Randomized Control Trial of Booster Seat Education Material to Increase Perceived Benefit Among Parents

NCT03573830 | Completed Results

• 1 other identifier: H14-01569
• Study Type: interventional
• Target: 731
• Locations: 1 country
• Sites: 1

Brief Summary

Seat belts protect people from injuries by diverting crash forces to stronger anatomical structures: the rib cage and the pelvis. Children between the ages of 4 and 8 years are typically not tall enough to wear the seat belt correctly across the chest and hips, and instead wear it on their abdomen and neck. When worn in this way, seat belts direct crash forces to these parts of the body, potentially causing serious damage to internal organs and the spine. For this reason, children of these ages need to use a booster seat; a safety device that prevents seat belt related injuries by raising the child and ensuring the straps are correctly worn across the thorax and hips. In Canada, half of the children who should be using booster seats are prematurely restrained using only the seat belt. The present research project seeks to develop and test a novel intervention to encourage booster seat use. Many Canadian provinces have enacted laws mandating use, and have developed and implemented evidence-based education programs. Despite these efforts, new approaches to encourage booster seat use are required. In 2010, more than 10 years after booster seats became mandatory, the rate of utilization in the Canadian provinces of Ontario and Quebec was still low (25%). Furthermore, recent research indicates that parents' perception of the safety benefit of booster seats is the strongest predictor of use, yet no study to date has tested an education intervention that increases perceived benefit; instead, these interventions focus on teaching guidelines (i.e., minimum and maximum age, height, and weight to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt). The present approach to encouraging booster seat use is novel, because it increases perceived benefit by teaching two principles: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (internal organs and spine). Once parents grasp these two principles, they are expected to better appreciate the safety benefit of booster seats and, thus, be more likely to use them.

Conditions

Wounds and Injuries

Keywords

Child Passenger Injury; Child Restraint Systems; Traffic Accidents

Outcome Measures

Primary Outcomes (2)

• Change in Perceived Safety Benefit of Booster Seats

  Assessed with the Perceived Benefit sub-scale of the BSASabb (an abridged version of the Booster Seat Attitudes Scale, Cunningham et al., 2011). The Perceived Benefit subscale evaluates parents' perception of the general safety afforded by booster seats (e.g., prevents children from being injured during normal driving). The Perceived Benefit sub-scale of the BSASabb ranges from 1 to 5, and higher scores mean better outcome.

  Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

• Change in Key Benefit of Booster Seats

  Change in key safety was measured as the difference between post- and pre-intervention scores assessed with the Key Benefit sub-scale of the BSASabb (an abridged version of the Booster Seat Attitudes Scale, Cunningham et al., 2011). The Key Benefit sub-scale evaluates parents' perception of the safety afforded by booster seats in relation to potentially fatal injuries to the spine and neck, a key feature of booster seats. The Key Benefit sub-scale of the BSASabb ranges from 1 to 5 and higher scores mean better outcome.

  Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

Secondary Outcomes (7)

• Change in Intention to Use Booster Seats

  Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

• General Knowledge of Booster Seats

  immediately after intervention (the mean duration of the intervention was 3 minutes)

• Projected Intent to Use

  Immediately after intervention (the mean duration of the intervention was 3 minutes)

• Interest in the Communication Material

  Immediately after intervention (the mean duration of the intervention was 3 minutes)

• Interest in Additional Information

  Immediately after intervention (the mean duration of the intervention was 3 minutes)

Study Arms (2)

Current material

ACTIVE COMPARATOR

Participants in this arm will be shown the online Transport Canada Material that is currently available at: https://www.tc.gc.ca/en/services/road/child-car-seat-safety/installing-using-child-car-seat-booster-seat-seat-belt/stage-3-booster-seats.html

Behavioral: Transport Canada material

Enhanced material

EXPERIMENTAL

Participants in this arm will be shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts.

Behavioral: Enhanced material

Interventions

Transport Canada material BEHAVIORAL

The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).

Also known as: Current Transport Canada material

Current material

Enhanced material BEHAVIORAL

Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).

Also known as: Enhanced Transport Canada material

Enhanced material

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Parents of children 4 thorough 8 years old
• Residing in any Canadian Province
• Fluent in English
• Drive with their child at least once a month

You may not qualify if:

• \- Child has a physical condition that requires special transportation

Sponsors & Collaborators

• University of British Columbia: lead
• Child and Family Research Institute: collaborator

Study Sites (1)

British Columbia Children's Hospital Research Institute

Vancouver, British Columbia, V6H 3V4, Canada

Location

Related Publications (4)

• Cunningham CE, Bruce BS, Snowdon AW, Chen Y, Kolga C, Piotrowski C, Warda L, Correale H, Clark E, Barwick M. Modeling improvements in booster seat use: a discrete choice conjoint experiment. Accid Anal Prev. 2011 Nov;43(6):1999-2009. doi: 10.1016/j.aap.2011.05.018. Epub 2011 Jun 25.

  PMID: 21819828 BACKGROUND

• Committee on Injury, Violence, and Poison Prevention; Durbin DR. Child passenger safety. Pediatrics. 2011 Apr;127(4):788-93. doi: 10.1542/peds.2011-0213. Epub 2011 Mar 21.

  PMID: 21422088 BACKGROUND

• Ishikawa T, Jiang A, Brussoni M, Reyna V, Weldon B, Bruce B, Pike I. Perceptions of injury risk associated with booster seats and seatbelts: the ejection stereotype hypothesis. Hypothesis Journal 15(1): e1.

  BACKGROUND

• A. W. Snowdon, A. Hussein, E. Ahmed, "Canadian National Survey on Child Restraint Use 2010" (AUTO21, 2011). https://www.tc.gc.ca/eng/motorvehiclesafety/resources-researchstats-child-restraint-survey-2010-1207.htm

  BACKGROUND

Related Links

• Transport Canada information on booster seats

MeSH Terms

Conditions

Wounds and Injuries

Limitations and Caveats

First: It is difficult to determine if findings are behaviorally meaningful, because the instruments used are new. Second: The presence of ceiling effects indicate that the effect was underestimated.

Results Point of Contact

• Title: Dr. Mariana Brussoni
• Organization: BC Children's Hospital Research Institute

mbrussoni@bcchr.ubc.ca

(604) 875-3712

Study Officials

• Mariana Brussoni, PhD

  University of British Columbia, BC Children's Hospital Research Institute

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: PARTICIPANT MASKING: Participants will be told the purpose of the study is to evaluate parents' reactions to two different information materials about booster seats and seatbelts. INVESTIGATOR MASKING: The study will be conducted entirely online using a online research platform, so allocation will be masked to all investigators. OUTCOMES ASSESSOR MASKING: Outcome evaluation will be conducted online using an online survey tool, so allocation will be masked to outcome assessors. STATISTICAL ANALYSIS: Allocation in the online survey will be coded using random numbers unknown to the person conducting statistical analysis.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 5, 2018
• First Posted: June 29, 2018
• Study Start: December 10, 2018
• Primary Completion: December 28, 2018
• Study Completion: December 28, 2018
• Last Updated: November 24, 2020
• Results First Posted: November 24, 2020

Record last verified: 2020-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
• Time Frame: until 2025
• Access Criteria: Amy scholarly requests will be considered.

Locations

CA (1)