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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：
10242737
负责人：
Michelle Lea Macy
金额：
$ 56.04万
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 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10242737
关键词：
Academy Accident and Emergency department Accidental Injury Affect African American 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.

项目总结