Buckle Up Safely (Shoalhaven): A Process and Impact Evaluation of a Pragmatic, Multifaceted Preschool-Based Pilot Program to Increase Correct Use of Age-Appropriate Child Restraints. Hunter, K., Keay, L., Clapham, K., Lyford, M., Brown, J., Bilston, L., Simpson, J., M., Stevenson, M., & Ivers, R., Q. Traffic Injury Prevention, 15(5):483-490, Taylor and Francis Inc., 2014.
abstract   bibtex   
Objective: To conduct a process and impact evaluation of a multifaceted\neducation-based pilot program targeting correct use of age-appropriate\nrestraints in a regional setting with a high proportion of Aboriginal\nand Torres Strait Islander families.\nMethods: The program was delivered in 2010 in 3 early learning centers\nwhere 31 percent of the children were of Aboriginal and Torres Strait\nIslander descent. Each component of the program was assessed for message\nconsistency and uptake. To measure program effectiveness, participating\nchildren were matched 1:1 by age, language spoken at home, and annual\nhousehold income with 71 children from the control arm of a\ncontemporaneous trial. The outcome measure in the control and program\ncenters (a 4-category ordinal scale of restraint use) was compared using\nordinal logistic regression accounting for age of the parent.\nResults: Process evaluation found that though program components were\ndelivered with a consistency of message, uptake was affected by turnover\nof all staff at one center and by parents experiencing difficulty in\npaying for subsidized restraints at each of the centers. Impact\nevaluation found that children from the centers receiving the program\nhad nearly twice the odds of being in a better restraint category than\nchildren matched from the control group (adjusted odds ratio [ORadj] =\n2.06, 95% confidence interval [CI], 1.09-3.90).\nConclusions: This was a pragmatic study reflecting the real-life issues\nof implementing a program in preschools where 57 percent of families had\na low income and turnover of staff was high. Despite these issues,\nimpact evaluation showed that the integrated educational program showed\npromise in increasing correct use of age-appropriate restraints. The\nfindings from this pilot study support the use of an integrated\neducational program that includes access to subsidized restraints to\npromote best practice child restraint use among communities that include\na high proportion of Aboriginal and Torres Strait Islander families in\nNew South Wales. Future trials in similar settings should consider\noffering more support in centers with high turnover of staff and\noffering alternative methods of payment when families experience\nfinancial difficulties in purchasing the subsidized restraints. If\nproven in larger trials, this approach could reduce death and injuries\nin child passengers in this vulnerable group.
@article{
 title = {Buckle Up Safely (Shoalhaven): A Process and Impact Evaluation of a Pragmatic, Multifaceted Preschool-Based Pilot Program to Increase Correct Use of Age-Appropriate Child Restraints},
 type = {article},
 year = {2014},
 identifiers = {[object Object]},
 keywords = {booster seats,car restraints,evaluatio,programs},
 pages = {483-490},
 volume = {15},
 publisher = {Taylor and Francis Inc.},
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 last_modified = {2016-09-13T05:55:58.000Z},
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 abstract = {Objective: To conduct a process and impact evaluation of a multifaceted\neducation-based pilot program targeting correct use of age-appropriate\nrestraints in a regional setting with a high proportion of Aboriginal\nand Torres Strait Islander families.\nMethods: The program was delivered in 2010 in 3 early learning centers\nwhere 31 percent of the children were of Aboriginal and Torres Strait\nIslander descent. Each component of the program was assessed for message\nconsistency and uptake. To measure program effectiveness, participating\nchildren were matched 1:1 by age, language spoken at home, and annual\nhousehold income with 71 children from the control arm of a\ncontemporaneous trial. The outcome measure in the control and program\ncenters (a 4-category ordinal scale of restraint use) was compared using\nordinal logistic regression accounting for age of the parent.\nResults: Process evaluation found that though program components were\ndelivered with a consistency of message, uptake was affected by turnover\nof all staff at one center and by parents experiencing difficulty in\npaying for subsidized restraints at each of the centers. Impact\nevaluation found that children from the centers receiving the program\nhad nearly twice the odds of being in a better restraint category than\nchildren matched from the control group (adjusted odds ratio [ORadj] =\n2.06, 95% confidence interval [CI], 1.09-3.90).\nConclusions: This was a pragmatic study reflecting the real-life issues\nof implementing a program in preschools where 57 percent of families had\na low income and turnover of staff was high. Despite these issues,\nimpact evaluation showed that the integrated educational program showed\npromise in increasing correct use of age-appropriate restraints. The\nfindings from this pilot study support the use of an integrated\neducational program that includes access to subsidized restraints to\npromote best practice child restraint use among communities that include\na high proportion of Aboriginal and Torres Strait Islander families in\nNew South Wales. Future trials in similar settings should consider\noffering more support in centers with high turnover of staff and\noffering alternative methods of payment when families experience\nfinancial difficulties in purchasing the subsidized restraints. If\nproven in larger trials, this approach could reduce death and injuries\nin child passengers in this vulnerable group.},
 bibtype = {article},
 author = {Hunter, Kate and Keay, Lisa and Clapham, Kathleen and Lyford, Marilyn and Brown, Julie and Bilston, Lynne and Simpson, Judy M. and Stevenson, Mark and Ivers, Rebecca Q.},
 journal = {Traffic Injury Prevention},
 number = {5}
}

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