Six-month Follow-up of a Brief Intervention on Self-reported Safety Belt Use Among Emergency Department Patients

Authors

  • William G. Fernandez MD, MPH,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Michael R. Winter MPH,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Patricia M. Mitchell RN,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Holly Bullock MPH,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Jacqueline Donovan,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Jill St. George,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • James A. Feldman MD, MPH,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Susan S. Gallagher MPH,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Mary Pat McKay MD, MPH,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Edward Bernstein MD,

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author
  • Theodore Colton ScD

    1. From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.
    Search for more papers by this author

  • Presented at the Society for Academic Emergency Medicine Annual Meeting, Washington, DC, 2008.

  • Supported by a grant from the National Center for Injury Control and Prevention, Centers for Disease Control and Prevention (1R49CE000681-01).

Address for correspondence and reprints: William G. Fernandez, MD, MPH; e-mail: william.fernandez@bmc.org.

Abstract

Objectives:  Safety belt use (SBU) reduces motor vehicle deaths by 45%. We previously reported that a brief intervention improved self-reported SBU among emergency department (ED) patients at 3 months. We sought to determine if these effects were sustained at 6 months postenrollment.

Methods:  This was a prospective, randomized controlled trial of adult patients (age ≥ 21 years) at an academic medical center ED from February 2006 to May 2006. Patients were systematically sampled for self-reported SBU. Those with self-reported SBU less than “always” were asked to participate. Subjects were surveyed at baseline with a nine-item series of situational SBU questions scored on a five-point Likert scale (e.g., 5 = always, 1 = never). This nine-item average comprised the mean SBU score. Subjects were randomized to a control group (CG) and an intervention group (IG). The CG received an injury prevention brochure; the IG received a brief motivation interview by a trained interventionist and the brochure. Subjects were phoned at 3 and 6 months to determine interval change in SBU scores via a standard script. Repeated-measures analysis of covariance and t-tests were used to analyze trends in mean SBU scores between groups, as well as to test mean changes in SBU scores from the 3- to 6-month intervals.

Results:  Of 432 eligible patients, 292 enrolled (mean age = 35 years, SD ± 11.2 years; 61% male). At baseline, there were no significant demographic differences; the IG (n = 147) and CG (n = 145) had similar mean SBU scores (2.8 vs. 2.6, p = 0.31), and 66% (n = 96 in each) completed both 3- and 6-month follow-up. The mean SBU score at 6 months in the IG was greater than in the CG group (3.6 vs. 2.9, p < 0.001), as were the mean SBU score differences from baseline (IG = 0.84 vs. CG = 0.29, p < 0.001). These differences were sustained from the 3-month interval (IG = −0.02 vs. CG = −0.06, p > 0.05).

Conclusions:  The previously reported finding that ED patients who received a brief motivation interview reported higher SBU scores at 3 months compared to a CG was sustained at 6-month follow-up. Although limited by self-report, a brief intervention may enhance lasting SBU behavior among high-risk ED patients.

Ancillary