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McAdams RJ, Acevedo-Fontánez AI, Arcury-Quandt AE, Heberger JR. Head Injuries Among Children Treated in US Emergency Departments, 2015-2019. Clin Pediatr (Phila) 2024; 63:659-668. [PMID: 37553815 DOI: 10.1177/00099228231191942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
This study evaluates the epidemiology of nonfatal head injuries among children aged 1 to 4 years associated with consumer products and identifies the specific consumer products associated with these injuries. Data for children aged 1 to 4 years who presented to emergency departments (EDs) from 2015 to 2019 for a nonfatal head injury were extracted from the National Electronic Injury Surveillance System. An estimated 1 032 429 (95% confidence interval [CI]: 675 822-1 389 063) children presented to US EDs for head injuries, averaging 566 injuries daily. The average rate of head injury did not change over the 5-year study period (slope = -0.003; P = .852); it was highest among children aged 1 year (2.06 per 100 children aged 1 year), which was nearly 3 times that of children aged 4 years (rate ratio = 2.75; 95% CI: 2.73-2.77). Most injuries occurred at home (80.4%) and occurred from interacting with home furnishings (45.1%). This study underscores the need for increased head injury mitigation efforts among young children.
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Affiliation(s)
- Rebecca J McAdams
- Center for Injury Research and Policy, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Alice E Arcury-Quandt
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - John R Heberger
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Schulze A, Lindemann AK, Brand F, Geppert J, Menning A, Stehr P, Reifegerste D, Rossmann C. Mobile Apps Aimed at Preventing and Handling Unintentional Injuries in Children Aged <7 Years: Systematic Review. Interact J Med Res 2023; 12:e45258. [PMID: 37672312 PMCID: PMC10512123 DOI: 10.2196/45258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Despite various global health crises, the prevention and handling of unintentional childhood injuries remains an important public health objective. Although several systematic reviews have examined the effectiveness of different child injury prevention measures, these reviews did not address the evaluation of mobile communication intervention tools. Whether and how mobile apps were evaluated provides information on the extent to which communication theories, models, and evidence-based knowledge were considered. Previous studies have shown that the effectiveness of mobile apps increases when theories and evidence are considered during their development. OBJECTIVE This systematic review aimed to identify research on mobile apps dealing with the prevention and handling of unintentional injuries in children and examine the theoretical and methodological approaches thereof. In addition, this review analyzed the different needs of various target groups of the mobile apps described in the articles. METHODS In total, 8 electronic databases, ranging from interdisciplinary to medical and technical as well as social sciences databases, were searched for original research articles or brief reports in peer-reviewed journals or conference proceedings. Moreover, this review encompassed a systematic scan of articles published in the BMJ journal Injury Prevention. These steps were followed by a snowball search based on the literature references in the articles identified through the initial screening. The articles had to be written in English or German, published between 2008 and 2021, and evaluate mobile apps dealing with the prevention and handling of unintentional child injuries. The identified 5 studies were analyzed by 5 independent researchers using an inductive approach. Furthermore, the quality of the studies was assessed using the Mixed Methods Appraisal Tool. RESULTS A total of 5 articles were included and assessed with regard to overall quality of theoretical and methodological foundations, assessed variables, the focal app's architecture, and the needs of the study participants. The overall study quality was moderate, although part of this classification was due to a lack of details reported in the studies. Each study examined 1 mobile app aimed at parents and other caregivers. Each study assessed at least 1 usability- or user experience-related variable, whereas the needs of the included study participants were detailed in only 20% (1/5) of the cases. However, none of the studies referred to theories such as the Technology Acceptance Model during the development of the apps. CONCLUSIONS The future development and evaluation of apps dealing with the prevention and handling of child injuries should combine insights into existing models on user experience and usability with established theories on mobile information behavior. This theory-based approach will increase the validity of such evaluation studies.
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Affiliation(s)
- Annett Schulze
- Department of Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Ann-Kathrin Lindemann
- Department of Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Fabian Brand
- Department of Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Johanna Geppert
- Department of Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Axel Menning
- Department of Risk Communication, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Paula Stehr
- Department of Media and Communication, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Doreen Reifegerste
- Department of Prevention and Health Promotion, Bielefeld University, Bielefeld, Germany
| | - Constanze Rossmann
- Department of Media and Communication, Ludwig-Maximilians-University Munich, Munich, Germany
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Blakeslee SB, Vieler K, Horak I, Stritter W, Seifert G. Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents. JMIR Mhealth Uhealth 2023; 11:e39929. [PMID: 37471125 PMCID: PMC10401193 DOI: 10.2196/39929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/12/2022] [Accepted: 05/02/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Increasingly, parents use child health promotion apps to find health information. An overview of child health promotion apps for parents currently does not exist. The scope of child health topics addressed by parent apps is thus needed, including how they are evaluated. OBJECTIVE This scoping review aims to describe existing reported mobile health (mHealth) parent apps of middle- to high-income countries that promote child health. The focus centers on apps developed in the last 5 years, showing how the reported apps are evaluated, and listing reported outcomes found. METHODS A scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guidelines to identify parent apps or web-based programs on child health promotion published between January 2016 and June 2021 in 5 databases: PubMed, ERIC, IEEE Xplore, Web of Science, and Google Scholar. Separate sources were sought through an expert network. Included studies were summarized and analyzed through a systematic and descriptive content analysis, including keywords, year of publication, country of origin, aims/purpose, study population/sample size, intervention type, methodology/method(s), broad topic(s), evaluation, and study outcomes. RESULTS In total, 39 studies met the inclusion criteria from 1040 database and 60 expert-identified studies. Keywords reflected the health topics and app foci. About 64% (25/39) of included studies were published after 2019 and most stemmed from the United States, Australian, and European-based research. Studies aimed to review or evaluate apps or conducted app-based study interventions. The number of participants ranged from 7 to 1200. Quantitative and qualitative methods were used. Interventions included 28 primary studies, 6 app feasibility studies, and 5 app or literature reviews. Eight separate topics were found: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. Study intervention evaluations cited behavior change theories in 26 studies and evaluations were carried out with a variety of topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools. To evaluate apps, user input and qualitative evaluations were often combined with surveys and frequently rated with the Mobile App Rating Scale. Outcomes reported some positive effects, while several intervention studies saw no effect at all. Effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement were challenges cited. CONCLUSIONS New parents are a key target group for child health apps, but evaluating child health promotion apps remains a challenge. Whether tailored to parent needs or adapted to the specific topic, apps should be rooted in a transparent theoretical groundwork. Applicable lessons for parent apps from existing research are to tailor app content, include intuitive and adaptive features, and embed well-founded parameters for long-term effect evaluation on child health promotion.
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Affiliation(s)
- Sarah B Blakeslee
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kristin Vieler
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo Horak
- Digital Health Entrepreneur, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Kawahara T, Doi S, Isumi A, Ochi M, Fujiwara T. Interventions to change parental parenting behaviour to reduce unintentional childhood injury: a randomised controlled trial. Inj Prev 2023; 29:126-133. [PMID: 36368911 DOI: 10.1136/ip-2022-044721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/22/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The previous study has shown the impact of paternal involvement in childcare on unintentional childhood injury; yet the causality is unknown. The purpose of this study is to investigate whether the intervention of an educational video on paternal involvement in childcare can prevent unintentional injury among young children. METHODS A randomised controlled trial of parents of children born at two obstetrics wards in Japan (n=451, intervention group: 223, control group: 228) was conducted. Parents in the intervention group watched an educational video that promote paternal involvement in childcare, while parents in the control group watched an educational video on the prevention of shaken baby syndrome. The participants were followed for up to 18 months after the birth of their child. The primary outcome of this study was unintentional injury at 3, 6, 12 and 18 months. The secondary outcome was paternal involvement in childcare based on maternal observation. Unintentional injury-free rates over time were assessed using the Cox proportional hazard model. RESULTS Children in the intervention group were less likely to have unintentional injury, such as burn (HR: 0.29 (95% CI: 0.09 to 0.87)) and caught by a door (HR: 0.66 (95% CI: 0.48 to 0.91)) compared with the control group. Fathers in the intervention group showed higher frequency of taking their children for a walk (coefficient: 0.19 (95% CI: 0.05 to 0.32)). CONCLUSIONS Educational videos promoting paternal involvement in childcare is effective to prevent unintentional childhood injury.
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Affiliation(s)
- Tomoki Kawahara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Manami Ochi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Department of Health and Welfare Services, National Institute of Public Health, Wako, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Japan
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Choi Y, Ahn HY. Developing and Evaluating a Mobile-based Parental Education Program for Preventing Unintentional Injuries in Early Childhood: A Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:329-336. [PMID: 34915186 DOI: 10.1016/j.anr.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This randomized controlled experimental study verified the educational effect of a mobile-based parental education program for preventing unintentional early childhood injuries. DESIGN AND METHODS From August 2019 to September 2019, 167 participants were recruited from parenting portal sites and randomly assigned to an e-learning group (n = 59), an electronic document distribution (EDD) group (n = 53), and a control group with no intervention (n = 55). Participants self-reported data regarding their safety knowledge and behavior before and after the experiment. Each intervention group received an e-learning program and electronic educational documents for two weeks and a satisfaction survey. Using an ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model, the relevant e-learning contents were developed with the Storyline 360 program. The collected data were analyzed using 1-way ANOVA, 2-way ANOVA, and independent t-test. RESULTS Results were as follows: (1) Postintervetion, no significant differences regarding safety knowledge were observed between the e-learning group, EDD group, and control group. (2) Postintervention, statistically significant differences regarding safety behaviors were observed between the three groups: 3.52 ± 0.28 (e-learning group), 3.51 ± 0.28 (EDD group), and 3.32 ± 0.25 (control group) (F = 10.091, p < .001). (3) No significant differences regarding education-related satisfaction were observed. CONCLUSIONS The mobile-based educational program for preventing unintentional injuries positively affected safety behavior in this study. Mobile-based parental education programs could contribute toward effectively preventing unintentional injuries in early childhood because many parents can use these without time and space constraints.
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Affiliation(s)
- Younglee Choi
- Department of Nursing, Eulji University, Gyeonggi-do, Republic of Korea
| | - Hye Young Ahn
- Department of Nursing, Eulji University, Gyeonggi-do, Republic of Korea.
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Assessing the effectiveness of an app-based child unintentional injury prevention intervention for caregivers of rural Chinese preschoolers: protocol for a cluster randomized controlled trial. BMC Public Health 2021; 21:2137. [PMID: 34801006 PMCID: PMC8606071 DOI: 10.1186/s12889-021-12156-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background Compared to urban children, children living in rural areas of most countries, including China, are at higher risk of suffering unintentional injuries. Most proven injury prevention interventions, however, are rarely implemented in rural China due to lack of resources. Mobile health interventions are low-cost and easy-to-implement, facilitating implementing injury prevention in resource-limited areas (e.g., rural areas). This study is designed and implemented to examine the effectiveness of an app-based intervention for unintentional injury prevention among rural preschoolers in China. Methods A single-blind, 18-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be implemented in 2 rural areas of China (Yang County, Shaanxi Province, and Shicheng County, Jiangxi Province). In total, at least 3508 rural caregivers of preschoolers aged 3–6 years old who own a smartphone will be recruited from 24 preschools. Clusters will be randomized at the preschool level and allocated to the control group (receiving routine school-based education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (receiving routine school-based education plus app-based parenting education including unintentional injury prevention). External support strategies will be adopted by local partners to minimize user fatigue, non-compliance, and attrition. Data collection will be conducted at baseline and then every 3 months during the 18-month follow-up time period. Intention-to-treat data analysis will be implemented. Missing values will be imputed by using the Expectation Maximization algorithm. Generalized estimating equation will test the overall effectiveness of the app-based intervention. A per-protocol sensitivity analysis will be conducted to test the robustness of results. Subgroup analyses will follow the strategies for primary analyses. The primary outcome measure is the incidence rate of unintentional injury among preschoolers during the study period. Secondary outcome measures comprise longitudinal changes in caregiver’s attitudes, caregiver-reported supervision behaviors, and caregiver-assessed home environment safety surrounding child unintentional injury prevention in the last week using a standardized audit instrument. Discussion The app-based intervention is expected to be feasible and effective over the 18-month intervention period. If the app is demonstrated effective as hypothesized, we will initiate processes to generalize and popularize it broadly to rural child caregivers across China. Trial registration ChiCTR2000037606, registered on August 29, 2020.
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McKenzie LB, Roberts KJ, McAdams RJ, Abdel-Rasoul M, Kristel O, Szymanski A, Keim SA, Shields WC. Efficacy of a mobile technology-based intervention for increasing parents' safety knowledge and actions: a randomized controlled trial. Inj Epidemiol 2021; 8:56. [PMID: 34593040 PMCID: PMC8485517 DOI: 10.1186/s40621-021-00350-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
Background Leading causes of unintentional child injury such as poisoning and falls are preventable, and the majority occur in the home. Numerous home safety interventions have been developed and tested to increase safety behaviors; however, no smart phone-based applications (apps) have been developed and evaluated for this purpose. The objective of this study was to evaluate whether a mobile technology-based health behavior change intervention, the Make Safe Happen® app, was an effective tool to increase safety knowledge and safety actions/behaviors for the prevention of child unintentional injuries in and around the home. Methods Data were collected in pretest and posttest online surveys from an existing nationwide population-based survey panel. Intervention subjects were randomized to organically (participant-driven) use the Make Safe Happen® app for 1 week, which provided home safety information and the ability to purchase safety products, while control participants were assigned to download and use an app about a topic other than home safety. The primary outcomes of safety knowledge and home safety actions were assessed by using linear mixed model regressions with intention-to-treat analyses. Results A total of 5032 participants were randomized to either the intervention (n = 4182) or control (n = 850) group, with 2055 intervention participants downloading and entering their participant IDs into the Make Safe Happen® app. The online posttest survey was completed by 770 intervention and 283 control subjects. Mean knowledge parent safety score increased at a greater rate for intervention than control subjects (p < 0.0001), and at posttest was significantly higher for intervention than control subjects (p < 0.0001). The percentage of intervention subjects who reported doing all one-time and repeated safety actions significantly increased from pretest to posttest (p < 0.0001 and p = 0.0001, respectively), but there was no change among the control subjects (p = 0.1041 and p = 0.9755, respectively). At posttest, this percentage was larger for intervention than control subjects only for repeated safety actions (p = 0.0340). Conclusions The mobile application significantly improved safety knowledge and safety actions for participants using the Make Safe Happen® app, although loss to follow-up was a limitation. The results of this study indicate the usefulness of widespread distribution and use of the Make Safe Happen® app. Trial registration numberNCT02751203; Registered April 26, 2016.
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Affiliation(s)
- Lara B McKenzie
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. .,Department of Pediatrics, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, 43210, USA. .,Division of Epidemiology, College of Public Health, The Ohio State University, 250 Cunz Hall, 1841 Neil Ave., Columbus, OH, 43210, USA.
| | - Kristin J Roberts
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Rebecca J McAdams
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Mahmoud Abdel-Rasoul
- Center for Biostatistics, The Ohio State University, 320 Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Orie Kristel
- Illuminology, 5258 Bethel Reed Park, Columbus, OH, 43220, USA
| | | | - Sarah A Keim
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.,Department of Pediatrics, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, 43210, USA.,Division of Epidemiology, College of Public Health, The Ohio State University, 250 Cunz Hall, 1841 Neil Ave., Columbus, OH, 43210, USA
| | - Wendy C Shields
- Bloomberg School of Public Health, Johns Hopkins Center for Injury Research and Policy, 624 N. Broadway, Baltimore, MD, 21205, USA
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Effect of Smartphone App's Intervention on Consumers' Knowledge, Attitude, Practice, and Perception of Food Poisoning Prevention When Dining Out at Selected Rural Areas in Terengganu. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910294. [PMID: 34639593 PMCID: PMC8508150 DOI: 10.3390/ijerph181910294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/19/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022]
Abstract
(1) Background: Lack of food safety awareness and preventive behaviour when dining out increases the risk of food poisoning. Furthermore, food poisoning cases among rural communities have been rising in recent years. However, the health-related mobile application is a promising tool in improving food poisoning prevention knowledge, attitude, practice, and perception (KAP2) among consumers. Therefore, the current study developed a novel smartphone app, MyWarung©, and determined its efficacy in increasing awareness, attitude, practice, and perception of food poisoning and its prevention when dining out, especially among rural consumers. (2) Methods: A quasi-experimental pre-and post-intervention study with a control and intervention group were performed on 100 consumers in Terengganu. (3) Results: The intervention's inter-group outcomes were analysed using the Mann-Whitney test, while the within-group effects were ascertained using the Wilcoxon sign rank test via the SPSS software. It was found that the control group had higher median scores in knowledge (30.0, IQR 7.0), attitude (46.0, IQR 5.0), and practice (34.0, IQR 3.0) than the intervention group before intervention. After the intervention programme, the intervention group showed significant improvement in food poisoning knowledge (p = 0.000), attitude (p = 0.001), and practice (p = 0.000). However, the intervention group's perceived barriers (p = 0.129) and susceptibility (p = 0.069) and the control group's perceived barriers (p = 0.422) did not show any significant improvement. (4) Conclusion: The findings indicated that the MyWarung© mobile app usage enhanced the food poisoning knowledge, preventive attitude, and practice among consumers when dining out.
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Manganello JA, Kane C, Roberts K, Klein EG, McAdams RJ, McKenzie LB. A Year of Child Injury Prevention on Instagram. JOURNAL OF HEALTH COMMUNICATION 2021; 26:636-644. [PMID: 34632948 DOI: 10.1080/10810730.2021.1985658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Injury is the leading cause of death for children but little is known about what types of injury prevention messages are communicated on Instagram. Conducted in the United States, the aim of this study was to better understand child injury prevention messages on Instagram to develop recommendations for the future. Informed by Social Cognitive Theory, a quantitative content analysis was conducted on all Instagram posts from selected organizations from May 2018 through April 2019. Of the 818 injury prevention posts, almost all included an image (575, 70%) or video (211, 26%). Of the 575 images, 245 (42.46%) had in image that did not match the topic of the post. Regarding injury prevention recommendations, 579 posts (71%) provided a clear action that parents should take. For these posts, 115 (20%) had an image that communicated the desired safety recommendation, but many more (285, 50%) did not; in 23 cases it was not clear if there was a match or not. There are missed opportunities for child health and injury organizations to reach parents and caregivers through Instagram. Posts made during the study period often lacked specificity about action-oriented measures and failed to utilize images that demonstrated the recommended practices. Organizations posting on Instagram and other social media platforms should provide clear action tips and utilize images that depict child injury prevention recommendations.
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Affiliation(s)
- Jennifer A Manganello
- School of Public Health, Department of Health Policy Management, and Behavior, University at Albany, One University Place, New York, USA
| | - Cassandra Kane
- School of Public Health, University at Albany, Rensselaer, New York, USA
| | - Kristin Roberts
- Center for Injury Research and Policy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Rebecca J McAdams
- Center for Injury Research and Policy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Lara B McKenzie
- Center for Injury Research and Policy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
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Yong TSM, Perialathan K, Ahmad M, Juatan N, Abdul Majid L, Johari MZ. Perceptions and Acceptability of a Smartphone App Intervention (ChildSafe) in Malaysia: Qualitative Exploratory Study. JMIR Pediatr Parent 2021; 4:e24156. [PMID: 34061039 PMCID: PMC8207251 DOI: 10.2196/24156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/14/2020] [Accepted: 03/11/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Home is a vulnerable place for accidental child injuries. Unintentional injuries are a leading cause of death, hospitalization, and disabilities. These injuries are considered preventable and if not tackled, they will continue to be a persisting problem. Smartphones have become increasingly important in our everyday life and is an important tool not only for communication but also for other purposes-they have apps that can be used for various purposes. Therefore, an app-based intervention (ChildSafe) was developed to assess and reduce child injury at home. OBJECTIVE This study aimed to evaluate the acceptance of the ChildSafe smartphone app intervention by parents/guardians. METHODS This study was conducted using a qualitative exploratory approach on selected participants of the ChildSafe intervention app study. A total of 27 semistructured in-depth interviews were carried out among parents or guardians who have at least one child between the age of 0 and 59 months in the area of Sungai Buloh, Selangor, between November 2017 and March 2018. Interview questions were developed from the consolidated framework for implementation research (CFIR). Interviews were recorded, transcribed verbatim, and data were thematically analyzed guided by CFIR. RESULTS The study revealed users' perception on usability, feasibility, and acceptability toward the ChildSafe app. Three CFIR domains were identified: intervention characteristics, inner setting, and characteristics of individuals. A total of 5 constructs were revealed under intervention characteristics: evidence strength and quality, relative advantage, adaptability, trialability, and design quality and packaging; 2 under inner setting: implementation climate and readiness for implementation; and 4 under characteristics of individuals: knowledge and beliefs about the intervention, self-efficacy, individual stage of change, and other personal attributes. In general, participants felt the app is extremely useful and effective, easy to use, and purposeful in achieving home safety assessment via reminders. The app replaces the need for participants to search for information on home safety and dangers, as the app itself was designed as a tool to assess for this specific purpose. Even at the nascent stage and despite its limitations, the app has prompted users to consider and make changes around their own home. However, future versions of the app should be expanded to make it more attractive to users as it lacks interactive feedback and additional features. CONCLUSIONS Parents/guardians are accepting the use of the ChildSafe app to prevent child injury at home. However, further expansion and improvements are needed to increase the acceptability of this app by parents/guardians.
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Affiliation(s)
- Teresa Sui Mien Yong
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Komathi Perialathan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Masitah Ahmad
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nurashma Juatan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Liana Abdul Majid
- Institute of Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
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Hakes NA, Kethman WC, Spain D, Nassar AK. Mobile application-based guidelines to enhance patient care and provider education in trauma and acute care surgery. Trauma Surg Acute Care Open 2020; 5:e000479. [PMID: 32760809 PMCID: PMC7380731 DOI: 10.1136/tsaco-2020-000479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/28/2020] [Accepted: 06/26/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Providing up-to-date, universally accessible care guidelines and education within a quaternary care center is challenging. At our institution, trauma and acute care surgery guidelines have historically been published using a paper-based format. Mobile application-based guidelines were developed to address the shortcomings of paper-based guidelines. Methods We assessed the utility, usability, and satisfaction of healthcare providers towards paper-based versus mobile application-based guidelines. A survey was administered to providers within the emergency department and intensive care unit. Results Fifty of 137 providers responded (36.5% response rate). Nearly half (47.4%, 9 of 19) of those who received a copy of the paper-based guidelines lost the guidelines at least once. Regarding usage of the mobile application-based guidelines, 92.6% (25 of 27) were aware of the application; 92.6% (25 of 27) considered the application comprehensive, 85.2% (23 of 27) thought the application was organized, and 66.7% (18 of 27) thought the application was easy to use. Additionally, 88.9% (24 of 27) found the application moderately, very, or extremely helpful and 85.2% (23 of 27) judged the application moderately, very, or extremely necessary. Overall, 88.9% (24 of 27) were satisfied with the application and indicated likeliness to recommend to a colleague. Seventeen of 27 (63.0%) agreed or strongly agreed that the application improved their provision of trauma and acute care. Conclusion This survey demonstrates positive usability, utility, and satisfaction among trauma healthcare providers with the mobile application-based guidelines. Additionally, this quality improvement initiative highlights the importance of having comprehensive, organized, and easy-to-use trauma and acute care surgery guidelines and targeted educational materials available on demand. The successful transition from paper to mobile application-based guidelines serves as a model for other institutions to modernize and improve patient care and provider education. Level of evidence IV.
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Affiliation(s)
- Nicholas A Hakes
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - William C Kethman
- Department of Surgery, University Hospitals Research in Surgical Outcomes and Effectiveness Center (RISES), Cleveland, Ohio, USA
| | - David Spain
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Aussama K Nassar
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
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Dekonenko C, McDonald T, Winfield RD. Smart Trauma: Improving the Delivery of Evidence-Based Trauma Care. J Surg Res 2019; 242:252-257. [DOI: 10.1016/j.jss.2019.04.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/12/2019] [Accepted: 04/24/2019] [Indexed: 11/25/2022]
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Ning P, Cheng P, Schwebel DC, Yang Y, Yu R, Deng J, Li S, Hu G. An App-Based Intervention for Caregivers to Prevent Unintentional Injury Among Preschoolers: Cluster Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e13519. [PMID: 31400105 PMCID: PMC6713040 DOI: 10.2196/13519] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/08/2019] [Accepted: 06/16/2019] [Indexed: 12/29/2022] Open
Abstract
Background App-based interventions have the potential to reduce child injury in countries with limited prevention resources, but their effectiveness has not been rigorously examined. Objective This study aimed to assess the effectiveness of an app-based intervention for caregivers of preschoolers to prevent unintentional injury among Chinese preschoolers. Methods A 6-month cluster randomized controlled trial was conducted from December 2017 to June 2018. Recruitment was conducted through preschools, which were randomly allocated to either the control group (ie, app-based parenting education excluding unintentional injury prevention) or the intervention group (ie, app-based parenting education including unintentional injury prevention). A total of 2920 caregivers of preschoolers aged 3-6 years from 20 preschools in Changsha, China, were recruited offline through the schools. The primary outcome was unintentional injury incidences among preschoolers in the past 3 months; this measure was assessed through an online caregiver-report at the baseline visit and at 3-month and 6-month follow-up visits. Secondary outcome measures included caregivers’ self-reported attitudes and behaviors concerning child supervision during the last week. Generalized estimating equations (GEEs) were used to assess the effectiveness of the app-based intervention on responses at 3 and 6 months after adjusting for sociodemographic variables, baseline level of the outcome variable, and engagement with interventions in the assigned group. All analyses were intention-to-treat. A per-protocol sensitivity analysis was also conducted. Results In total, 1980 of the 2920 caregivers completed the study. The mean age of participants was 32.0 years (SD 5.5) and 68.99% (1366/1980) of them were female. During the 6-month follow-up visit, unintentional injury incidence did not change significantly in either group: incidence in the intervention group went from 8.76% (94/1073) to 8.11% (87/1073), P=.59; incidence in the control group went from 9.4% (85/907) to 7.5% (69/907), P=.15. The changes did not differ between the groups (odds ratio [OR] 1.14, 95% CI 0.80-1.62). Changes in the average score in attitude concerning unintentional injury prevention were also similar between the groups (B .05, 95% CI -0.03 to 0.13). Changes in unintentional injury prevention behaviors were greater in the intervention group than in the control group after the intervention (B .87, 95% CI 0.33-1.42). Analyses of individual injury prevention behaviors showed that the intervention reduced three risky behaviors: unsafe feeding of children (OR 0.73, 95% CI 0.60-0.89); incorrectly placing children in cars (OR 0.73, 95% CI 0.57-0.93); and allowing children to ride bicycles, electric bicycles, or motorcycles unsupervised (OR 0.80, 95% CI 0.64-0.99). The intervention also improved scores on three safety-focused behaviors: testing water temperature before giving children a bath (OR 1.26, 95% CI 1.05-1.52); properly storing sharp objects (OR 1.24, 95% CI 1.01-1.52); and safely storing medicines, detergents, and pesticides (OR 1.24, 95% CI 1.02-1.51). Conclusions The app-based intervention did not reduce unintentional injury incidence among preschoolers but significantly improved caregivers’ safety behaviors. This app-based intervention approach to improve caregiver behaviors surrounding child injury risk offers promise to be modified and ultimately disseminated broadly. Trial Registration Chinese Clinical Trial Registry ChiCTR-IOR-17010438; http://www.chictr.org.cn/showproj.aspx?proj=17376 (Archived by WebCite at http://www.webcitation.org/75jt17X84) International Registered Report Identifier (IRRID) RR2-10.1186/s12889-018-5790-1
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Affiliation(s)
- Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogen Institute, University of Florida, Gainesville, FL, United States
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shukun Li
- Information and Network Center, Central South University, Changsha, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative Evaluation of the Make Safe Happen App: Mobile Technology-Based Safety Behavior Change Intervention for Parents. JMIR Pediatr Parent 2019; 2:e12022. [PMID: 31518322 PMCID: PMC6715056 DOI: 10.2196/12022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/11/2019] [Accepted: 01/31/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Nearly half of the unintentional injuries in children happen in and around the home; many of these injuries are preventable. Providing parents and caregivers with proper injury prevention information that is easily accessible may help them make their homes safer for children. OBJECTIVE The aim of this study was to evaluate parental injury prevention awareness and home safety behaviors, motivations for and challenges to taking injury prevention and safety actions for parents as well as user experience following the use of the Make Safe Happen mobile app. METHODS A total of 40 parents with children aged 0-12 years living in Columbus, Ohio, participated in 1 of 5 focus group discussions following the completion of (1) a pretest survey, (2) use of the Make Safe Happen app, and (3) a posttest survey. RESULTS Following the use of the Make Safe Happen app, parents reported a significant increase in injury prevention awareness and completed 45% more home safety behaviors in and around their homes. Nearly all of the parents felt the app provided them with the information needed to make their home safer for their children; the great majority of parents intended to make such changes in the future. CONCLUSIONS The combination of qualitative and quantitative data collection allowed for rich data capture and provided a deeper understanding of parents' safety knowledge, behaviors, app use, and decision making regarding child injury prevention in and around the home. The Make Safe Happen app provides the information and motivation parents and caregivers need to help them take steps to prevent child injuries that may occur in and around their homes.
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Affiliation(s)
- Kristin J Roberts
- Center for Injury Research and Policy, The Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Rebecca J McAdams
- Center for Injury Research and Policy, The Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | | | | | - Lara B McKenzie
- Center for Injury Research and Policy, The Research Institute, Nationwide Children's Hospital, Columbus, OH, United States.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, United States.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States
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