Results of an RCT in Two Pediatric Emergency Departments to Evaluate the Efficacy of an m-Health Educational App on Car Seat Use

Abstract

Introduction: The growing interest in incorporating prevention into emergency health care make it timely to examine the use of computer technology to efficiently deliver effective education in this setting. Study design: This RCT compared results from an intervention group (n=367) that received child passenger safety information, to an attention-matched control (n=375). A baseline survey and two follow-up surveys at 3 and 6 months were conducted. Setting/participants: Data were collected from June 2014 to September 2016 from a sample of parents with children aged 4–7 years recruited from a pediatric emergency department in an East Coast urban area and one in a Midwest semi-rural area. Intervention: A theory-based, stage-tailored educational program, Safety in Seconds v2.0TM, delivered on a mobile app. Main outcome measures: Four car seat behaviors: (1) having the correct restraint for the child's age and weight; (2) having the child ride in the backseat all the time; (3) buckling up the child all the time; and (4) having the child's restraint inspected by a child passenger safety technician. Results: At 3 months, adjusting for baseline behaviors and attrition, the odds of reporting the correct behavior by the intervention group relative to the control group was 2.07 (p<0.01) for using the correct car seat; 2.37 (p<0.05) times for having the child ride in the back seat; 1.04 (nonsignificant) for riding buckled up all the time; and 1.99 (p<0.01) times for having the car seat inspected. At 6 months, there were statistically significant effects for reporting use of the correct car seat (OR=1.84, p<0.01) and having the car seat inspected (OR=1.73, p<0.01). Conclusions: Mobile apps hold promise for reaching large populations with individually tailored child passenger safety education. Trial registration: Clinical Trial Registration # NCT02345941.