Efficacy of a mobile technology-based intervention for increasing parents' safety knowledge and actions: a randomized controlled trial

Lara B McKenzie, Kristin J Roberts, Rebecca J McAdams, Mahmoud Abdel-Rasoul, Orie Kristel, Alison Szymanski, Sarah A Keim, Wendy C Shields, Lara B McKenzie, Kristin J Roberts, Rebecca J McAdams, Mahmoud Abdel-Rasoul, Orie Kristel, Alison Szymanski, Sarah A Keim, Wendy C Shields

Abstract

Background: Leading causes of unintentional child injury such as poisoning and falls are preventable, and the majority occur in the home. Numerous home safety interventions have been developed and tested to increase safety behaviors; however, no smart phone-based applications (apps) have been developed and evaluated for this purpose. The objective of this study was to evaluate whether a mobile technology-based health behavior change intervention, the Make Safe Happen® app, was an effective tool to increase safety knowledge and safety actions/behaviors for the prevention of child unintentional injuries in and around the home.

Methods: Data were collected in pretest and posttest online surveys from an existing nationwide population-based survey panel. Intervention subjects were randomized to organically (participant-driven) use the Make Safe Happen® app for 1 week, which provided home safety information and the ability to purchase safety products, while control participants were assigned to download and use an app about a topic other than home safety. The primary outcomes of safety knowledge and home safety actions were assessed by using linear mixed model regressions with intention-to-treat analyses.

Results: A total of 5032 participants were randomized to either the intervention (n = 4182) or control (n = 850) group, with 2055 intervention participants downloading and entering their participant IDs into the Make Safe Happen® app. The online posttest survey was completed by 770 intervention and 283 control subjects. Mean knowledge parent safety score increased at a greater rate for intervention than control subjects (p < 0.0001), and at posttest was significantly higher for intervention than control subjects (p < 0.0001). The percentage of intervention subjects who reported doing all one-time and repeated safety actions significantly increased from pretest to posttest (p < 0.0001 and p = 0.0001, respectively), but there was no change among the control subjects (p = 0.1041 and p = 0.9755, respectively). At posttest, this percentage was larger for intervention than control subjects only for repeated safety actions (p = 0.0340).

Conclusions: The mobile application significantly improved safety knowledge and safety actions for participants using the Make Safe Happen® app, although loss to follow-up was a limitation. The results of this study indicate the usefulness of widespread distribution and use of the Make Safe Happen® app. Trial registration number NCT02751203 ; Registered April 26, 2016.

Keywords: Behavior change; Child; Home; Multiple injury; Randomized trial; Safety.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
CONSORT flowchart of study enrollment
Fig. 2
Fig. 2
Mean knowledge score by child age, study group, and pretest and posttest

References

    1. Leading causes of death and numbers of deaths, by age: United States, 1980 and 2017 Centers of Disease Control and Prevention. 2018. Available from: .
    1. CDC Childhood Injury Report Centers for Disease Control and Prevention. 2019. Available from: .
    1. WISQARS Injury Data Centers for Disease Control and Prevention. 2019. Available from: .
    1. Bergen G, Chen LH, Warner M, Fingerhut LA. Injury in the United States: 2007 chartbook. Hyattsville: National Center for Health Statistics; 2008.
    1. Kendrick D, Watson M, Mulvaney C, Burton P. How useful are home safety behaviours for predicting childhood injury? A cohort study. Health Educ Res. 2005;20(6):709–18. doi: 10.1093/her/cyh021.
    1. Poisoning Prevention Centers for Disease Control and Prevention. 2019. Available from: .
    1. Burn Prevention Centers for Disease Control and Prevention. 2019. Available from: .
    1. McKenzie LB, Roberts KJ, Kaercher RM, Collins CL, Comstock RD, Fernandez S, et al. Paediatric emergency department-based carbon monoxide detector intervention: a randomised trial. Inj Prev J Int Soc Child Adolesc Inj Prev. 2016;20:314–320.
    1. Fall Prevention Centers for Disease Control and Prevention. 2019. Available from: .
    1. Safe Kids Worldwide. Report to the nation: protecting children in your home. Washington, DC; 2015.
    1. Gaines J, Schwebel DC. Recognition of home injury risks by novice parents of toddlers. Accid Anal Prev. 2009;41(5):1070–4. doi: 10.1016/j.aap.2009.06.010.
    1. Kendrick D, Young B, Mason-Jones AJ, Ilyas N, Achana FA, Cooper NJ, et al. Home safety education and provision of safety equipment for injury prevention. Cochrane Database Syst Rev. 2012;9:Cd005014.
    1. Kendrick D, Mulvaney CA, Ye L, Stevens T, Mytton JA, Stewart-Brown S. Parenting interventions for the prevention of unintentional injuries in childhood. Cochrane Database Syst Rev. 2013;3:Cd006020.
    1. Mobile Fact Sheet Pew Research Center. 2019. Available from: .
    1. Zhao J, Freeman B, Li M. Can mobile phone apps influence people’s health behavior change? An evidence review. J Med Internet Res. 2016;18(11):e287. doi: 10.2196/jmir.5692.
    1. Omaki E, Rizzutti N, Shields W, et al. A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change. Injury Prevention. 2017;23:138–146. doi: 10.1136/injuryprev-2015-041740.
    1. Poison Control National Capital Poison Center. Contact Us. 2021. Available from: .
    1. McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, et al. A randomized controlled trial to evaluate the Make Safe Happen(R) app-a mobile technology-based safety behavior change intervention for increasing parents’ safety knowledge and actions. Inj Epidemiol. 2018;5(1):5. doi: 10.1186/s40621-018-0133-3.
    1. King WJ, LeBlanc JC, Barrowman NJ, Klassen TP, Bernard-Bonnin A-C, Robitaille Y, et al. Long term effects of a home visit to prevent childhood injury: three year follow up of a randomized trial. Inj Prev. 2005;11(2):106–9. doi: 10.1136/ip.2004.006791.
    1. King WJ, Klassen TP, LeBlanc J, Bernard-Bonnin AC, Robitaille Y, Pham B, et al. The effectiveness of a home visit to prevent childhood injury. Pediatrics. 2001;108(2):382–8. doi: 10.1542/peds.108.2.382.
    1. Horsch CH, Lancee J, Griffioen-Both F, Spruit S, Fitrianie S, Neerincx MA, et al. Mobile phone-delivered cognitive behavioral therapy for Insomnia: a randomized waitlist controlled trial. J Med Internet Res. 2017;19(4):e70. doi: 10.2196/jmir.6524.
    1. Moberg C, Niles A, Beermann D. Guided self-help works: randomized waitlist controlled trial of Pacifica, a mobile app integrating cognitive behavioral therapy and mindfulness for stress, anxiety, and depression. J Med Internet Res. 2019;21(6):e12556. doi: 10.2196/12556.
    1. Roberts KJ, McAdams RJ, Kristel OV, Szymanski AM, McKenzie LB. Qualitative and Quantitative evaluation of the Make Safe Happen app: mobile technology-based safety behavior change intervention for parents. JMIR pediatr Parent. 2019;2(1):e12022. doi: 10.2196/12022.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe