Brief motivational intervention to increase self-reported safety belt use among emergency department patients.
OBJECTIVE
Brief motivational interventions have shown promise in reducing harmful behaviors. The authors tested an intervention to increase safety belt use (SBU) among emergency department (ED) patients.


METHODS
From February 2006 to May 2006, the authors conducted a randomized trial of adult ED patients at a teaching hospital in Boston. ED patients were systematically sampled for self-reported SBU. Those with SBU other than "always" were asked to participate. At baseline, participants answered a 9-item series of situational SBU questions, each scored on a 5-point Likert scale. SBU was defined as a continuous variable (9-item average) and as a dichotomous variable (response of "always" across all items). Participants were randomized to an intervention or a control group. The intervention group received a 5- to 7-minute intervention, adapted from classic motivational interviewing techniques, by a trained interventionist. Participants completed a 3-month follow-up phone survey to determine changes from baseline SBU. Continuous and dichotomous SBU were analyzed via analysis of covariance and chi-square testing.


RESULTS
Of 432 eligible patients, 292 enrolled (mean age 35 years, standard deviation [SD] +/-11 years; 61% male). At baseline, the intervention and control groups had similar mean (+/-SD) SBU scores (2.8 [+/-1.1] vs. 2.6 [+/-1.1], p = 0.31) and SBU prevalence (each 0%). At 3 months, 81% completed follow-up. The intervention group had significantly greater improvement in mean (+/-SD) SBU scores than controls (0.76 [+/-0.91] vs. 0.34 [+/-0.88], p < 0.001). Also, SBU prevalence of "always" was higher for the intervention group than controls (14.4% vs. 5.9%, p = 0.03).


CONCLUSIONS
Participants receiving a brief motivational intervention reported higher SBU at follow-up compared to controls. An ED-based intervention may be useful to increase SBU.
Fernandez
William G
WG
Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, USA. william.fernandez@bmc.org
Mitchell
Patricia M
PM
Jamanka
Amber S
AS
Winter
Michael R
MR
Bullock
Holly
H
Donovan
Jacqueline
J
George
Jill St
JS
Feldman
James A
JA
Gallagher
Susan S
SS
McKay
Mary Pat
MP
Bernstein
Edward
E
Colton
Ted
T
D000063:Accidents, Traffic / Q000523:psychology* / Q000706:statistics & numerical data; D000328:Adult; D001900:Boston; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D012309:Risk-Taking; D012449:Safety; D012622:Seat Belts / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014193:Trauma Centers / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000209:etiology / Q000517:prevention & control*