in Panama was performed. To carry out this study, the records pertaining to victims of motor vehicle collisions in Panama were obtained from the National Institute of Statistics and Census and the Spanish data were obtained from the Road Accident Report. The variables analyzed were age, sex, number of victims, number of injuries, number of fatalities, and type of motor vehicle collision. RESULTS The child mortality rate in Panama by motor vehicle collisions during the evaluated time period ranged from 2.11 to 3.63, whereas mortality rates in Spain ranged from 0.6 to 1.9, making rates in Panama 3 to 4 times higher than the rates observed in Spain. Children under 5 years old were the group with the highest number of fatalities in Panama. CONCLUSIONS In Panama, a lack of specific legislation on the use of child restraints (car seats) as well as a lack of information and awareness campaigns could be responsible for the high toll of child victims associated with motor vehicle collisions.
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Affiliation(s)
- Virginia Nuñez-Samudio
- a Unidad de Microbiología y Salud Pública, Instituto de Ciencias Médicas , Las Tablas , Panama
- b Sección de Epidemiologia, Departamento de Salud Pública, Región de Salud de Herrera, Ministry of Health Panama , Las Tablas , Panama
| | | | - Ivan Landires
- a Unidad de Microbiología y Salud Pública, Instituto de Ciencias Médicas , Las Tablas , Panama
- c Región de Salud de los Santos, Provincia de Los Santos, Ministry of Health , Las Tablas , Panama
- d National System of Research (SNI) , Senacyt, Las Tablas , Panama
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Adopting child restraint laws to address child passenger injuries: Experience from high income countries and new initiatives in low and middle income countries. Injury 2015; 46:933-4. [PMID: 26003092 DOI: 10.1016/j.injury.2015.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Yanchar NL, Young JB, Langille DB. Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: phase II. ACCIDENT; ANALYSIS AND PREVENTION 2015; 74:150-156. [PMID: 25463955 DOI: 10.1016/j.aap.2014.09.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 08/25/2014] [Accepted: 09/29/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To examine changes to knowledge and practice of childhood motor vehicle restraint (CMVR) use in Nova Scotia after the implementation of stricter car seat and new booster seat (BS) legislation in 2007. METHODS A random telephone survey of households (at least one child <12 years) was performed in 2004 and 2010. Logistic regression determined variables independently associated with correct knowledge and/or practice of CMVR use. RESULTS Families were surveyed in the pre- (N=426 families, 728 children) and post- (N=453 families, 723 children) legislative periods. Reported appropriate use of forward-facing car seats (FFCSs) and BSs increased significantly (74-92% and 58-95%, respectively). After adjusting for covariates, the post-law period remained a significant predictor of increased knowledge of when to graduate to a BS or a seat belt alone (SB) (OR:1.4(95% CI:1.0-2.0) and 1.9(1.4-2.7), respectively), which was significantly associated with correct use. The strongest independent predictor of the correct use of FFCSs and BSs was the post-law period (OR:14(3.0-68) and 43(17-114), respectively). With regards to rear-facing car seats (RFCSs), new legislation and associated social marketing on graduating from a rear-facing car seat was not associated with increases in correct practice. CONCLUSIONS Legislation, combined with social marketing at the time of introduction, is an effective means to educate parents on when to graduate from a FFCS and the importance of BSs while also influencing parents to use them, though not for RFCS graduation. The known protective effect of BSs dictates the need for all regions in Canada to adopt comprehensive BS legislation.
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Affiliation(s)
- Natalie L Yanchar
- Division of Pediatric General Surgery and IWK Trauma Care Program, IWK Health Centre, Halifax, Nova Scotia, Canada.
| | - Julian B Young
- Provincial Coordinator, Injury Prevention and Control, Nova Scotia Department of Health and Wellness, Halifax, Nova Scotia, Canada.
| | - Donald B Langille
- Faculty of Medicine, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
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Nguyen AV, Cohen NJ, Gao H, Fishbein DB, Keir J, Ocana JM, Senini L, Flores A, Waterman SH. Knowledge, attitudes, and practices among border crossers during temporary enforcement of a formal entry requirement for Mexican-style soft cheeses, 2009. J Food Prot 2014; 77:1571-8. [PMID: 25198849 PMCID: PMC4638153 DOI: 10.4315/0362-028x.jfp-13-395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mexican-style soft cheese known as queso fresco (QF), which is often unpasteurized, has been implicated in outbreaks of foodborne illness in the United States. The U.S. Food and Drug Administration (FDA) exercises discretion in enforcement of noncommercial importation of cheese. To test control measures aimed at decreasing unlawful QF importation, in 2009 the FDA temporarily enforced a requirement for formal commercial entry for all cheeses over 5 lb (2.3 kg) at the San Diego-Tijuana border. Enforcement was combined with educational outreach. Border crossers importing cheese and those not importing cheese were surveyed at the beginning and end of the temporary enforcement period. Data collected included participant demographic information, knowledge of QF-associated health risks, and attitudes and practices regarding QF consumption and importation. We surveyed 306 importers and 381 nonimporters. Compared with nonimporters, importers had a lower level of knowledge regarding QF-associated health risks (P < 0.0001). Border crossers carrying cheese were more likely to have less education, be U.S. or dual residents, consume QF more frequently, and cross the border less often. Importation and consumption of unpasteurized QF remained prevalent among border crossers during the temporary enforcement period, and the level of knowledge regarding QF-associated risks remained low among these crossers. More vigorous, sustained messaging targeted at high-risk groups is needed to change behaviors. Definition and consistent enforcement of limits will likely be needed to reduce QF importation and the risk of QF-associated diseases along the U.S.-Mexico border; however, public health benefits will need to be balanced against the cost of enforcement.
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Affiliation(s)
- An V Nguyen
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA; Council of State and Territorial Epidemiologists, Atlanta, Georgia 30341, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Nicole J Cohen
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
| | - Hongjiang Gao
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - Daniel B Fishbein
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA; SRA International, Atlanta, Georgia 30329, Myanmar Research International, Yangon, Myanmar
| | - Jane Keir
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, Strive Preparatory Schools, Denver, CO 80219, USA
| | - J Miguel Ocana
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - Lori Senini
- San Diego County Office of Public Health Services, Health and Human Services Agency, San Diego, California 92101, USA
| | - Aleta Flores
- U.S. Food and Drug Administration, Alameda, California 94502, USA
| | - Stephen H Waterman
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Chen X, Yang J, Peek-Asa C, Li L. Parents' experience with child safety restraint in China. BMC Public Health 2014; 14:318. [PMID: 24708776 PMCID: PMC4234189 DOI: 10.1186/1471-2458-14-318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 04/03/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Child safety restraints are effective measures in protecting children from an injury while traveling in a car. However, the rate of child restraint use is extremely low in Chinese cities. Parent drivers could play an important role in promoting child safety restraint use, but not all of them take active responsibility. METHODS This study used a qualitative approach and included 14 in-depth interviews among parents with a child, under the age of 6, living in Shantou City (7 child safety restraint users and 7 non-users). Purposive sampling was used to recruit eligible parent drivers who participated in a previous observation study. Interview data were collected from March to April 2013. The audio taped and transcribed data were coded and analyzed to identify key themes. RESULTS Four key themes on child safety restraint emerged from the in-depth interviews with parents. These included 1) Having a child safety restraint installed in the rear seat with an adult sitting next to the restrained child is ideal, and child safety restraint is seen as an alternative when adult accompaniment is not available; 2) Having effective parental education strategies could help make a difference in child safety restraint use; 3) Inadequate promotion and parents' poor safety awareness contribute to the low rate of child safety restraint in China; 4) Mandatory legislation on child safety restraint use could be an effective approach. CONCLUSION Inadequate promotion and low awareness of safe traveling by parents were closely linked to low child safety seat usage under the circumstance of no mandatory legislation. Future intervention efforts need to focus on increasing parents' safe travel awareness combined with CSS product promotion before the laws are enacted.
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Affiliation(s)
- Xiaojun Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Jingzhen Yang
- The University of Iowa Injury Prevention Research Center, Iowa, USA
- Department of Social and Behavioral Sciences, Kent State University, Kent, USA
| | - Corinne Peek-Asa
- The University of Iowa Injury Prevention Research Center, Iowa, USA
- Department of Occupational and Environmental Health, University of Iowa, Iowa, USA
| | - Liping Li
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Chen X, Yang J, Peek-Asa C, McGehee DV, Li L. Parents' knowledge, attitude, and use of child restraints, Shantou, China. Am J Prev Med 2014; 46:85-8. [PMID: 24355676 DOI: 10.1016/j.amepre.2013.08.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/15/2013] [Accepted: 08/27/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND China has not adopted national policies for child safety restraints in cars, although children are increasingly traveling in cars. OBJECTIVE To describe child restraint use, and parents' knowledge of and attitude toward child restraint in Shantou, China. METHODS An observational study and driver survey on child restraint use was conducted in the Southeast China city of Shantou in 2012. Observational sites included 22 middle schools, 31 primary schools, 24 kindergartens, and 4 hospitals. Drivers were asked about their knowledge of and attitude toward the use of child restraints. In September 2012, multivariate regression was used to evaluate the factors associated with increased child restraint use. RESULTS Of 3333 children observed in vehicles, only 22 (0.6%) children were secured in child safety seats or booster seats and 292 (8.7%) children were wearing seatbelts. More than half (n=508, 56.1%) of the infants or toddlers were riding on the laps of adults. Of 1069 drivers who responded to the survey, more than 62% thought it was necessary to use child restraint while traveling in a car. The drivers' higher education status (OR=1.56, 95% CI=1.07, 2.27) and seatbelt use (OR=4.00, 95% CI=2.56, 6.25) were associated with increased child restraint use. Parents (OR=0.55, 95% CI=0.34, 0.88) and male drivers (OR=0.61, 95% CI=0.46, 0.81) had reduced odds of children properly rear-seated. CONCLUSIONS Child restraint use is very low in China, although the majority of drivers had positive attitudes about child restraint. These findings indicate that child restraint policies and educational approaches are urgently needed in China.
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Affiliation(s)
- Xiaojun Chen
- First Affiliated Hospital, China; Injury Prevention Research Center, Shantou University Medical College, China
| | - Jingzhen Yang
- University of Iowa Injury Prevention Research Center, Iowa City, Iowa
| | - Corinne Peek-Asa
- University of Iowa Injury Prevention Research Center, Iowa City, Iowa
| | - Daniel V McGehee
- University of Iowa Injury Prevention Research Center, Iowa City, Iowa
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, China.
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Bryant-Stephens T, Garcia-Espana JF, Winston FK. Boosting restraint norms: a community-delivered campaign to promote booster seat use. TRAFFIC INJURY PREVENTION 2013; 14:578-583. [PMID: 23859278 DOI: 10.1080/15389588.2012.733840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the effectiveness of a theoretically grounded community-delivered marketing campaign to promote belt-positioning booster seat (BPB) use among vulnerable populations when disseminated by community members. METHODS A prospective, nonrandomized community intervention trial was conducted to evaluate the "Boosting Restraint Norms" social marketing campaign delivered by community partners in Norristown, Pennsylvania (intervention community), between October 2008 and November 2008. York, Pennsylvania, served as the comparison community. In total, 800 vehicles with 822 children aged 4 to 7 years were observed for BPB use, the primary outcome of interest, at baseline (September 2008) and at 6 months after intervention (April 2009). RESULTS During the study period, a 28 percent increase in the prevalence of BPB use at 6 months was observed in the intervention community with no change in the prevalence of BPB use in the comparison community. After adjustment for child age and gender, vehicle type, driver gender, and driver level, BPB use increased from 39 to 50 percent in the intervention community. CONCLUSIONS The "Boosting Restraint Norms" social marketing campaign, distributed through community organizations combined with caregiver education and a one-time free distribution of BPBs, was effective in increasing BPB use. This study demonstrates the feasibility of utilizing community organizations with established audiences to spread the "No Regrets" messaging of the campaign in the community. This study also indicates that spreading evidence-based messages in this manner may effectively change behavior in populations that are often hard to reach. Future studies are needed in which this methodology is tested in additional communities and rural settings.
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Affiliation(s)
- Tyra Bryant-Stephens
- The Community Asthma Prevention Program, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
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20
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Keay L, Hunter K, Brown J, Simpson JM, Bilston LE, Elliott M, Stevenson M, Ivers RQ. Evaluation of an education, restraint distribution, and fitting program to promote correct use of age-appropriate child restraints for children aged 3 to 5 years: a cluster randomized trial. Am J Public Health 2012; 102:e96-102. [PMID: 23078492 DOI: 10.2105/ajph.2012.301030] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated an education, distribution, and fitting program for increasing age-appropriate and correct child restraint use. METHODS We performed a cluster randomized trial involving 28 early childhood education centers in low socioeconomic status areas in Sydney, Australia. The main outcome was optimal restraint use defined as age-appropriate restraints, installed into the vehicle correctly and used correctly. RESULTS One service withdrew after randomization, so data are presented for 689 child passengers, aged 3 to 5 years, from 27 centers. More children attending intervention centers were optimally restrained (43% vs 31%; P = .01; allowing for clustering). More 3-year-olds were using forward-facing seats rather than booster seats, more 4- to 5-year-olds were using booster seats instead of seat belts alone, and there were fewer errors in use at intervention centers. Among non-English-speaking families, more children attending intervention centers were optimally restrained (43% vs 17%; P = .002; allowing for clustering). CONCLUSIONS The program increased use of age-appropriate restraints and correct use of restraints, which translates to improved crash injury protection. Multifaceted education, seat distribution, and fitting enhanced legislation effects, and the effect size was larger in non-English-speaking families.
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Affiliation(s)
- Lisa Keay
- The George Institute for Global Health and the Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
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Pan S, Du W, Jiang F, Bilston L, Brown J, Shen X. Restraint use and seating position among child car passengers: an observational study in Shanghai. ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:2195-2199. [PMID: 21819852 DOI: 10.1016/j.aap.2011.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 05/17/2011] [Accepted: 06/22/2011] [Indexed: 05/31/2023]
Abstract
Child passenger restraint practices in China are poorly characterized and few direct observational studies have been performed. This study aims to describe child passenger restraint use and to investigate factors influencing the restraint practices. A cross-sectional observational study was conducted at toll-gates in Shanghai during an 11-day period in June in 2009. A pro-forma observation checklist was used to collect data related to restraint use by child passengers aged ≤ 12 years, restraint use by drivers, and the number of child passengers traveling in passenger cars registered in Shanghai. Adjusted risk ratios (RR) comparing those children who were properly rear seated with those in other positions (front seat, on adult's lap) and any restraint use with no restraint use were evaluated using multivariate binomial regression with robust variance estimation. Among 967 children observed, 44.1% of children were in suboptimal seating positions (i.e., 12.2% in the front seat and 31.9% in adult laps) and 93.9% were unrestrained. Children aged ≤ 4 years (RR: 0.35, 95% Confidence Interval: 0.28-0.44), and those who were the only child in a car (RR: 0.84, 95% confidence interval: 0.74-0.96) had a lower likelihood of being properly rear seated. Children traveling with unrestrained drivers (RR: 0.09, 95% confidence interval: 0.01-0.60) were less likely to be restrained. This study demonstrates low restraint use and common suboptimal seating positions for child passengers in China and relates these to driver restraint use. These findings support the need for targeted programs to improve child restraint practices in China.
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Affiliation(s)
- Shuming Pan
- Emergency Department, Xinhua Hospital, and Faculty of Medicine, Shanghai Jiaotong University, China; Shanghai Paediatric Research Institute, Shanghai Key Laboratory of Children's Environmental Health, China
| | - Wei Du
- Neuroscience Research Australia, University of New South Wales, Australia; Institute of Population Research, Peking University, China; The George Institute for International Health, Faculty of Medicine, University of Sydney, Australia
| | - Fan Jiang
- Shanghai Paediatric Research Institute, Shanghai Key Laboratory of Children's Environmental Health, China; Department of Developmental and Behavioural Paediatrics, Shanghai Children's Medical Centre, China
| | - Lynne Bilston
- Neuroscience Research Australia, University of New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, Australia
| | - Julie Brown
- Neuroscience Research Australia, University of New South Wales, Australia; School of Medical Sciences, University of New South Wales, Australia
| | - Xiaoming Shen
- Shanghai Paediatric Research Institute, Shanghai Key Laboratory of Children's Environmental Health, China.
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Cunningham CE, Bruce BS, Snowdon AW, Chen Y, Kolga C, Piotrowski C, Warda L, Correale H, Clark E, Barwick M. Modeling improvements in booster seat use: a discrete choice conjoint experiment. ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:1999-2009. [PMID: 21819828 DOI: 10.1016/j.aap.2011.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 03/30/2011] [Accepted: 05/17/2011] [Indexed: 05/31/2023]
Abstract
Automobile crashes are the leading cause of death in children aged 1-14 years. Many children, however, are not properly restrained in safety seats that reduce serious injury and death. This study used a discrete choice conjoint experiment to study factors influencing the decision to use booster seats. Parents of 1714 children aged 4-9 years from nine Canadian provinces completed choice tasks presenting experimentally varied combinations of 15 4-level booster seat promotion attributes. Latent class analysis yielded three segments of parents. The choices of the Benefit Sensitive segment (50%) were most sensitive to the injury prevention benefits of booster seats. The choices of parents in the Context Sensitive segment (33.5%) were more likely to be influenced by installation complexity, oppositional behavior, and the prospect that their child may be teased for riding in booster seats. Parents in the High Risk segment (16.5%) were younger, less educated, and less knowledgeable about vehicle safety legislation. They anticipated fewer benefits, expected more barriers and were less likely to use booster seats. Simulations suggest that consistent enforcement coupled with advertising focusing on injury prevention and the use of booster seats by other parents would increase adoption.
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Affiliation(s)
- Charles E Cunningham
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L9C 7N4, Canada.
| | - Beth S Bruce
- Faculty of Health Professions, Dalhousie University, Halifax, Canada
| | - Anne W Snowdon
- Odette School of Business, University of Windsor, Windsor, Canada
| | - Yvonne Chen
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L9C 7N4, Canada
| | | | - Caroline Piotrowski
- Department of Family Social Sciences, University of Manitoba, Winnipeg, Canada
| | - Lynne Warda
- Department of Pediatrics, University of Manitoba, Winnipeg, Canada
| | - Heather Correale
- School of Nursing, University of Northern British Columbia, British Columbia, Canada
| | - Erica Clark
- School of Nursing, University of Northern British Columbia, British Columbia, Canada
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Abstract
BACKGROUND Injury is the leading cause of death for children older than 1 year. The incidence of childhood injury varies greatly depending on social factors, including income, family violence, and other social stressors. This study reports the incidence of injury among children aged 5 years in a cohort of vulnerable families. METHODS The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 at-risk families across the United States. Data from interviews with mothers conducted shortly after giving birth and follow-up surveys at 1 year, 3 years, and 5 years were used. Multivariate regression analysis was used to identify independent risk factors for injury in year 5. RESULTS Five-year follow-up data on injury was complete for 2,397 families. Two hundred ninety-six children were injured at the age of 5 years (12.3%). Multivariate regression found that the strongest predictors of injury in year 5 were male gender (OR, 2.62; 95% CI, 1.02-6.75; p = 0.04) and being in the lowest income stratum (OR, 1.23; 95% CI, 1.01-1.49; p = 0.03). CONCLUSIONS Children in vulnerable families are at higher risk for injury. The incidence of 12.3% found in this cohort is substantially higher than CDC risk for 5-year-old children, that is, overall 9.3%. This longitudinal cohort has demonstrated a persistently elevated risk of childhood injury, but risk factors for injury have changed with age. As these children reached school age, low household income and male gender were risk factors for injury. This suggests that recognition of gender differences and targeted interventions for caregivers and play environments may be useful.
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Stahl CE, Necheles JW, Mayefsky JH, Wright LK, Rankin KM. 5-4-3-2-1 go! Coordinating pediatric resident education and community health promotion to address the obesity epidemic in children and youth. Clin Pediatr (Phila) 2011; 50:215-24. [PMID: 21098524 DOI: 10.1177/0009922810385106] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the feasibility and effectiveness of training pediatric residents to conduct a brief clinic-based behavioral intervention in coordination with community dissemination of a health promotion message developed by the Consortium for Lowering Obesity in Chicago Children. A total of 113 residents completed a short (<60 minutes) online training program. Some (64) residents distributed interview contact cards to patients they saw in their continuity of care clinics after training; others (45) distributed cards before training. A researcher interviewed 75% of the 509 patients 4 weeks after the visit. More patients of trained residents reported positive changes in behaviors which have been associated with lower obesity rates: increased intake of fruits and vegetables (28% vs 16%, P < .01), increased intake of water (30% vs 19%, P < .01), increased physical activity (40% vs 29%, P < .03), and decreased television time (36% vs 24%, P < .01). Brief training using the 5-4-3-2-1-Go! message seems to be feasible and effective.
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Ivers RQ, Keay L, Brown J, Bilston LE, Hunter K, Simpson JM, Stevenson M. Buckle up safely: a cluster randomised trial to evaluate the effectiveness of a pre-school based program to increase appropriate use of child restraints. BMC Public Health 2011; 11:16. [PMID: 21211053 PMCID: PMC3024224 DOI: 10.1186/1471-2458-11-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 01/06/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Road traffic crashes for car occupants are a leading cause of death and serious injury in children from high and middle income countries globally. Correct use of appropriate child restraints can significantly reduce death and serious injury but there is a need for well powered trials to examine effectiveness of programs to increase optimal child restraint practices. The aim of this trial is to examine the effectiveness of a comprehensive intervention to increase the use of appropriate child restraints, and decrease incorrect use of child restraints in pre-school aged children traveling in cars. METHODS AND DESIGN A cluster randomised controlled trial will be conducted, involving 28 pre-school or childcare centres in low income areas of Sydney, Australia, over one calendar year. The intervention is an educational program involving an in-service for centre staff, distribution of educational materials to parents, a parent workshop demonstrating restraint use, subsidised restraints for parents in need, and vouchers for a free restraint checking service. Blinded assessors will observe restraint use at all centres at the end of the calendar year. Data will be analysed on an intention-to-treat basis; the primary analysis will compare the proportion of each of the two outcome measures (use of appropriate restraints, and incorrect use of restraints) at each centre between intervention and control groups. Detailed process evaluation will be conducted, including examination of implementation and utilisation of various elements of the program by both centres and families. DISCUSSION This assessor blinded cluster randomised trial is powered to provide credible evidence about the efficacy of an education and distribution program in a pre-school setting to increase appropriate use, and decrease incorrect use of child restraints. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12609000612213.
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Affiliation(s)
- Rebecca Q Ivers
- The George Institute for Global Health, The University of Sydney, Sydney, Australia.
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Abstract
OBJECTIVES The objective of the study was to test the impact of an educational video in improving child passenger safety knowledge. METHODS This was a prospective randomized study performed in the emergency department of an urban children's hospital involving parents of non-critically ill children younger than 9 years. Parents were randomized to observe a video on child passenger safety or comparison group. All completed a survey, 8-question pretest at enrollment, and posttest after 1 month and received written safety materials at discharge. The outcome measure to test knowledge was the difference in mean pretest-posttest scores on a questionnaire. RESULTS We enrolled 274 parents (137 intervention, 137 comparison). Thirty subjects were found ineligible for analysis after enrollment because their children were outside the age range for inclusion. Analysis was restricted to 131 parents in the intervention group and 113 in the comparison group. No significant differences existed between groups when comparing demographics and child passenger safety characteristics except for the number of children in the household. After excluding those lost to follow-up (91 parents) and who dropped out (14 parents), analysis was restricted to 74 subjects in the intervention group and 65 in the comparison group. Mean pretest scores were as follows: intervention, 4.95 (SD, 1.49); comparison, 5.12 (SD, 1.32). Mean posttest scores were as follows: intervention, 5.24 (SD,1.60); comparison, 4.77 (SD, 1.39). Difference in mean pretest-posttest scores showed a significant improvement in the intervention group compared with the comparison group: 0.65 (95% confidence interval, 0.14-1.16) on independent-samples t test (P = 0.012). CONCLUSIONS Child passenger safety education can be effectively imparted to parents in the emergency department.
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Du W, Finch CF, Hayen A, Bilston L, Brown J, Hatfield J. Relative benefits of population-level interventions targeting restraint-use in child car passengers. Pediatrics 2010; 125:304-12. [PMID: 20064863 DOI: 10.1542/peds.2009-1171] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Because public health resources for injury prevention are limited, methods for comparing competing strategies are needed. We aimed to estimate potential injury reductions for 4 population-level interventions that target restraint practices for child car passengers aged 0 to 12 years. METHODS Population-attributable risk fraction (PARF) is a population-level estimate of excess risk from exposure to a risk factor. PARFs were calculated for each intervention scenario by using published age-specific mortality/injury relative-risk estimates; restraint practices among injured child car passengers from police-collected data; and observational data for correctness of restraint use in New South Wales, Australia. PARF reductions were estimated for population uptakes of 25%, 50%, and 75%. RESULTS Assuming a 50% population uptake, (1) promoting age-appropriate restraint use could prevent additional fatalities (5.1%, infants; 3.4%, 1- to 6-year-olds) and nonfatal injuries (3.2%, infants; 16.2%, 1- to 6-year-olds) compared with promoting any restraint use; (2) further encouraging correct age-appropriate restraint use could also prevent additional fatalities (9.1%, infants; 14.3%, 1- to 6-year-olds) and nonfatal injuries (9.2%, infants; 10.7%, 1- to 6-year-olds); and (3) for children aged 7 to 12 years, promoting correct use of restraints could prevent an additional 3.4% fatalities and 3.1% nonfatal injuries compared with promoting any restraint use. CONCLUSIONS Interventions that target child passenger-restraint practices offer population-level benefits in terms of reduction in fatalities and injuries. These tangible benefits call for action internationally, not only to promote restraint use but correct age-appropriate restraint use for child car passengers.
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Affiliation(s)
- Wei Du
- the George Institute for International Health, University of Sydney, PO Box M201, Missenden Road, New South Wales 2050, Australia.
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Brixey S, Ravindran K, Guse CE. Legislating child restraint usage -Its effect on self-reported child restraint use rates in a central city. JOURNAL OF SAFETY RESEARCH 2010; 41:47-52. [PMID: 20226950 DOI: 10.1016/j.jsr.2009.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 11/18/2009] [Accepted: 12/15/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the effect of the newly enacted child passenger safety law, Wisconsin Act 106, on self-report of proper restraint usage of children in Milwaukee's central city population. METHOD A prospective, non-randomized study design was used. The settings used were (a) a pediatric urban health center, and (b) two Women, Infants and Children offices in Milwaukee, Wisconsin. Participants included 11,566 surveys collected over 18 months that spanned the pre-legislation and post-legislation time periods from February 2006 through August 2008. RESULTS The study set out to assess appropriate child passenger restraint. The results showed that the changes in adjusted proper restraint usage rates for infants between the pre-law, grace period, and post-fine periods were 94%, 94%, and 94% respectively. For children 1-3years old, the adjusted proper usage rates were 65%, 63%, and 59%, respectively. And for children 4-7years old, the rates were 43%, 44% and 42%, respectively. There was a significant increase in premature booster seat use in children who should have been restrained in a rear- or forward-facing car seat (10% pre-law, 12% grace period, 20% post-fine; p<0.0005). There was no statistically significant change over time in unrestrained children (2.1%, 1.7%, 1.7%, p=0.7, respectively). CONCLUSIONS The passage of a strengthened child passenger safety law with fines did not significantly improve appropriate restraint use for 0-7year olds, and appropriate use in 1-7year olds remained suboptimal with a majority of urban children inappropriately restrained. Although the number of unrestrained children decreased, we identified an unintended consequence of the legislation - a significant increase in the rate of premature belt-positioning booster seat use among poor, urban children. IMPACT ON INDUSTRY The design of child restraint systems maximizes protection of the child. Increasing reports of misuse is a call to those who manufacture these child passenger restraints to improve advertising and marketing to the correct age group, ease of installation, and mechanisms to prevent incorrect safety strap and harness placement. To ensure accurate and consistent use on every trip, car seat manufacturers must ensure that best practice recommendations for use as well as age, weight, and height be clearly specified on each child restraint. The authors support the United States Department of Transportation's new consumer program that will assist caregivers in identifying the child seat that will fit in their vehicle. In addition, due to the increase in premature graduation of children into belt-positioning booster seats noted as a result of legislation, promoting and marketing booster seat use for children less than 40 pounds should not be accepted. Child passenger safety technicians must continue to promote best practice recommendations for child passenger restraint use and encourage other community leaders to do the same.
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Affiliation(s)
- Suzanne Brixey
- Department of Pediatrics and Injury Research Center, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
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[Evidence-based effectiveness of road safety interventions: a literature review]. GACETA SANITARIA 2009; 23:553.e1-14. [PMID: 19896245 DOI: 10.1016/j.gaceta.2009.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Revised: 04/14/2009] [Accepted: 04/16/2009] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Only road safety interventions with scientific evidence supporting their effectiveness should be implemented. The objective of this study was to identify and summarize the available evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths. METHODOLOGY All literature reviews published in scientific journals that assessed the effectiveness of one or more road safety interventions and whose outcome measure was road traffic crashes, injuries or fatalities were included. An exhaustive search was performed in scientific literature databases. The interventions were classified according to the evidence of their effectiveness in reducing road traffic injuries (effective interventions, insufficient evidence of effectiveness, ineffective interventions) following the structure of the Haddon matrix. RESULTS Fifty-four reviews were included. Effective interventions were found before, during and after the collision, and across all factors: a) the individual: the graduated licensing system (31% road traffic injury reduction); b) the vehicle: electronic stability control system (2 to 41% reduction); c) the infrastructure: area-wide traffic calming (0 to 20%), and d) the social environment: speed cameras (7 to 30%). Certain road safety interventions are ineffective, mostly road safety education, and others require further investigation. CONCLUSION The most successful interventions are those that reduce or eliminate the hazard and do not depend on changes in road users' behavior or on their knowledge of road safety issues. Interventions based exclusively on education are ineffective in reducing road traffic injuries.
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Abstract
Motor vehicle crashes result in more than 40 000 deaths and 4.3 million nonfatal injuries annually. Many known effective strategies to address these preventable deaths and injuries are closely related to lifestyle factors. Clinicians can play a large part in supporting effective interventions in their practice, for example, by counseling patients about seat belt use. Clinicians can also have an impact in their community by supporting positive public policy change.
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Affiliation(s)
- Ann M. Dellinger
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia,
| | - David A. Sleet
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Evaluating the Educational Component of a Hospital-Based Child Passenger Safety Program. ACTA ACUST UNITED AC 2009; 67:S30-3. [DOI: 10.1097/ta.0b013e3181a93512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Motor Vehicle Occupant Injury and Related Hospital Expenditures in Children Aged 3 Years to 8 Years Covered Versus Uncovered by Booster Seat Legislation. ACTA ACUST UNITED AC 2009; 67:S20-9. [DOI: 10.1097/ta.0b013e3181951a90] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Will KE, Sabo CS, Porter BE. Evaluation of the Boost 'em in the Back Seat Program: using fear and efficacy to increase booster seat use. ACCIDENT; ANALYSIS AND PREVENTION 2009; 41:57-65. [PMID: 19114138 DOI: 10.1016/j.aap.2008.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Revised: 08/31/2008] [Accepted: 09/08/2008] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Recent research supports the use of high-threat messages when they are targeted appropriately and designed to promote high efficacy as well as fear. This research examined the effectiveness of using a novel threat-appeal approach to encourage parents to place their children in booster seats and rear seats of vehicles. METHOD A 6-min video-intervention was created and evaluated at after-school/daycare centers via an interrupted time series design with similar control sites for comparison. Caregivers (N=226) completed knowledge and practice surveys and fear and efficacy estimations related to childhood motor vehicle hazards. Researchers observed booster-seat and rear-seat use in study site parking lots. RESULTS Compared to baseline and control assessments, the treatment groups' child passenger safety knowledge, risk-reduction attitudes, behavioral intentions, sense of fear related to the hazard, and sense of efficacy related to the recommended behaviors increased significantly. Further, observed overall restraint use and booster-seat use increased significantly following the intervention. CONCLUSIONS Applying high-threat messages to child passenger safety interventions is promising and has the potential to be adapted to other health risk areas.
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Affiliation(s)
- Kelli England Will
- Department of Pediatrics, Williams Hall, Eastern Virginia Medical School, 855 West Brambleton Avenue, Norfolk, VA 23510-1001, USA.
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Snowdon AW, Hussein AA, Ahmed SE. Children at risk: predictors of car safety seat misuse in Ontario. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:1418-1423. [PMID: 18606275 DOI: 10.1016/j.aap.2008.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 12/29/2007] [Accepted: 03/12/2008] [Indexed: 05/26/2023]
Abstract
When used correctly, child safety seats can reduce the risk of death and serious injury by 54% in toddlers and 71% in infants [National Highway Traffic Safety Administration (NHTSA), 2001. Traffic Safety Facts 2001. Children (DOT HS 809 471), U.S. Department of Transportation, Washington, DC]. The purpose of this study was to identify factors that predict correct use of car safety seats. The study was conducted in a large urban area in Southwestern Ontario and a small urban and rural area in Northern Ontario. Participants were 1263 caregivers who completed a self-report survey on their knowledge and use of car safety seats for their children (N=2199). Logistic regression analysis revealed that female caregivers, caregivers with higher levels of education, and caregivers who reported that finding information about the correct use of child safety seats was "difficult" were more likely to report correctly using car safety seats. The results also showed that children aged 7 months to 8 years old had substantially lower odds of being in the correct car safety seat compared to children aged 6 months or younger, or children aged 9 years or older. The high risk nature of misuse of child seats for infants and younger children may be an important cue to action for health professionals to develop comprehensive prevention strategies.
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Affiliation(s)
- Anne W Snowdon
- Odette School of Business, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, Canada.
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March J. Motor Vehicle Occupant Restraints and Alcohol Use While Driving. South Med J 2008. [DOI: 10.1097/smj.0b013e318167da58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Snowdon AW, Hussein A, High L, Stamler L, Millar-Polgar J, Patrick L, Ahmed E. The effectiveness of a multimedia intervention on parents' knowledge and use of vehicle safety systems for children. J Pediatr Nurs 2008; 23:126-39. [PMID: 18339338 DOI: 10.1016/j.pedn.2007.08.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2006] [Revised: 08/07/2007] [Accepted: 08/30/2007] [Indexed: 11/17/2022]
Abstract
Trauma due to road crashes is the leading cause of death and injury in Canadian children younger than 14 years, despite mandatory use of vehicle restraints since 1977. A multisite intervention study using a pretest-posttest design was conducted in four Ontario cities to test the effectiveness of an educational program on parents' knowledge of safety system use for children (0-12 years) 6 weeks following the educational intervention. The sample consisted of 418 families who reported on 732 children. Results indicated that knowledge increased significantly following the intervention. Use of professional sources of information was an important factor that is linked with increased parents' knowledge.
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Affiliation(s)
- Anne W Snowdon
- Odette School of Business, University of Windsor, Windsor, Ontario, Canada.
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Hutchinson TP. Promoting child booster seat use. Has no one ever done high-quality research? Am J Prev Med 2008; 34:267-8. [PMID: 18312818 DOI: 10.1016/j.amepre.2007.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 07/26/2007] [Accepted: 11/08/2007] [Indexed: 11/28/2022]
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Lee KC, Shults RA, Greenspan AI, Haileyesus T, Dellinger AM. Child passenger restraint use and emergency department--reported injuries: a special study using the National Electronic Injury Surveillance System-All Injury Program, 2004. JOURNAL OF SAFETY RESEARCH 2008; 39:25-31. [PMID: 18325413 DOI: 10.1016/j.jsr.2007.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 08/28/2007] [Accepted: 10/25/2007] [Indexed: 05/26/2023]
Abstract
INTRODUCTION In 2004, more than 180,000 child passengers aged <or=12 years sought care in U.S. hospital emergency departments (EDs) for injuries sustained in motor-vehicle crashes (MVCs). METHOD We expanded the National Electronic Injury Surveillance System-All Injury Program for 635 injured children aged <or=12 years treated at 15 hospital EDs in 2004 by collecting multiple injury diagnoses and interviewing parents about MVC circumstances. RESULTS Nine percent of the children were unrestrained and 36% were inappropriately restrained. Blacks and Hispanics were about six times more likely to be unrestrained than Non-Hispanic Whites (12% and 14%, respectively, vs. 2%). Seventy-seven percent of inappropriate restraint use occurred among children aged 4-8 years, who were prematurely placed in seatbelts. Eight percent of children required hospitalization; unrestrained children were three times more likely to be hospitalized than restrained children (21% vs. 7%). CONCLUSION Age-appropriate restraint use should be promoted for child passengers, particularly among Blacks, Hispanics, and children riding in trucks.
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Affiliation(s)
- Karen C Lee
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention, USA
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