POSTER TEMPLATE BY: SAFE-SEAT: An Education Program on Child Passenger Safety for Pediatric Residents Anita Mantha MD 1, Kristen Beckworth 2, John Ansiaux 2, Carol Chen MD 3, Benjamin Hoffman MD, FAAP 4, Rohit Shenoi MD 3 (1) Baylor College of Medicine, BCM (2) Texas Children’s Hospital, Center for Childhood Injury Prevention, (3) Pediatric Emergency Medicine, BCM (4) Oregon Health and Science University Background Demographics Preliminary Results Motor vehicle crashes are a leading cause of death in US children The CDC recommends using age- and size-appropriate child safety seats (CSS) to reduce injuries 43% of physicians report having received no training in child passenger safety (CPS) and only 37% know where to refer caregivers for more information Baylor pediatric residents have no formal curriculum on CPS Content validity: assessed by 2 pediatricians and 2 CPS technicians Construct validity: Significant difference in mean scores between 8 allied-health students (novices) and 10 CPS trained technicians (experts). Mean (Std. Dev.) scores for novices: 4.3 (+ 1.5); experts: 9.7 (+ 0.2) Inter-rater reliability: 2 CPS technicians assessed accuracy of students in installing CSS using above assessment tool. Inter-rater reliability was κ = 0.75 Objectives 1.Assess learner knowledge and skills in Child Safety Seat (CSS) installation 2.Administer an educational intervention in CSS installation 3.Reassess CSS knowledge and skill retention after 6 months 4.Utilize information to provide future residents the opportunity to learn correct car seat installation methods Validation of Knowledge Instrument References 1. Muller VM et al. Evaluation of a child passenger safety class in increasing parental knowledge. Accid Anal Prev. 2014; 63: Rothenstein J et al. Community paediatricians' counseling patterns and knowledge of recommendations relating to child restraint use in motor vehicles. Inj Prev. 2004; 10: Brixey SN, Guse CE. Knowledge and behaviors of physicians and caregivers about appropriate child passenger restraint use. J Community Health. 2009; 34: Cohen LR e al. Social determinants of pediatric residents‘ injury prevention counseling. Arch Pediatr Adolesc Med. 1998; 152: Wright MS. Pediatric injury prevention. Preparing residents for patient counseling. Arch Pediatr Adolesc Med. 1997:151: Tessier K. Effectiveness of hands-on education for correct child restraint use by parents. Accid Anal Prev. 2010; 42: Hands- On OnlineP-value Mean baseline knowledge scores (Std. dev) a 6.2 (1.5)5.7 (1.7)0.36 Post-intervention knowledge scores (Std. dev) d 9.3 (0.8)8.4 (1.5)0.025 Gain in Pre-Post intervention knowledge scores (Std. dev) 3.1 (1.5)2.6 (1/2)0.37 Mean follow up knowledge scores (Std. dev) d 7.4 (1.6)7 (2.1)0.66 Gain in long-term knowledge scores from baseline (std. dev) 1.6 (1/5)1.3 (1.1)0.62 a,d Maximum 10 points, b Maximum 6 points, c Maximum 7 points *follow up at 6-11 months Comparison of Knowledge Scores at Baseline, Post-intervention, and at Follow-up Between Groups Study design Hands-on group (n=22) Online group (n=17) Median age (years)28 Percentage female77%94% Previously installed seat 9.1%19% Previous CPS instruction 32%19% Minimal to no Confidence in seat installation 63%69% 1.Statistically significant improvement in mean pre-post test knowledge and long-term knowledge scores for both groups 2.Hands-on group: improvement in CSS installation scores at follow-up (n=11) was statistically significant for forward-facing seats: 0.91 (95% CI: 0.15 – 1.7) and rear-facing seats: 0.91 (95% CI: 0.2 – 1.6) 3.Online group: improvement in CSS installation scores at follow up (n=9) was statistically significant for forward-facing seats: 1.7 (95% CI: 0.5 – 2.8) but not for rear-facing seats: 0.0 (95% CI: -1.5 – 1.5) Prospective, Randomized study with cross-over design comparing two types of education methods in child passenger safety (CPS) 1) Hands-on education performed by certified CPS technician 2) Online education with a 60 minute American Academy of Pediatrics module Group 1: Hands-on education followed by Online module after 6 months Group 2: Online module followed by Hands-on education after 6 months Baseline CPS knowledge assessed using validated 10-item questionnaire Baseline CSS skills assessed using Safe-Kids ® assessment tool for forward CSS (6-items) and rear facing CSS (7-items) –Each correct item on questionnaire and assessment tool given 1 point –Participants could access product manual during CSS installation CSS installation skills and knowledge were assessed after 6 months and compared between group Pre- post intervention knowledge improvement was assessed using t-tests Study approved by Baylor College of Medicine Institutional Review Board 1.Both methods of CPS education (hands-on and online) are equivalent in producing short and long-term improvement in pediatric residents’ knowledge 2. Hands-on education improves long-term CSS installation skills but the results are indeterminate for online education Preliminary Conclusions Limitations: 1.Larger sample size is needed to improve the accuracy of the results 2.Needs to be tested in other groups of learners such as allied health, nursing, etc. FORWARD-FACING SEAT Hands-onOnlinep-value Baselinen=22n=17 Mean baseline CSS installation scores (std. dev) 4.7 (1.3)4.0 (1.5)0.14 Follow-upn=11n=9 Mean forward-facing CSS installation scores (std. dev) 5.3 (1.1)5.0 (1.0)0.55 Improvement in forward-facing scores 0.9 (1.1)1.7 (1.5)0.2 CSS Installation Scores at Baseline and Follow-up for Forward- Facing and Rear-Facing Seats by Group REAR-FACING SEATHands-onOnlinep-value Baselinen=22n=17 Mean rear-facing CSS installation scores (std. dev) 5.1 (1.1)4.9 (1.3)0.5 Follow-upn=11n=9 Mean rear-facing CSS installation scores (std. dev) 5.9 (1.2)4.6 (1.6)0.045* Improvement in rear-facing scores0.9(1.0)0.0 (1.9)0.2 Forward–facing: maximum 6 points Rear-facing: maximum 7 points