A brief tailored family-centered seat belt intervention for hospitalized trauma patients.

Ehrlich, Peter F.; Cunningham, Rebecca; Walton, Maureen · 2010 · ROSA P / University of Michigan. Transportation Research Institute

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Summary

This study addresses the high morbidity and mortality associated with motor vehicle crashes among children, specifically targeting the subset of hospitalized trauma patients who are part-time seat belt users. The research was motivated by data indicating that while seat belts significantly reduce injury severity, less than 50% of children hospitalized for motor vehicle crash injuries were restrained at the time of the accident. Prior research demonstrated that parental seat belt use is a primary determinant of child restraint behavior, suggesting that family-centered interventions could effectively modify safety practices. The study aimed to develop and test a brief, tailored, family-centered seat belt brief intervention (SBBI) based on Motivational Interviewing and the Stages of Change model, comparing it against an enhanced usual care (EUC) control condition consisting of informational pamphlets. The randomized controlled trial was conducted at the University of Michigan’s CS Mott Children’s Hospital, a Level I pediatric trauma center, between April and October 2009. Eligible participants were children aged 7–14 admitted with injuries (excluding sexual assault and suicide) who self-reported inconsistent seat belt use, improper seating position, or lack of booster seat use. Of 301 eligible children, 130 participated, and 115 completed the one-month follow-up. Participants were randomized to either the SBBI, which involved age-appropriate, interactive counseling sessions with both the child and parent to explore ambivalence and develop behavioral plans, or the EUC group, which received standard safety pamphlets. Data were collected via surveys assessing knowledge, attitudes, self-efficacy, and behavioral intentions, with primary outcomes measured at one month post-intervention. The results indicated that both groups improved their self-reported seat belt use at one month, with 56% of children who previously did not always wear seat belts reporting consistent use. However, there was no statistically significant difference in seat belt use between the SBBI and EUC groups (p=0.06). Logistic regression identified baseline readiness to change as the strongest predictor of behavior change, followed by participation in the SBBI. While overall seat belt use did not differ significantly between groups, the SBBI was significantly more effective than the EUC in promoting correct child seating positions (sitting in the back seat) and booster seat use among children under eight. Additionally, participation in the SBBI was associated with significant improvements in positive attitudes, knowledge, and commitment to change compared to the control group. Parental seat belt use also improved in both groups, with the EUC group showing statistically significant improvement. The study concludes that brief interventions in a trauma setting are feasible and can leverage the "teachable moment" of injury to improve safety behaviors. Although the SBBI did not significantly outperform the enhanced control condition in overall seat belt use, it demonstrated superior efficacy in specific safety practices like booster seat usage and proper seating positioning. The findings suggest that even minimal interventions, such as screening and providing information, can yield behavioral changes, potentially explaining the lack of difference in primary outcomes. The authors recommend further research with larger sample sizes to determine if the tailored SBBI offers distinct advantages over standard informational interventions and emphasize the importance of targeting both parents and children to address the social norms influencing safety behavior.

Key finding

The tailored family-centered intervention significantly improved child seating position and booster seat usage compared to enhanced usual care, although overall seat belt use improvements did not differ significantly between groups.

Methodology

lab_experiment

Sample size: 130

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• seat belt use
• child passenger safety
• parental management

Information type

What kind of knowledge this paper contributes, grouped by family — independent of topic (what it is about) and method (how it was studied).

• Applied Guidance: countermeasure evaluation
• Empirical Findings: observational prevalence