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

描述(由申请人提供)：尽管乘客的安全有了很大的改善，但机动车碰撞(MVC)仍然是第一年后儿童死亡的主要原因。2007年，1至12岁的儿童因入住MVC而死亡的人数多于死于心脏病、流感/肺炎或败血症的儿童。通过始终如一地使用大小适中的儿童乘客安全带，可以显著减少MVC造成的死亡和重伤。尽管如此，仍有10%的儿童完全不受限制地骑车，大约四分之一的儿童没有使用针对他们体型的推荐限制。需要新的方法来激励父母改变行为，这些父母不总是为1到12岁的孩子使用尺寸合适的乘客约束。急诊科就诊是接触易受伤害儿童及其父母的独特机会，这些儿童及其父母难以进入通常提供儿童伤害预防信息的初级保健环境。ED中的动机访谈(MI)已被用来鼓励高危患者的各种健康行为。然而，MI之前没有接受过儿童乘客安全促进计划的评估。这一职业发展奖将为Macy博士提供所需的额外技能和高级研究培训，以开发和评估基于ED的干预措施，利用MI技术和以患者为中心(例如，有针对性和量身定制的)打印材料，促进正确和一致地使用适合尺寸的儿童乘客安全座椅。梅西博士在她的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，该团队包括行为改变、伤害预防和儿科健康服务研究方面的健康沟通领域的专家。该建议分为4个阶段：(1)对从寻求急诊护理的1至12岁儿童的父母那里获得的调查数据进行受众细分分析，以确定不同的儿童乘客约束小组，以制定有针对性的干预措施；(2)与父母一起开展重点小组，以深入了解第一阶段确定的小组，并试行针对这些小组的儿童乘客安全信息测试；(3)制定干预材料，包括简短的MI信息、有针对性的信息表和量身定制的小册子；和(4)干预的随机先导试验，采用2x2析因设计，检验基于ED的MI和定制印刷材料对一致使用尺寸合适的儿童乘客安全座椅的独立和相加效应。梅西博士的职业发展活动将包括受众细分的统计分析、定性方法以及与ED环境中行为干预的设计和实施相关的高级理论和应用技术方面的正式培训。通过正式的课程学习、与她的高素质指导团队的互动以及拟议项目的执行，梅西博士将获得成为以急诊为基础的儿科伤害预防干预方面的独立研究员和专家的知识和技能。

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.