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Using the Pediatric Emergency Department to Deliver Tailored Safety Messages: Results of a Randomized Controlled Trial

Shields, Wendy C. MPH*; McDonald, Eileen M. MS*; McKenzie, Lara PhD, MA; Wang, Mei-Cheng PhD; Walker, Allen R. MD§; Gielen, Andrea C. ScD*

doi: 10.1097/PEC.0b013e31828e9cd2
Original Articles

Objective: This study aimed to evaluate the impact of a computer kiosk intervention on parents’ self-reported safety knowledge as well as observed child safety seat, smoke alarm use, and safe poison storage and to compare self-reported versus observed behaviors.

Methods: A randomized controlled trial with 720 parents of young children (4 months to 5 years) was conducted in the pediatric emergency department of a level 1 pediatric trauma center. Enrolled parents received tailored safety information (intervention) or generic information (control) from a computer kiosk after completing a safety assessment. Parents were telephoned 4 to 6 months after the intervention to assess self-reported safety knowledge and behaviors; in-home observations were made 1 week after the telephone interview for a subset of 100 randomly selected participants. Positive and negative predictive values were compared between the intervention and control groups.

Results: The intervention group had significantly higher smoke alarm (82% vs 78%) and poison storage (83% vs 78%) knowledge scores. The intervention group was more likely to report correct child safety seat use (odds ratio, 1.36; 95% confidence interval, 1.05–1.77; P = 0.02). Observed safety behaviors were lower than self-reported use for both groups. No differences were found between groups for positive or negative predictive values.

Conclusions: These results add to the limited literature on the impact of computer tailoring home safety information. Knowledge gains were evident 4 months after intervention. Discrepancies between observed and self-reported behavior are concerning because the quality of a tailored intervention depends on the accuracy of participant self-reporting. Improved measures should be developed to encourage accurate reporting of safety behaviors.

From the *Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, OH; ‡Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health; and §Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.

Disclosure: The authors declare no conflict of interest.

Reprints: Wendy C. Shields, MPH, Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Room 519 Baltimore, MD 21205 (e-mail:

Preparation of this article was supported by the Cooperative Agreement number 5R49CE001507 from the Centers for Disease Control and Prevention (CDC). Data collection for this research was funded a grant to Johns Hopkins Bloomberg School of Public Health from the National Institute of Child Health and Human Development, grant no. 5RO1 HD042777-03, and a subcontract to the Health Communication Research Laboratory at Saint Louis University.

© 2013 Lippincott Williams & Wilkins, Inc.