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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.