Evaluating Models for Dissemination of Injury Prevention Information in the Pediatric Emergency Department Setting

The long-term goal of the present research program is to enhance the utilization of
evidence-based injury prevention strategies and to encourage medical practitioners to
disseminate focused information regarding injury prevention in the Pediatric Emergency
Department (ED). This study examines the Pediatric Emergency Department as a location for
increasing safe car seat practices by parents who are not restraining their children
appropriately in motor vehicles. Three different intervention will be tested to determine
their effectiveness in increasing safe car seat practices. The proposed research plan: 1.
examines the efficacy of a Brief Motivational Intervention to enhance automobile safety
restraint-specific injury prevention behaviors in parents/caregivers of younger children;
and 2. examines the efficacy of focused, behavior-specific, injury prevention discharge
instruction supplements (Enhanced Standard Care) in increasing safety restraint-specific
injury prevention behaviors in parents/caregivers of younger children. We will conduct a
randomized, controlled trial of parent/caregivers of children being evaluated in the Hasbro
Children's Hospital Emergency Department in Providence, Rhode Island. Eligible, consenting
participants will be screened with an injury assessment tool for inappropriate use of motor
vehicle child safety restraints. High risk participants will be randomized into three
intervention groups: Standard Care (SC), Enhanced Standard Care (ESC) and Brief Motivational
Intervention (BMI). All participants will then be contacted three months following
enrollment and surveyed regarding child safety restraint practices, attitudes and knowledge.
The following main effects will be evaluated with relation to child safety restraint
practice and attitude change: 1. Intervention (SC vs. ESC vs. BMI); 2. Injury status of
child (Injured vs. non-injured). In addition, we will monitor re-injury rates of the index
children of all enrolled parent/caregivers for one year from the time of enrollment and
compare on the bases of the above main effects.

Inclusion Criteria:

- Parents/primary caregivers of children ages 0-7 years who are being seen in the
Pediatric ED for a non life-threatening injury or non-injury related complaint

- Parents/primary caregivers whose children are medically stable

- Parent/primary caregiver has legal custody of the index child and is able to provide
informed consent for participation

- Parent/primary caregiver speaks English or Spanish

- Parent/primary caregiver must have access to a motor vehicle in which the child is
transported

Exclusion Criteria:

- parents/primary caregivers who are cognitively unable to take part in the
intervention

- those whose children are suspected by the clinical staff of being victims of child
abuse

- those whose children are medically or surgically unstable

- those whose children are being evaluated for possible psychiatric disorders or
suicidal ideation

- those who do not speak English or Spanish, and those without a telephone