title: Assessing the knowledge of all-terrain vehicle safety for children among Alabama pediatricians.
abstract: BACKGROUND
  Since 1987, the American Academy of Pediatrics (AAP) has had a policy regarding the use of all-terrain vehicles (ATVs) by children, which calls for pediatricians to educate families regarding the dangers of ATV use and to give recommendations for safety. Given the high incidence of ATV-related injuries in Alabama, our objective was to determine if pediatricians in our state are educating patients on ATV hazards and safety.
  
  
  METHODS
  All general pediatricians in Alabama who are members of the AAP were asked to complete a survey distributed through e-mail using Survey Monkey® (Survey Monkey Palo Alto, Calif). Data were entered into Microsoft® Excel (Microsoft Corporation Redmond, Wash).
  
  
  RESULTS
  Of the 353 general pediatricians in Alabama, 104 responded. Forty-one percent of the respondents were not aware that there is an AAP policy. Of the 59% who knew of the policy, 36% correctly identified the age limit recommendations. Forty-eight percent said that they routinely give anticipatory guidance regarding ATV use. Of them, 63% gave age recommendations younger than stated in the AAP policy. In addition, only 52% of them recommend helmet use, 5% recommend use of reflective clothing, 35% discourage passenger riding, and 8% encourage ATV training classes. Respondents who had patients treated for ATV-related injuries were more likely to give anticipatory guidance than those who had not had patients treated (χ² = 5.3; P = 0.02; odds ratio, 3.9 [95% confidence interval, 1.2-13.6]). Respondents who practice in rural areas were more likely not to give anticipatory guidance than those who practice in urban areas (χ² = 2.1; P = 0.14; odds ratio, 2.9 [95% confidence interval, 0.8-5.4]).
  
  
  CONCLUSIONS
  Many general pediatricians in a state where ATV use is popular are not familiar with the current AAP policy and do not routinely follow its guidelines. Given the high incidence of ATV-related injuries and the complexities of general practice, exploring multiple methods to modify risk-taking ATV behavior is warranted.
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA. mfrascogna@umsmed.edu
authors.forename: Melissa Nan
authors.initials: MN
authors.lastname: Frascogna
authors.forename: Bill
authors.initials: B
authors.lastname: King
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lycans
authors.forename: Michele
authors.initials: M
authors.lastname: Nichols
authors.forename: Kathy
authors.initials: K
authors.lastname: Monroe
mesh_terms: D000328:Adult; D000407:Alabama; D002648:Child; D003376:Counseling / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D015541:Off-Road Motor Vehicles; D010372:Pediatrics; D010819:Physician's Role; D012955:Societies, Medical