title: Evaluating a Website to Teach Children Safety with Dogs: A Randomized Controlled Trial.
abstract: Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A randomized controlled trial was conducted with 69 children aged 4-5 randomly assigned to use the dog safety website or a control transportation safety website for ~3 weeks. Assessment of dog safety knowledge and behavior plus skill in three relevant cognitive constructs (impulse control, noticing details, and perspective-taking) was conducted both at baseline and following website use. The dog safety website incorporated interactive games, instructional videos including testimonials, a motivational rewards system, and messaging to parents concerning child lessons. Our results showed that about two-thirds of the intervention sample was not adherent to website use at home, so both intent-to-treat and per-protocol analyses were conducted. Intent-to-treat analyses yielded mostly null results. Per-protocol analyses suggested children compliant to the intervention protocol scored higher on knowledge and recognition of safe behavior with dogs following the intervention compared to the control group. Adherent children also had improved scores post-intervention on the cognitive skill of noticing details compared to the control group. We concluded that young children's immature cognition can lead to dog bites. Interactive eHealth training on websites shows potential to teach children relevant cognitive and safety skills to reduce risk. Compliance to website use is a challenge, and some relevant cognitive skills (e.g., noticing details) may be more amenable to computer-based training than others (e.g., impulse control).
authors.affiliation: UAB Youth Safety Lab, Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA. schwebel@uab.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Schwebel
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA. pli@uab.edu.
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA. lam439@drexel.edu.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: McClure
authors.affiliation: Digital Artefacts, LLC, Iowa City, IA 52240, USA. joan@digitalartefacts.com.
authors.forename: Joan
authors.initials: J
authors.lastname: Severson
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000517:prevention & control*; D002657:Child Development; D002669:Child Welfare; D002675:Child, Preschool; D004285:Dogs; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D012449:Safety; D017216:Telemedicine / Q000379:methods*
keywords: cognitive development; dog bite; ehealth; prevention; safety; website