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Zhang AY, Leviter J, Baird J, Charles-Chauvet D, Frackiewicz LM, Duffy S, Dessie A. Buckle me up! A randomised controlled trial using a tablet-based emergency department intervention for child car safety education. Inj Prev 2024; 30:334-340. [PMID: 38302281 DOI: 10.1136/ip-2023-044998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/04/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND AND OBJECTIVES Correct child car restraint use significantly reduces risk of death and serious injury in motor vehicle crashes, but millions of US children ride with improper restraints. We created a tablet-based car restraint educational intervention using Computer Intervention Authoring Software (CIAS) and examined its impact on knowledge and behaviours among parents in the paediatric emergency department (PED). METHODS This was a non-blinded, randomised controlled trial of parents of PED patients ages 0-12 years. Participants were evaluated for baseline car restraint knowledge and behaviour. The intervention group completed an interactive tablet-based module, while the control group received printed handouts on car restraint safety. After 1 week, both groups received a follow-up survey assessing changes in car restraint knowledge and behaviour. Logistic regressions determined predictors of knowledge retention and behavioural changes. Parents in the CIAS group were also surveyed on programme acceptability. RESULTS 211 parents completed the study with follow-up data. There was no significant difference in baseline car restraint knowledge (74.3% correct in intervention, 61.8% in control, p=0.15), or increase in follow-up restraint knowledge. Significantly more intervention-group caregivers reported modifying their child's car restraint at follow-up (52.5% vs 31.8%,p=0.003), and 93.7% of them found CIAS helpful in learning to improve car safety. CONCLUSION Parents had overall high levels of car restraint knowledge. Using CIAS led to positive behavioural changes regarding child car restraint safety, with the vast majority reporting positive attitudes towards CIAS. This novel, interactive, tablet-based tool is a useful PED intervention for behavioural change in parents. TRIAL REGISTRATION NUMBER NCT03799393.
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Affiliation(s)
- Angela Yu Zhang
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Julie Leviter
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Pediatrics, Yale University, New Haven, Connecticut, USA
| | - Janette Baird
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Injury Prevention Center, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Danielle Charles-Chauvet
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, USA
| | - Laura M Frackiewicz
- Providence College, Providence, Rhode Island, USA
- University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
| | - Susan Duffy
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Almaz Dessie
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Marsala J, Hightower T, Stucke S, Trujillo B, Malone C, Bertolani J, Jacobs J, Silverberg D, Rivera N, Fiore N. Evaluating Child Passenger Restraint Use Education. J Trauma Nurs 2024; 31:196-202. [PMID: 38990875 DOI: 10.1097/jtn.0000000000000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
BACKGROUND Despite recommendations and laws for child restraint use in motor vehicles, evidence of low restraint use remains, and there is a lack of evidence addressing the effectiveness of restraint use education. OBJECTIVE This project aims to measure the impact of an education initiative on child passenger restraint use. METHODS This pre- and postintervention study was conducted in six elementary schools in a Southwestern U.S. metropolitan area over 5 months from October 2022 to March 2023. Motor vehicle restraint use was collected from occupants arriving at elementary schools during the morning drop-off times. Participants were provided one-on-one education regarding child passenger safety guidelines and state laws. Comparison data were collected 1-3 weeks later at the same schools to evaluate the education provided. RESULTS A total of 1,671 occupants in 612 vehicles were observed across six schools, with 343 adults and 553 children preintervention and 306 adults and 469 children postintervention. Overall restraint adherence in children improved postintervention from 42.3% to 56.1%, a 32.6% increase (p = < .001). In the primary age group of 4-8 years, restraint adherence improved postintervention from 34.8% to 54.2%, a 55.8% increase (p = <.001). CONCLUSIONS The study results demonstrate that one-on-one education increases child passenger restraint use.
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Affiliation(s)
- Jeanne Marsala
- Author Affiliations: Trauma Services, Sunrise Hospital and Medical Center (Mrs Marsala, Mr Hightower, Dr Stucke, Mrs Trujillo, Ms Malone, Mrs Bertolani, Drs Rivera, and Fiore); Department of General Surgery, Sunrise Health GME Consortium, HCA Healthcare, Las Vegas, Nevada (Drs Stucke and Rivera); Center for Trauma, Acute Care Surgery Research, Nashville, Tennessee (Mr Jacobs); and Department of Surgery, Silver State Orthopedics, Sunrise Hospital and Medical Center, Las Vegas, Nevada (Dr Silverberg)
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Bakhurji EA, M Alqahtani A, M Alwashmi E, S Husain M, Gaffar BO. The effect of social media campaign on parental knowledge, attitudes and practices regarding the use of children car seats in the Gulf region. BMC Public Health 2023; 23:1816. [PMID: 37726749 PMCID: PMC10508007 DOI: 10.1186/s12889-023-16742-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Motor vehicle crashes (MVCs) are the leading cause of child deaths in the Gulf Cooperation Council. This study aimed to investigate the effect of a social media educational campaign on parents' knowledge of child safety seats. METHODS We conducted a pre-post interventional study as an online educational module in Arabic and English. The module link was shared on social media and was accompanied by a pre-post survey that included questions about demographics, knowledge, and practices of car seat use. RESULTS A total of 303 participants completed the campaign, with 23.8% fathers and 76.2% mothers answered the survey. The majority of participants were from Saudi Arabia (95.7%), while 4.3% were from other Gulf Cooperation Council (GCC) countries. Most parents agreed on the importance of organizing awareness campaigns and having a law to enforce the use of car seats. The pre-survey mean knowledge score was 11.64, which significantly increased to 13.1 in the post-survey (p < 0.001). CONCLUSIONS The intervention of the educational campaign through social media resulted in a significant increase in parents' knowledge and awareness of the importance of using car seats correctly. This study highlights the potential effectiveness of social media campaigns in improving parents' knowledge and awareness of child safety seats.
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Affiliation(s)
- Eman A Bakhurji
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, 34212, Dammam, Saudi Arabia.
| | - Albandari M Alqahtani
- College of Dentistry, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
| | - Ezdehar M Alwashmi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
| | - Manayer S Husain
- College of Dentistry, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
| | - Balgis O Gaffar
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, 34212, Dammam, Saudi Arabia
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Macy ML, Lee JY, Kendi S, Zonfrillo MR, Hill A. Ease of Use ratings and real-world child restraint system errors from Safe Kids Illinois seat checks, 2015-2019. TRAFFIC INJURY PREVENTION 2023; 24:625-631. [PMID: 37477419 PMCID: PMC10535899 DOI: 10.1080/15389588.2023.2233647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Child restraint systems (CRSs) significantly reduce risk of crash-related injury, however installation and use errors undermine their benefits. The National Highway Traffic Safety Administration (NHTSA) created the Ease of Use (EOU) rating system to help guide consumers and incentivize manufacturers to improve their products. The EOU rating system assigns one to five stars to four CRS features and overall. Our study assessed the relationship between EOU ratings and CRS installation and use errors documented in seat checks conducted by child passenger safety technicians (CPSTs). METHODS We performed a secondary analysis of data from Safe Kids Illinois seat check records from 2015 through 2019 and EOU ratings from 2008 to 2020. Five types of errors were documented by CPSTs. Study authors (JYL and MLM) used a tiered system to match seat check model numbers to EOU ratings. We calculated chi-square statistics and performed logistic regression analyses to assess for EOU as a predictor of relevant CRS errors (e.g., tether errors for forward-facing CRSs). RESULTS Our analyses included 2132 seat check observations, of which 217 (10.2%) were exact, 244 (10.5%) were probable, and 1671 (78.4%) were near matches via sorting and web search. Errors were most common for seat belts (70.7%) and least common for recline angle (36.9%). Star ratings for instructions, vehicle installation, and labels were associated with recline angle and seat belt errors. Star ratings for instructions, labels, and securing child were associated with harness errors. CRSs with 4-star and 5-star ratings had lower odds of errors for recline angle (Odds Ratio (OR) 0.62; 95% Confidence Interval (CI): 0.43, 0.89 and OR 0.31; 95% CI: 0.17, 0.56) lower anchors (OR 0.59; 95% CI 0.40, 0.89 and OR 0.38; 95% CI: 0.21, 0.68), and harness (OR 0.56; 95% CI: 0.40, 0.76 and OR 0.19; 95% CI: 0.10, 0.35) when compared with 1 and 2-star CRSs. CONCLUSIONS This study provides evidence in support of NHTSA's EOU ratings as predictors of some CRS installation and use errors among caregivers who obtain seat checks. A higher star rating may be helpful for caregivers when choosing a CRS that will yield lower installation errors.
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Affiliation(s)
- Michelle L Macy
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Chicago, Illinois
| | - Joo-Young Lee
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sadiqa Kendi
- Pediatric Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Mark R Zonfrillo
- Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Amy Hill
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Almodovar HL, Thorson CM, Cardy CR. Standardizing Child Passenger Safety Screening in the Emergency Department: A Quality Improvement Study. J Trauma Nurs 2023; 30:177-185. [PMID: 37144809 DOI: 10.1097/jtn.0000000000000724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Motor vehicle collisions remain a leading cause of death and injury in children in the United States. Our Level I trauma center found that 53% of children ages 1-19 years are improperly restrained or unrestrained. Our center employs a Pediatric Injury Prevention Coalition with nationally certified child passenger safety technicians who are active in the community yet remain underutilized in the clinical setting. OBJECTIVE The purpose of the quality improvement project was to standardize child passenger safety screening in the emergency department to increase referrals to a Pediatric Injury Prevention Coalition. METHODS This quality improvement project utilized a pre-/postdesign of data collected before and after implementing the child passenger safety bundle. Using the Plan-Do-Study-Act model, organizational change processes were identified, and quality improvement interventions implemented from March to May 2022. RESULTS The total number of families referred was 199, representing 230 children, which was 3.8% of the eligible population. A significant relationship was found between child passenger safety screening and referral to the Pediatric Injury Prevention Coalition in 2019 and 2021, χ2 (1, n = 230) = 239.98, p < .001, and χ2 (1, n = 230) = 240.78, p < .001, respectively. Forty-one percent of the referred families established contact with the Pediatric Injury Prevention Coalition. CONCLUSION Standardizing child passenger safety screening in the emergency department increased referrals to a Pediatric Injury Prevention Coalition and resulted in improved child safety seat distribution and child passenger safety education.
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Affiliation(s)
- Heidi L Almodovar
- Division of Pediatric and Adolescent Surgery, Department of Surgery, University of Miami/Jackson Health System, Miami, Florida, and University of South Florida College of Nursing, Tampa (Dr Almodovar); Division of Pediatric and Adolescent Surgery, Department of Surgery, University of Miami/Miller School of Medicine, Miami, Florida (Dr Thorson); and University of South Florida College of Nursing, and Division of Cardiovascular Sciences, Department of Internal Medicine, University of South Florida Health, Tampa (Dr Cardy)
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MacDonald NE, Dubé È, Comeau J. Vaccines, Politics and Mandates: Can We See the Forest for the Trees? Comment on "Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates". Int J Health Policy Manag 2022; 12:7572. [PMID: 36404500 PMCID: PMC10125092 DOI: 10.34172/ijhpm.2022.7572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022] Open
Abstract
Under-vaccination is a complex problem that is not simple to address whether this is for routine childhood immunization or for coronavirus disease 2019 (COVID-19) vaccination. Vaccination mandates has been one policy instrument used to try to increase vaccine uptake. While the concept may appear straight forward there is no standard approach. The decision to shift to a more coercive mandated program may be influenced by both functional and/or political needs. With mandates there may be patient and/or public push back. Anti-mandate protests and increased public polarization has been seen with COVID-19 vaccine mandates. This may negatively impact on vaccine acceptance ie, be counterproductive, causing more harm than overall good in the longer term. We need a better understanding of the political and functional needs that drive policy change towards mandates as well as cases studies of the shorter- and longer-term outcomes of mandates in both routine and pandemic settings.
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Affiliation(s)
- Noni E. MacDonald
- Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Ève Dubé
- Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Québec, QC, Canada
| | - Jeannette Comeau
- Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Ramsey GC, Grippi C. Impact of Child Passenger Safety Education for Pediatric Nurses. J Trauma Nurs 2022; 29:262-265. [DOI: 10.1097/jtn.0000000000000674] [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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