title: Six-month follow-up of a brief intervention on self-reported safety belt use among emergency department patients.
abstract: OBJECTIVE
  Safety belt use (SBU) reduces motor vehicle deaths by 45%. We previously reported that a brief intervention improved self-reported SBU among emergency department (ED) patients at 3 months. We sought to determine if these effects were sustained at 6 months postenrollment.
  
  
  METHODS
  This was a prospective, randomized controlled trial of adult patients (age > or = 21 years) at an academic medical center ED from February 2006 to May 2006. Patients were systematically sampled for self-reported SBU. Those with self-reported SBU less than "always" were asked to participate. Subjects were surveyed at baseline with a nine-item series of situational SBU questions scored on a five-point Likert scale (e.g., 5 = always, 1 = never). This nine-item average comprised the mean SBU score. Subjects were randomized to a control group (CG) and an intervention group (IG). The CG received an injury prevention brochure; the IG received a brief motivation interview by a trained interventionist and the brochure. Subjects were phoned at 3 and 6 months to determine interval change in SBU scores via a standard script. Repeated-measures analysis of covariance and t-tests were used to analyze trends in mean SBU scores between groups, as well as to test mean changes in SBU scores from the 3- to 6-month intervals.
  
  
  RESULTS
  Of 432 eligible patients, 292 enrolled (mean age = 35 years, SD +/- 11.2 years; 61% male). At baseline, there were no significant demographic differences; the IG (n = 147) and CG (n = 145) had similar mean SBU scores (2.8 vs. 2.6, p = 0.31), and 66% (n = 96 in each) completed both 3- and 6-month follow-up. The mean SBU score at 6 months in the IG was greater than in the CG group (3.6 vs. 2.9, p < 0.001), as were the mean SBU score differences from baseline (IG = 0.84 vs. CG = 0.29, p < 0.001). These differences were sustained from the 3-month interval (IG = -0.02 vs. CG = -0.06, p > 0.05).
  
  
  CONCLUSIONS
  The previously reported finding that ED patients who received a brief motivation interview reported higher SBU scores at 3 months compared to a CG was sustained at 6-month follow-up. Although limited by self-report, a brief intervention may enhance lasting SBU behavior among high-risk ED patients.
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: Michael R
authors.initials: MR
authors.lastname: Winter
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Mitchell
authors.forename: Holly
authors.initials: H
authors.lastname: Bullock
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Donovan
authors.forename: Jill
authors.initials: J
authors.lastname: St 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: Theodore
authors.initials: T
authors.lastname: Colton
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D010353:Patient Education as Topic; D011446:Prospective Studies; D012622:Seat Belts / Q000706:statistics & numerical data*; D055815:Young Adult