title: Brief motivational intervention to increase self-reported safety belt use among emergency department patients.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, USA. william.fernandez@bmc.org
authors.forename: William G
authors.initials: WG
authors.lastname: Fernandez
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Mitchell
authors.forename: Amber S
authors.initials: AS
authors.lastname: Jamanka
authors.forename: Michael R
authors.initials: MR
authors.lastname: Winter
authors.forename: Holly
authors.initials: H
authors.lastname: Bullock
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Donovan
authors.forename: Jill St
authors.initials: JS
authors.lastname: George
authors.forename: James A
authors.initials: JA
authors.lastname: Feldman
authors.forename: Susan S
authors.initials: SS
authors.lastname: Gallagher
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: McKay
authors.forename: Edward
authors.initials: E
authors.lastname: Bernstein
authors.forename: Ted
authors.initials: T
authors.lastname: Colton
mesh_terms: 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*