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: 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
• 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

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）：本提案是1 RO 1HD 069221的修订版。我们正在解决的需要，在紧急医疗服务的背景下，特别是使用计算机技术的行为改变干预评估的预防创新研究。我们建议在两个儿科急诊科（PED）和一个1级儿科创伤服务（PTS）中测试一种基于网络的、理论驱动的、计算机量身定制的儿童乘客安全干预措施，为不同人群提供服务。该提案的重点是父母为8岁及以下儿童使用儿童约束装置（CRD）--汽车安全座椅（CSS）和安全带定位助推器座椅（BPBS）。之所以选择这些安全行为，是因为它们是已知的有效对策，有助于防止机动车乘员受伤，这是美国儿童死亡的主要原因。虽然CSS用于年幼的儿童是常见的，但在人群中存在差异，BPBS用于年长儿童的比例很低，CRD的滥用很普遍。 我们以前的工作，包括NICHD资助的秒安全性（SIS）研究和其他研究，已经证明计算机定制的干预措施在临床环境中是可行和有效的，包括PED。然而，我们的工作是我们所知的唯一一项将这项技术应用于CSS和BPBS特定问题的研究，也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，计算机定制的程序，在一个PED中在低收入，城市和主要是非洲裔美国人的人群中取得了一些成功。该提案将测试一个增强的基于网络的计划，安全在第二次v 2.0（SIS v2.0），与英语和西班牙语的家庭从巴尔的摩，马里兰州和小石城，AR。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以前的工作：在PTS中测试该程序;测试西班牙语版本;并添加短信提醒和可以多次访问的门户网站，以加强教育信息。评估方案的成本效益，确定方案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。 本研究的具体目的是：1）评估一个基于网络的、量身定制的计划对英语和西班牙语父母的儿童乘客安全知识、预防信念以及对0-8岁儿童正确和一致地使用CSS和BPBS的影响; 2）评估该计划对父母为他们的孩子使用BPBS的成本效益比;以及3）确定PED和PTS环境中采用和实施计划的障碍和促进因素。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“秒内安全”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）对1，650名父母进行的随机对照试验（600例JH-PED、450例JH-PTS、600例AR-PED），包括基线和6个月随访评估以及CSS观察; c）从医疗索赔第三方支付者的角度对该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的计划采用和实施进行深入研究。 随着计算机的普及，本研究的成果将对向广大受众传播有效的CSS和BPBS行为改变计划具有广泛的实用性，我们将在一个新的领域推进计算机裁剪理论和方法的应用。