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.

项目摘要汽车碰撞（MVC）仍然是儿童无意伤害死亡的主要原因美国（美国）和种族/族裔少数民族儿童被视为次优儿童的影响不成比例在某些社区中，乘客安全行为更为普遍。现有的通用方法促进儿童乘客的安全性未能确保所有儿童乘客正确使用尺寸 - 适当的儿童乘客约束根据美国美国学院发布的指南儿科和国家公路交通安全管理局。精确预防计划是迫切的需要改善没有回应的照顾者之间的儿童乘客安全行为指南，法律和公共教育运动。拟议的研究将测试小货物的功效， Big Deal（TCBD），急诊科（ED）的预防干预措施以自我为基础确定理论。 TCBD基于激励原则整合个性化咨询采访（MI）和EHEADH组件，包括量身定制的教育网络应用程序（APP）和简短消息服务（SMS）通信，目的是提高儿童乘客安全性。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技能，以某种方式进行约束使用支持自主动机TCBD干预将比普遍性更有效方法（法律/指南）实现正确使用适合尺寸的儿童乘客限制因素。这主要结果，适合尺寸的约束用途和儿童乘客安全评分（CPASS）将是通过直接观察到计划，面对面的约会和远程观察数字观察评估护理人员提交的照片是针对未定义的短信。我们将检验我们的假设使用随机自适应试验设计具有以下目的：目标1：优化和验证的可靠性 100点CPASS中的元素，这是一种新颖的儿童乘客安全综合量度。目标2：测试与通常的护理相比在6个月和12个月时，适当的约束（二分）和CPass-D（数字）]。目标3：使用潜在增长曲线模型以识别12张在数字照片中观察到的CAPS-R的特征轨迹研究月份和评估轨迹类型的相关性。这项创新的理论基础研究通过告知最佳方法以增加正确使用的方法，将对儿童乘客的安全产生长期影响在他们互动时，各种背景的护理人员之间适合大小的儿童约束系统与医疗保健系统。这项工作有可能在ED中进行大规模实施转化为初级保健办公室，学校和社区环境，其最终目标是消除儿童乘客安全差异和减少MVC的儿童伤害数量。