Randomized trial of enhanced anticipatory guidance for injury prevention.
OBJECTIVE
To develop and evaluate an injury prevention anticipatory guidance training program for pediatric residents.


METHODS
Thirty-one residents were randomly assigned to an intervention or control group. Both groups attended a 1-hour seminar about injury prevention and the American Academy of Pediatrics TIPP (The Injury Prevention Program) materials. The intervention group also received 5 hours of experiential instruction on injury prevention content and counseling skills (SAFE Counseling Framework). Families with infants from birth to age 6 months were enrolled in the study (N = 196); they were followed up until the child was aged 12 to 18 months. Data were collected by means of baseline and follow-up interviews, audiotapes of medical visits, parent exit surveys, and home observations.


METHODS
A hospital-based continuity clinic that serves families living in low-income, inner-city neighborhoods.


RESULTS
Physician counseling and parent satisfaction, knowledge, beliefs, and behaviors.


RESULTS
Parents seen by physicians in the intervention group received significantly more injury prevention counseling for 5 of the 6 safety practices, and they were significantly more satisfied with the help their physicians provided on safety topics. They were no less satisfied with their physicians' counseling on other anticipatory guidance topics. Parents' knowledge, beliefs, and home safety behaviors did not differ between the 2 groups.


CONCLUSIONS
The frequency and impact of pediatric counseling can be enhanced by experiential training that targets specific injury hazards. Because low-income families face many barriers to carrying out the recommended safety practices, supplemental strategies are needed to ensure safer homes.
Gielen
A C
AC
Center for Injury Research and Policy, Johns Hopkins University, School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA. agielen@jhsph.edu
Wilson
M E
ME
McDonald
E M
EM
Serwint
J R
JR
Andrews
J S
JS
Hwang
W T
WT
Wang
M C
MC
D000061:Accidents, Home / Q000517:prevention & control; D000328:Adult; D001294:Attitude to Health; D003376:Counseling / Q000193:education*; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D007318:Inservice Training / Q000458:organization & administration*; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D010290:Parents / Q000193:education* / Q000523:psychology; D010372:Pediatrics / Q000193:education*; D015397:Program Evaluation; D012449:Safety; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000517:prevention & control*