How can we teach them about neurotrauma prevention? Prospective and randomized "Pense Bem-Caxias do Sul" study with multiple interventions in preteens and adolescents.
OBJECT.: A previous study published by the authors showed that a single intervention could not change the baseline attitudes toward neurotrauma prevention. The present study was designed to evaluate the effectiveness of multiple interventions in modifying knowledge and attitudes for the prevention of neurotrauma in Brazilian preteens and adolescents.


METHODS
In a randomized controlled trial, fifth-year primary school (PS) and second-year high school (HS) students were divided into a control and 2 intervention (single/multiple) groups. The study was conducted in the following 8 stages: T1, questionnaire to measure baseline characteristics; T2, lecture on trauma prevention; T3, reapplying the questionnaire used in T1; T4, Traffic Department intervention; T5, a play about trauma and its consequences; T6, Fire Department intervention; T7, Emergency Medical Service intervention; and T8, reapplying the questionnaire used in T1 and T3. Positive answers were considered those affirming the use of safety devices "always or sometimes" and negative as "never" using safety devices.


RESULTS
The sample consisted of 535 students. Regarding attitudes, students in all groups at any stage of measurement showed protective behavior more than 95% of the time about seat belt use. There were only differences between attitudes in PS and HS students on T8 assessment concerning the use of safety equipment on bikes in the multiple-intervention group and concerning the use of safety equipment on skateboards and rollerblades in single- and multiple-intervention groups. These differences were caused mainly by the reduction in positive answers by the HS group, rather than by the increase in positive or protective answers by the PS group. However, there was no difference when the control and intervention groups were compared, independent of the attitudes or the student groups studied. The most important reason for not using protective devices was the belief that they would not get hurt.


CONCLUSIONS
Multiple and different types of educational interventions, such as lectures, scenes from plays about trauma and its consequences, traffic and fire department intervention, and medical emergency intervention directed to preteens and adolescents from public and private schools did not modify most students' attitudes toward injury prevention. Clinical trial registration no: U1111-1121-0192 (National System of Ethics and Research in Brazil).
Department of Neurology and Neurosurgery, University of Caxias do Sul;
Asdrubal
A
Falavigna
Gregory Saraiva
GS
Medeiros
Carolina Travi
CT
Canabarro
Daniel Ongaratto
DO
Barazzetti
Grasiela
G
Marcon
Gabriela Massaro
GM
Carneiro Monteiro
Júlia Bertholdo
JB
Bossardi
Pedro Guarise
PG
da Silva
Alisson Roberto
AR
Teles
Maíra Cristina
MC
Velho
Priscila
P
Ferrari
D000056:Accident Prevention / Q000379:methods*; D000063:Accidents, Traffic / Q000517:prevention & control*; D000293:Adolescent; D001290:Attitude; D001938:Brazil; D002648:Child; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D011322:Primary Prevention / Q000379:methods; D011446:Prospective Studies; D012449:Safety; D012574:Schools; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D020196:Trauma, Nervous System / Q000209:etiology / Q000517:prevention & control*; D017211:Treatment Failure
HS = high school; MI = multiple interventions; PS = primary school; Pense Bem project; SCI = spinal cord injury; SI = single intervention; TBI = traumatic brain injury; ThinkFirst; injury prevention; spinal cord injury; trauma; traumatic brain injury