title: Is an emergency department encounter for a motor vehicle collision truly a teachable moment?
abstract: BACKGROUND
  Some have suggested that a pediatric emergency department (PED) visit for an injury represents a "teachable moment." Our aim was to determine if a motor vehicle collision (MVC) instigates greater change in booster seat use compared with children presenting for non-injury-related complaints.
  
  
  METHODS
  A prospective pilot study of children 4 years to 8 years who never used a booster seat and were in a minor MVC were compared with children presenting to the PED for non-injury-related complaints. After completing a survey of demographics and knowledge about booster seats, all parents received brief, standardized counseling about booster seats. Two weeks after the PED visit, follow-up telephone calls were made to assess behavior change.
  
  
  RESULTS
  Sixty-seven youth were enrolled (37 MVC group, 30 controls). Initially, 65 (97%) used a seat belt alone (36 MVC, 29 controls); the rest were unrestrained. There was no difference between the groups in mean age, sex of child, or insurance type. Significantly more families in the MVC group claimed that they would get a booster seat after their PED encounter (46% vs. 19%, p = 0.02) and their child would consistently use a booster seat (54% vs. 23%, p = 0.01). At follow-up, 45 families (67%) were reached (25 cases [68%] and 20 controls [67%]). There was no significant difference between the groups in having a booster seat at follow-up (12 cases [48%] and 9 controls [45%]) and reports of booster seat use more than 75% of the time (9 cases [36%] and 7 controls [35%]).
  
  
  CONCLUSIONS
  A minor MVC did not serve as a teachable moment to entice families to consistently use a booster seat more than families presenting to a PED for non-injury-related complaints. However, more than one third of the families who learned about booster seats in the PED reported using a booster seat regularly.
  
  
  METHODS
  Therapeutic study, level II.
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio 45229, USA. mike.gittelman@cchmc.org
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gittelman
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Pomerantz
authors.forename: Mona
authors.initials: M
authors.lastname: Ho
authors.forename: Richard
authors.initials: R
authors.lastname: Hornung
authors.forename: Nicole
authors.initials: N
authors.lastname: McClanahan
mesh_terms: D000056:Accident Prevention / Q000379:methods*; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D017677:Age Distribution; D016022:Case-Control Studies; D002648:Child; D057207:Child Restraint Systems / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006776:Hospitals, Pediatric; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012309:Risk-Taking; D012622:Seat Belts / Q000706:statistics & numerical data; D017678:Sex Distribution; D014481:United States