title: Evaluation of the Boost 'em in the Back Seat Program: using fear and efficacy to increase booster seat use.
abstract: OBJECTIVE
  Recent research supports the use of high-threat messages when they are targeted appropriately and designed to promote high efficacy as well as fear. This research examined the effectiveness of using a novel threat-appeal approach to encourage parents to place their children in booster seats and rear seats of vehicles.
  
  
  METHODS
  A 6-min video-intervention was created and evaluated at after-school/daycare centers via an interrupted time series design with similar control sites for comparison. Caregivers (N=226) completed knowledge and practice surveys and fear and efficacy estimations related to childhood motor vehicle hazards. Researchers observed booster-seat and rear-seat use in study site parking lots.
  
  
  RESULTS
  Compared to baseline and control assessments, the treatment groups' child passenger safety knowledge, risk-reduction attitudes, behavioral intentions, sense of fear related to the hazard, and sense of efficacy related to the recommended behaviors increased significantly. Further, observed overall restraint use and booster-seat use increased significantly following the intervention.
  
  
  CONCLUSIONS
  Applying high-threat messages to child passenger safety interventions is promising and has the potential to be adapted to other health risk areas.
authors.affiliation: Department of Pediatrics, Williams Hall, Eastern Virginia Medical School, 855 West Brambleton Avenue, Norfolk, VA 23510-1001, USA. willke@evms.edu
authors.forename: Kelli England
authors.initials: KE
authors.lastname: Will
authors.forename: Cynthia Shier
authors.initials: CS
authors.lastname: Sabo
authors.forename: Bryan E
authors.initials: BE
authors.lastname: Porter
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D016730:Program Development; D011482:Protective Devices; D012622:Seat Belts / Q000592:standards / Q000706:statistics & numerical data*; D040241:Social Marketing; D011795:Surveys and Questionnaires; D014481:United States; D014741:Video Recording; D014768:Virginia