Tiny Cargo, Big Deal! An Adaptive ED-Based eHealth Intervention to Promote Correct and Consistent Size-Appropriate Child Passenger Safety Behaviors and Reduce Disparities

小货，大事！

基本信息

批准号：
10475123
负责人：
Michelle Lea Macy
金额：
$ 49.65万
依托单位：
LURIE CHILDREN'S HOSPITAL OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-17 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10475123
关键词：
Academy Accident and Emergency department Accidental Injury Affect African American population Age American Appointment Behavior Car Seats Caregivers Cessation of life Characteristics Child Childhood Injury Communication Communication Research Communities Competence Counseling Elements Emergency Care Emergency department visit Emotional Ensure Family Fatality rate Feedback Goals Growth Guidelines Health Services Accessibility Health system Healthcare Systems Injury Intervention Knowledge Laws Light Low income Massage Measures Mediator of activation protein Mentored Patient-Oriented Research Career Development Award Methods Michigan Minority Minority Groups Modeling Motivation Outcome Measure Pamphlets Paper Parents Participant Pediatrics Persons Population Prevention program Primary Health Care Public Health Publishing Race Randomized Recommendation Research Risk Safety Schedule Schools Self Determination Site Socioeconomic Status System Telephone Testing Text Text Messaging Translations Travel United States Universities Vehicle crash Work base behavior change community setting comparison intervention cost design digital disparity reduction eHealth efficacy testing follow-up group intervention handheld mobile device health communication improved individualized prevention injury prevention innovation intervention effect minority children mortality risk motivational enhancement therapy novel premature preventive intervention primary outcome prototype public education racial and ethnic recruit response restraint safety education severe injury sex skills success theories treatment as usual trial design usability web app

项目摘要

PROJECT SUMMARY Motor vehicle collisions (MVCs) remain the leading cause of unintentional injury deaths among children in the United States (U.S.) and racial/ethnic minority children are disproportionately impacted as suboptimal child passenger safety behaviors are more prevalent in some communities. Existing universal approaches to promote child passenger safety have fallen short of ensuring that all child passengers are correctly using size- appropriate child passenger restraints according to guidelines published by the American Academy of Pediatrics and the National Highway Traffic Safety Administration. Precision prevention programs are urgently needed to improve child passenger safety behaviors among caregivers who have not been responsive to guidelines, laws, and public education campaigns. The proposed research will test the efficacy of Tiny Cargo, Big Deal (TCBD), an emergency department (ED)-based precision prevention intervention grounded in Self- Determination Theory. TCBD integrates personalized counseling based on principles of motivational interviewing (MI) and eHealth components including a tailored educational web application (app) and short message service (SMS) communications with the goal of improving child passenger safety. We hypothesize that by providing tailored child passenger safety education and personalized skills for restraint use in a manner that supports autonomous motivation the TCBD intervention will be more efficacious than universal approaches (laws/guidelines) for realizing correct use of size-appropriate child passenger restraints. The primary outcomes, size-appropriate restraint use and the Child Passenger Safety Score (CPaSS), will be assessed with direct observation at scheduled, in-person appointments and remote observation of digital photographs submitted by caregivers in response to unscheduled text messages. We will test our hypothesis using a randomized adaptive trial design with the following aims: Aim 1: To refine and verify the reliability of elements in the 100-point CPaSS, a novel composite measure of child passenger safety. Aim 2: To test the efficacy of the TCBD intervention compared to usual care for improving primary outcomes [i.e., size- appropriate restraint (dichotomous) and CPaSS-D (numeric)] at 6 and 12 months. Aim 3: To use latent growth curve models to identify characteristic trajectories for the CPaSS-R observed in digital photographs over the 12 study months and assess for correlates of the trajectory types. This innovative, theoretically grounded research will have long-standing impact on child passenger safety by informing the best methods to increase correct use of size-appropriate child restraint systems among caregivers of diverse backgrounds at the point they interact with the health care system. The work has the potential for wide-scale implementation in the ED and for translation to primary care offices, schools, and community settings with an ultimate goal of eliminating child passenger safety disparities and reducing the number of childhood injuries from MVCs.

项目概要机动车碰撞（MVC）仍然是儿童意外伤害死亡的主要原因美国和少数族裔儿童作为次优儿童受到不成比例的影响乘客安全行为在一些社区更为普遍。现有的通用方法促进儿童乘客安全未能确保所有儿童乘客正确使用尺寸 - 根据美国科学院发布的指南，适当的儿童乘客约束装置儿科和国家公路交通安全管理局。精准预防方案刻不容缓需要改善未对儿童乘客做出反应的护理人员的安全行为指导方针、法律和公共教育活动。拟议的研究将测试 Tiny Cargo 的功效， Big Deal（TCBD），一种基于急诊科（ED）的精准预防干预措施，以自我为基础决定论。 TCBD 整合了基于激励原则的个性化咨询访谈 (MI) 和电子医疗组件，包括定制的教育网络应用程序 (app) 和简短的消息服务 (SMS) 通信，旨在提高儿童乘客的安全。我们假设通过提供量身定制的儿童乘客安全教育和个性化的约束使用技能支持自主动机的 TCBD 干预将比普遍的干预更有效实现正确使用适合尺寸的儿童乘客约束装置的方法（法律/指南）。这主要结果，尺寸合适的约束装置的使用和儿童乘客安全评分（CPaSS）将通过预定的面对面预约的直接观察和数字化远程观察进行评估护理人员在回复计划外短信时提交的照片。我们将检验我们的假设使用随机适应性试验设计，其目标如下：目标 1：完善和验证 100 分 CPaSS 中的要素，这是一种新颖的儿童乘客安全综合衡量标准。目标 2：测试与常规护理相比，TCBD 干预措施在改善主要结局方面的功效[即大小- 6 个月和 12 个月时适当的约束（二分法）和 CPaSS-D（数字）]。目标 3：利用潜在增长曲线模型来识别 12 年来在数码照片中观察到的 CPaSS-R 的特征轨迹研究几个月并评估轨迹类型的相关性。这项创新的、有理论基础的研究通过告知增加正确使用的最佳方法，将对儿童乘客的安全产生长期影响不同背景的护理人员在互动时采用尺寸合适的儿童约束系统与医疗保健系统。这项工作有可能在教育部广泛实施翻译到初级保健办公室、学校和社区环境，最终目标是消除儿童乘客安全差异并减少 MVC 造成的儿童伤害数量。

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

"Tiny Cargo, Big Deal! Abróchame Bien, Cuídame Bien", an emergency department-based intervention to promote child passenger safety: Protocol for an adaptive randomized trial among caregivers of 6-month through 10-year-old children.

“小货物，大交易！Abróchame Bien，Cuídame Bien”，一项基于急诊室的干预措施，旨在促进儿童乘客安全：针对 6 个月至 10 岁儿童的护理人员进行适应性随机试验的方案。

DOI：
发表时间：
2022-09
期刊：
影响因子：
2.2
作者：
Macy, Michelle L;Carter, Patrick;Kendi, Sadiqa;Pollock, Bethany;San Miguel, Liliana;Goldstick, Jason;Resnicow, Ken
通讯作者：
Resnicow, Ken

Ease of Use ratings and real-world child restraint system errors from Safe Kids Illinois seat checks, 2015-2019.

2015-2019 年伊利诺伊州安全儿童座椅检查中的易用性评级和实际儿童约束系统错误。