title: Using the pediatric emergency department to deliver tailored safety messages: results of a randomized controlled trial.
abstract: OBJECTIVE
  This study aimed to evaluate the impact of a computer kiosk intervention on parents' self-reported safety knowledge as well as observed child safety seat, smoke alarm use, and safe poison storage and to compare self-reported versus observed behaviors.
  
  
  METHODS
  A randomized controlled trial with 720 parents of young children (4 months to 5 years) was conducted in the pediatric emergency department of a level 1 pediatric trauma center. Enrolled parents received tailored safety information (intervention) or generic information (control) from a computer kiosk after completing a safety assessment. Parents were telephoned 4 to 6 months after the intervention to assess self-reported safety knowledge and behaviors; in-home observations were made 1 week after the telephone interview for a subset of 100 randomly selected participants. Positive and negative predictive values were compared between the intervention and control groups.
  
  
  RESULTS
  The intervention group had significantly higher smoke alarm (82% vs. 78%) and poison storage (83% vs 78%) knowledge scores. The intervention group was more likely to report correct child safety seat use (odds ratio, 1.36; 95% confidence interval, 1.05-1.77; P = 0.02). Observed safety behaviors were lower than self-reported use for both groups. No differences were found between groups for positive or negative predictive values.
  
  
  CONCLUSIONS
  These results add to the limited literature on the impact of computer tailoring home safety information. Knowledge gains were evident 4 months after intervention. Discrepancies between observed and self-reported behavior are concerning because the quality of a tailored intervention depends on the accuracy of participant self-reporting. Improved measures should be developed to encourage accurate reporting of safety behaviors.
authors.affiliation: Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. wshields@jhsph.edu
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Shields
authors.forename: Eileen M
authors.initials: EM
authors.lastname: McDonald
authors.forename: Lara
authors.initials: L
authors.lastname: McKenzie
authors.forename: Mei-Cheng
authors.initials: MC
authors.lastname: Wang
authors.forename: Allen R
authors.initials: AR
authors.lastname: Walker
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Gielen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D057207:Child Restraint Systems / Q000706:statistics & numerical data; D002675:Child, Preschool; D004356:Drug Storage / Q000592:standards; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D010290:Parents / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods / Q000458:organization & administration*; D010372:Pediatrics; D011237:Predictive Value of Tests; D015397:Program Evaluation; D012153:Retention, Psychology; D040242:Risk Reduction Behavior; D012449:Safety; D057566:Self Report; D012906:Smoke; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D012906:Smoke