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The importance of a preclinical trial: a selected injury intervention program for pediatric trauma centers
Peter F Ehrlich1, Amy Drongowski, Samuel Swisher-McClure
1Department of Surgery, Section of Pediatric Surgery, University of Michigan, Ann Arbor, Michigan, USA. pehrlich@med.umich.edu
Insights
Pediatric trauma centers can effectively implement screening and brief interventions for injury prevention. This parent/child-centered approach is feasible and well-accepted by families and staff.
Area of Science:
- Pediatric trauma surgery
- Injury prevention research
- Public health interventions
Background:
- Trauma centers are ideal settings for screening and intervening in risky behaviors.
- A parent/child-centered intervention was hypothesized as a feasible injury prevention method for pediatric trauma centers.
Purpose of the Study:
- To evaluate the feasibility and acceptance of a parent/child-centered injury prevention program.
- To assess the effectiveness of screening and brief intervention for high-risk behaviors in children.
Main Methods:
- Study conducted in children aged 7-17 years at two level one pediatric trauma centers.
- Targeted high-risk behaviors included seat belt use, bicycle helmet use, and front-seat car placement for young children.
- Patients with positive screening tests received a brief intervention; endpoints included accrual, acceptability, and knowledge retention.
Main Results:
- 88% of approached families participated; 60% screened positive for at least one high-risk behavior.
- Intervention was well-integrated into trauma center routine, with 92% of healthcare professionals finding it suitable.
- At 3-month follow-up, 97% recalled key safety messages, and 79% found the information helpful.
Conclusions:
- Screening and brief intervention is a well-accepted and operationally practical method for injury prevention in pediatric trauma settings.
- The study supports further controlled trials to validate this intervention approach.
Background:
Trauma centers are an ideal site to conduct screening and intervention programs that target risk taking behaviors. We hypothesized that a parent/child-centered intervention is a feasible method of injury prevention for a level one pediatric trauma center.
Methods:
The study was conducted in children aged 7 years to 17 years at two level one pediatric trauma centers. The high-risk behaviors targeted were (i) not always using a seat belt, (ii) not always using a bicycle helmet, or (iii) placing children under 12 in the front seat of the car. Those patients who had a positive screening test underwent a brief intervention. Experimental end points included accrual rates, acceptability of protocol by patients and medical staff, knowledge retention.
Results:
Eighty-eight of the 101 families approached participated. The mean age was 13.3 +/- 2.8 years. The time to consent and screen was 2.7 +/- 0.2 minutes and 9.5 +/- 0.54 minutes. Fifty-three of 88 (60%) children had a positive screening test to one or more of the high risk behaviors. It took 11.5 +/- 1.2 minutes for intervention. Ninety-two percent of healthcare professionals felt that program fit into the trauma center routine. Forty-nine of the 53 families who had a positive screen were successfully contacted 3 months after the intervention. Ninety-seven percent of the follow-up group remembered talking about how seat belts and helmets save lives and about placing children in the back seat of a car. Seventy-nine percent of the families found the information helpful, 53% felt they learned something from the intervention.
Conclusions:
Screening and brief intervention is a well-accepted and operationally practical injury prevention intervention. Further controlled injury intervention trials are justified.
