A Brief Intervention to Increase Size-Appropriate Child Passenger Restraint Use

增加适当尺寸儿童乘客约束装置使用的简短干预措施

• 批准号: 8224894
• 负责人: Michelle Lea Macy
• 金额: $ 13.39万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-20 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8224894
• 关键词: 12 year old; 3 year old; 7 year old; Accident and Emergency department; Adolescent; Adult; Age; Attitude; Awareness; Behavior; Behavior Therapy; Car Seats; Caring; Cause of Death; Cessation of life; Child; Childhood; Childhood Injury; Clinical; Counseling; Data; Development; Development Plans; Education; Emergency Care; Engineering; Ensure; Faculty; Family; Focus Groups; Funding; Generic Drugs; Health Communication; Health Services Research; Health behavior; Health system; Heart Diseases; Hispanics; Hospitals; Infant; Influenza; Injury; Intervention; K-Series Research Career Programs; Knowledge; Laws; Lead; Legal; Life; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Minority; Motivation; Pamphlets; Parents; Patients; Pattern; Phase; Pneumonia; Positioning Attribute; Printing; Provider; Public Health; Punishment; Qualifying; Qualitative Methods; Randomized; Randomized Controlled Trials; Regulation; Research; Research Personnel; Research Training; Risk; Role; Safety; Seat Belts; Self Determination; Sepsis; Statutes and Laws; Subgroup; Surveys; System; Techniques; Testing; Training; Vehicle crash; Visit; base; behavior change; brief intervention; career development; communication behavior; design; disability; evidence base; experience; improved; injury prevention; interest; motivated behavior; motivational enhancement therapy; multidisciplinary; novel strategies; patient oriented; pilot trial; primary care setting; programs; research and development; response; restraint; skills; theories; therapy development

DESCRIPTION (provided by applicant): Motor vehicle collisions (MVCs) remain a leading cause of death among children after the first year of life despite substantial improvements in passenger safety. In 2007, more children ages 1 to 12 years died as occupants in MVCs than died of heart disease, influenza/pneumonia, or sepsis. Deaths and severe injuries from MVCs can be reduced significantly through the consistent use of size-appropriate child passenger restraints. Still 10% of children ride completely unrestrained and roughly one-quarter do not use the recommended restraint for their size. New approaches are needed to motivate behavior change among parents who do not consistently use size-appropriate passenger restraints for their 1- to 12-year-old children. Emergency department (ED) visits represent unique opportunities to reach vulnerable children and their parents who have difficulty accessing the primary care settings where childhood injury prevention information is commonly provided. Motivational interviewing (MI) in the ED has been used to encourage a variety of health behaviors among at-risk patients. However, MI has not been previously evaluated for child passenger safety promotion programs. This career development award will provide Dr. Macy with the additional skill set and advanced research training required to develop and evaluate an ED-based intervention utilizing MI techniques and patient-centered (e.g., targeted and tailored) print materials to promote the correct and consistent use of size-appropriate child passenger restraints. Dr. Macy has developed the proposed research and career development plans under the guidance of her experienced multidisciplinary mentoring team that includes experts in the fields of health communications for behavior change, injury prevention, and pediatric health services research. The proposal is organized into 4 phases: (1) audience segmentation analysis of survey data obtained from parents of 1- to 12-year-old children seeking ED care in order to identify distinct child passenger restraint use subgroups for the development of targeted interventions; (2) focus groups with parents in order to obtain an in-depth understanding of the subgroups identified in Phase 1 and to pilot test child passenger safety messages intended for these subgroups; (3) development of intervention materials including brief MI messages, targeted information sheets, and tailored brochures; and (4) randomized pilot trial of the intervention utilizing a 2x2 factorial design to examine the independent and additive effects of ED-based MI and tailored print materials on the consistent use of size-appropriate child passenger restraints. Dr. Macy's career development activities will include formal training in statistical analysis for audience segmentation, qualitative methods, and advance theories and applied techniques related to the design and implementation of behavioral interventions in the ED setting. Through formal coursework, interaction with her highly qualified mentoring team, and the execution of the proposed project, Dr. Macy will acquire the knowledge and skills to become an independent researcher and expert in ED-based interventions for pediatric injury prevention. PUBLIC HEALTH RELEVANCE: Preventable injuries sustained by child occupants in motor vehicle collisions are a significant and costly public health concern. Child passenger restraint systems have proven effective in reducing the risk of injury and death associated with a motor vehicle collision, yet there are few evidence-based approaches to promote the correct and consistent use of the size-appropriate child passenger restraint. By using successful strategies for behavior change, including motivational interviewing and personalized health communication, the proposed intervention could remarkably improve passenger safety among children who contact the health system through the emergency department.

描述（由申请人提供）：尽管乘客安全有了很大的改善，但在生命第一年后，机动车碰撞（MVC）仍然是儿童死亡的主要原因。在2007年，在MVC中以1至12岁的儿童死亡的儿童多于心脏病，流感/肺炎或败血症。通过持续使用适合尺寸的儿童乘客约束，可以显着减少MVC的死亡和严重伤害。仍然有10％的儿童完全不受限制，大约四分之一的孩子不使用建议的约束。需要采用新的方法来激励不断使用适合大小的乘客限制的父母的行为改变。急诊室（ED）访问代表了接触弱势儿童及其父母的独特机会，他们在通常提供了预防儿童伤害信息的初级保健环境中很难。 ED中的动机访谈（MI）已用于鼓励高危患者的各种健康行为。但是，MI先前尚未对儿童乘客安全促进计划进行评估。该职业发展奖将为梅西（Macy）博士提供额外的技能和高级研究培训，以开发和评估采用MI技术和以患者为中心（例如，有针对性和量身定制的）印刷材料的基于ED的干预措施，以促进正确且一致地使用适合大小的儿童乘客限制。梅西百货博士在她经验丰富的多学科指导团队的指导下制定了拟议的研究和职业发展计划，其中包括卫生通信领域的专家，以改变行为改变，预防伤害和儿科卫生服务研究。该提案分为4个阶段：（1）从1至12岁的孩子寻求护理的父母获得的调查数据的受众细分分析，以确定不同的儿童乘客约束使用亚组，以开发目标干预措施； （2）与父母的重点小组，以便获得对第1阶段确定的子组的深入了解，并试行针对这些亚组的儿童乘客安全消息； （3）开发干预材料，包括简短的MI消息，有针对性的信息表和量身定制的手册； （4）使用2x2阶乘设计的干预措施随机试验试验，以检查基于ED的MI和量身定制的印刷材料对始终使用适合尺寸的儿童乘客约束的独立和加性效应。梅西百货（Macy）博士的职业发展活动将包括针对受众细分，定性方法的统计分析进行正式培训，以及与ED环境中行为干预措施的设计和实施相关的提前理论和应用技术。通过正式的课程工作，与她高素质的指导团队的互动以及拟议项目的执行，梅西百货博士将获得知识和技能，成为针对预防儿科损伤的独立研究人员和专家。 公共卫生相关性：儿童乘员在汽车碰撞中遭受的可预防伤害是一个重大且昂贵的公共卫生问题。事实证明，儿童乘客约束系统有效地降低了与汽车碰撞相关的伤害和死亡的风险，但是几乎没有证据的方法可以促进正确和一致地使用适合大小的儿童乘客约束。通过使用成功的行为改变策略，包括动机访谈和个性化的健康沟通，拟议的干预措施可以显着改善通过急诊室与卫生系统联系的儿童的乘客安全。