@article{ref1,
title="Pilot trial of an emergency department-based intervention to promote child passenger safety best practices",
journal="Academic emergency medicine",
year="2019",
author="Macy, Michelle L. and Kandasamy, Deepika and Resnicow, Ken and Cunningham, Rebecca M.",
volume="26",
number="7",
pages="770-783",
abstract="BACKGROUND: Despite demonstrated effectiveness of child restraint systems (CRSs), use remains suboptimal. In this randomized pilot trial, we sought to determine the feasibility, acceptability, and potential efficacy of &quot;Tiny Cargo, Big Deal&quot; an ED-based intervention to promote guideline-concordant size-appropriate CRS use. <br><br>METHODS: Parents of children < 11 years old were recruited in two EDs and randomized in a 2 × 2 factorial design to four conditions: 1) generic information sheet, 2) tailored brochure mailed after the ED visit, 3) a single motivational interviewing-based counseling session in the ED, and 4) full intervention (counseling session plus tailored brochure). We assessed feasibility (recruitment, completion, follow-up rates) and acceptability (parent attitudes, uptake of information) in the ED, at 1 month and at 6 months. We obtained preliminary estimates of effect sizes of the intervention components on appropriate CRS use at 6-month follow-up. <br><br>RESULTS: Of the 514 parents assessed for eligibility, 456 met inclusion criteria and 347 consented to participate. Enrolled parents were mostly mothers (88.1%); 48.7% were 18 to 29 years old; 52.5% were non-Hispanic, white; and 65.2% reported size-appropriate CRS use. Completion rates were 97.7% for baseline survey, 81.6% for counseling, 51.9% for 1-month follow-up, and 59.3% for 6-month follow-up. In the ED, 70.5% rated thinking about child passenger safety in the ED as very helpful. At 1 month, 70.0% expressed positive attitudes toward the study. Of 132 parents who reported receiving study mailings, 78.9% reviewed the information. Parents randomized to the full intervention demonstrated an increase (+6.12 percentage points) and other groups a decrease (-1.69 to -9.3 percentage points) in the proportion of children reported to use a size-appropriate CRS at 6-month follow-up. <br><br>CONCLUSIONS: Suboptimal CRS use can be identified and intervened upon during a child's ED visit. A combined approach with ED-based counseling and mailed tailored brochures shows promise to improve size-appropriate CRS use.<br><br>© 2019 by the Society for Academic Emergency Medicine.<p /> <p>Language: en</p>",
language="en",
issn="1069-6563",
doi="10.1111/acem.13687",
url="http://dx.doi.org/10.1111/acem.13687"
}