Evaluating a Web-based Child Passenger Safety Program: Safety in Seconds v 2.0

评估基于网络的儿童乘客安全计划：Safety in Seconds v 2.0

• 批准号: 8236459
• 负责人: Andrea C Gielen
• 金额: $ 57.86万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8236459
• 关键词: 8 year old; Accident and Emergency department; Address; Adoption; African American; Age; American; Area; Arkansas; Baltimore; Behavior; Belief; Cause of Death; Cessation of life; Child; Child Mortality; Childhood; Childhood Injury; Clinic; Clinical; Computers; Cost-Benefit Analysis; Costs and Benefits; Data; Devices; Elements; Emergency Situation; Emergency medical service; Environment; Evaluation; Family; Funding; Future; Goals; Health; Health Communication; Hispanics; Injury; Internet; Intervention; Interview; Knowledge; Language; Low income; Medical; Methods; Modification; Motor Vehicles; National Institute of Child Health and Human Development; Online Systems; Parents; Pediatric Hospitals; Physicians; Population; Population Heterogeneity; Positioning Attribute; Prevention; Randomized Controlled Trials; Relative (related person); Research; Resources; Risk; Safety; Seat Belts; Services; Societies; Technology; Testing; Text; Third-Party Payer; Time; United States; Vehicle crash; Visit; Work; age group; base; behavior change; college; cost efficient; follow up assessment; informant; injury prevention; innovation; pediatric trauma; prevent; prevention service; programs; response; restraint; safety study; success; theories; trauma centers

DESCRIPTION (provided by applicant): This proposal is a revision of 1RO1HD069221. We are addressing the need for innovative research on prevention in the context of emergency medical services, specifically evaluation of behavior change interventions using computer technology. We propose to test a web based, theory driven, computer-tailored intervention for child passenger safety in two Pediatric Emergency Departments (PEDs) and a Level 1 Pediatric Trauma Service (PTS) that serve diverse populations. The focus of this proposal is on parents' use of child restraint devices (CRDs) -- Car Safety Seats (CSS) and Belt-Positioning Booster Seats (BPBS) -- for their children ages 8 years and younger. These safety behaviors were chosen because they are effective countermeasures known to help prevent motor vehicle occupant injuries, the leading cause of child mortality in the United States. Although CSS use with younger children is common, there are disparities across populations, BPBS use for older children is low, and misuse of CRDs is widespread. Our previous work, including the NICHD-funded study of Safety in Seconds (SIS) and that of others, has demonstrated that computer-tailored interventions can be feasible and effective in clinical settings, including PEDs. However, our work is the only research to our knowledge applying this technology to the specific issues of CSS and BPBS and the first to use it with Spanish speaking families. The original SIS was a kiosk-based, computer tailored program that demonstrated some success in a low income, urban, and predominantly African-American population in a single PED. This proposal will test an enhanced web-based program, Safety in Seconds v 2.0 (SIS v2.0), with English and Spanish speaking families from Baltimore, MD and Little Rock, AR. We will also extend our prior work by adding several elements never previously considered: testing the program in a PTS; testing a Spanish language version; and adding text messaging reminders and a web portal that can be accessed multiple times to reinforce the educational messages. Evaluating the program's cost benefit and determining barriers and facilitators to program adoption and implementation are also innovative aspects of the proposed work that will contribute to future dissemination. The specific aims of the study are to: 1) evaluate the impact of a web-based, tailored program on English and Spanish speaking parents' child passenger safety knowledge, prevention beliefs, and the proper and consistent use of CSS and BPBS for their children ages 0-8; 2) evaluate the cost benefit ratio of the program for parents' utilization of BPBS for their children; and 3) determine the barriers and facilitators to program adoption and implementation in both PED and PTS settings. This 5-year study will take place in the Johns Hopkins PED (JH-PED) and the Johns Hopkins PTS (JH-PTS) as well as in the Arkansas Children's Hospital PED (AR-PED). Methods include: a) a modification of the existing Safety in Seconds program to convert it to a web-based platform and incorporate additional video, audio, texting reminders and repeat visit capabilities; b) a randomized controlled trial with 1,650 parents (600 JH-PED, 450 JH-PTS, 600 AR-PED), including baseline and 6-month follow up assessments and CSS observations; c) a cost benefit analysis of the program's expected financial benefit from the perspective of a third party payer of medical claims; and d) an in-depth examination of program adoption and implementation in all three study settings using qualitative data collected from key informant interviews, direct observations of the clinic environments, and document review. With the ever-growing access to computers, results of this work will have widespread utility for disseminating effective CSS and BPBS behavior change programs to a broad audience, and we will advance the application of computer tailoring theories and methods in a new area. PUBLIC HEALTH RELEVANCE: This proposal will evaluate an innovative web-based program -- Safety in Seconds v 2.0 - to increase the proper and consistent use of Car Safety Seats and Belt-Positioning Booster Seats for children ages 8 years and younger. Motor vehicle crashes are the leading cause of death for children and child restraint devices are proven to reduce the risk of death and injury. The program will be evaluated in pediatric emergency departments and a pediatric trauma center with both English and Spanish speaking families. We will also complete a cost benefit analysis of the program and a study of how to implement the program in other settings.

描述（由申请人提供）：本提案是 1RO1HD069221 的修订版。我们正在解决紧急医疗服务背景下预防创新研究的需求，特别是使用计算机技术评估行为改变干预措施。我们建议在两个儿科急诊科 (PED) 和一个为不同人群提供服务的 1 级儿科创伤服务中心 (PTS) 测试一种基于网络、理论驱动、计算机定制的儿童乘客安全干预措施。该提案的重点是父母为 8 岁及以下的孩子使用儿童约束装置 (CRD)——汽车安全座椅 (CSS) 和安全带定位加高座椅 (BPBS)。选择这些安全行为是因为它们是已知有助于防止机动车辆乘员受伤的有效对策，而机动车辆乘员受伤是美国儿童死亡的主要原因。尽管 CSS 在年幼儿童中的使用很常见，但不同人群之间存在差异，BPBS 在年龄较大儿童中的使用率较低，并且 CRD 的滥用也很普遍。 我们之前的工作，包括 NICHD 资助的秒级安全研究 (SIS) 和其他研究，已经证明计算机定制的干预措施在包括 PED 在内的临床环境中是可行且有效的。然而，据我们所知，我们的工作是唯一将该技术应用于 CSS 和 BPBS 的具体问题的研究，并且是第一个将其用于西班牙语家庭的研究。最初的 SIS 是一个基于信息亭的计算机定制程序，该程序在单一 PED 中在低收入、城市和以非洲裔美国人为主的人群中取得了一些成功。该提案将与来自马里兰州巴尔的摩和阿肯色州小石城的讲英语和西班牙语的家庭一起测试基于网络的增强型程序 Safety in Seconds v 2.0 (SIS v2.0)。我们还将通过添加以前从未考虑过的几个元素来扩展我们之前的工作：在 PTS 中测试程序；测试西班牙语版本；添加短信提醒和可多次访问的门户网站以强化教育信息。评估计划的成本效益并确定计划采用和实施的障碍和促进因素也是拟议工作的创新方面，将有助于未来的传播。 该研究的具体目的是： 1) 评估基于网络的定制计划对英语和西班牙语家长的儿童乘客安全知识、预防信念以及为孩子正确和一致使用 CSS 和 BPBS 的影响0-8岁； 2）评估家长为孩子使用BPBS项目的成本效益比； 3) 确定 PED 和 PTS 环境中计划采用和实施的障碍和促进因素。这项为期 5 年的研究将在约翰·霍普金斯 PED (JH-PED) 和约翰·霍普金斯 PTS (JH-PTS) 以及阿肯色州儿童医院 PED (AR-PED) 进行。方法包括： a) 修改现有的“秒速安全”计划，将其转换为基于网络的平台，并纳入额外的视频、音频、短信提醒和重复访问功能； b) 一项有 1,650 名家长参加的随机对照试验（600 名 JH-PED、450 名 JH-PTS、600 名 AR-PED），包括基线和 6 个月随访评估以及 CSS 观察； c) 从医疗索赔第三方付款人的角度对计划的预期财务效益进行成本效益分析； d) 使用从关键知情人访谈、对诊所环境的直接观察和文件审查中收集的定性数据，对所有三个研究环境中计划的采用和实施进行深入检查。 随着计算机的普及，这项工作的成果将具有广泛的用途，可以向广大受众传播有效的 CSS 和 BPBS 行为改变计划，并且我们将推动计算机裁剪理论和方法在新领域的应用。 公共健康相关性：该提案将评估一项基于网络的创新计划——Safety in Seconds v 2.0——以提高 8 岁及以下儿童对汽车安全座椅和安全带定位加高座椅的正确和持续使用。机动车碰撞是儿童死亡的主要原因，儿童约束装置已被证明可以降低死亡和受伤的风险。该计划将在儿科急诊科和儿科创伤中心与讲英语和西班牙语的家庭进行评估。我们还将完成该计划的成本效益分析以及如何在其他环境中实施该计划的研究。