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

基本信息

批准号：
8606226
负责人：
Andrea C Gielen
金额：
$ 58.7万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
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/8606226
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 Department Physician 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 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

项目摘要

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.

描述（由申请人提供）：此提案是1RO1HD069221的修订版。在紧急医疗服务的背景下，我们解决了预防创新研究的需求，特别是使用计算机技术评估行为变化干预措施。我们建议在两个儿科急诊室（PED）和1级儿科创伤服务（PTS）（PTS）中测试基于Web的，理论驱动的计算机计算机干预，以服务于不同人群。该提案的重点是父母使用儿童约束设备（CRD） - 汽车安全座椅（CSS）和皮带位置助推器座椅（BPB） - 年龄以上的孩子。之所以选择这些安全行为，是因为它们是已知的有效对策，可以帮助防止汽车乘员受伤，这是美国儿童死亡率的主要原因。尽管CSS与年幼的孩子一起使用很常见，但人群之间存在差异，但BPB用于大儿童的使用率很低，CRD的滥用很普遍。我们以前的工作，包括NICHD资助的秒数（SIS）和其他工作，已经证明，计算机限制的干预措施在包括PED在内的临床环境中是可行有效的。但是，我们的工作是我们知识的唯一研究，将该技术应用于CSS和BPB的特定问题，也是第一个将其与西班牙语家庭一起使用的研究。最初的SIS是一个基于售货亭的计算机量身定制计划，在单一PED中表现出在低收入，城市和主要是非裔美国人人口中的成功。该提案将测试一个增强的基于Web的程序，即Seconds v 2.0（SIS v2.0）的安全性，其中来自马里兰州巴尔的摩的英语和西班牙语家庭。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的先前工作：在PTS中测试该程序；测试西班牙语版本；并添加文本消息传递提醒和一个可以多次访问的Web门户网站来加强教育信息。评估该计划的成本收益，并确定计划采用和实施的障碍和促进者也是拟议工作的创新方面，这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，量身定制的计划对英语和西班牙语父母的儿童安全知识，预防信念以及对孩子的CSS和BPB的适当和一致使用的影响年龄0-8； 2）评估父母对子女使用BPB的计划的成本收益率； 3）确定在PED和PTS设置中编程采用和实施的障碍和促进者。这项为期5年的研究将在Johns Hopkins PED（JH-PED）和Johns Hopkins PTS（JH-PTS）以及阿肯色州儿童医院PED（AR-PED）中进行。方法包括：a）修改秒程序中现有安全性的修改，以将其转换为基于Web的平台，并包含其他视频，音频，发短信提醒和重复访问功能； b）一项随机对照试验，有1,650个父母（600个JH-PED，450 JH-PTS，600 AR-PED），包括基线和6个月的随访评估和CSS观察结果； c）从第三方医疗索赔付款人的角度来看，该计划的预期财务收益的成本收益分析； d）在所有三个研究环境中，使用关键知情者访谈，对诊所环境的直接观察和文件审查收集的定性数据对计划采用和实施的深入研究。随着对计算机的不断增长的访问，这项工作的结果将具有广泛的实用程序，用于传播有效的CSS和BPBS行为更改程序，我们将推动在新领域中使用计算机调整理论和方法的应用。