OBJECTIVE: To determine whether a brief session of behavior change counseling (BCC), offered to injured adolescents in the emergency department (ED) as a therapeutic intervention, could be used to change injury-related risk behaviors and the risk of reinjury. STUDY DESIGN: A randomized, controlled trial. PARTICIPANTS: Adolescents between 12 and 20 years old who were undergoing treatment for an injury in the ED and who were cognitively able to participate in the intervention. SETTING: An urban ED at a level 1 pediatric trauma center. INTERVENTION: Study participants completed a baseline risk behavior prevalence assessment. Participants were then randomly assigned to receive BCC or routine ED care. Those in the treatment group underwent a brief session of BCC with a study social worker focused on changing an identified injury-related risk behavior (seatbelt use, bicycle helmet use, driving after drinking, riding with an impaired driver, binge drinking, or carrying a weapon). Participants were recontacted 3 months and 6 months after enrollment to assess the prevalence of positive behavior change and the interim occurrence of medically treated injuries. RESULTS:We enrolled 631 participants (78% of those eligible) and obtained follow-up for 76% at 3 months and 75% at 6 months. The relative risk of a positive behavior change with respect to seatbelt use was 1.34 (95% confidence interval [CI]: 1.00, 1.79) at 3 months, favoring the intervention group. The relative risk for the same outcome was 1.47 (95% CI: 1.09, 1.96) at 6 months. A positive change in bicycle helmet use was 1.81 (95% CI: 1.02, 3.18) times more likely at 3 months and 2.00 (95% CI: 1.00, 4.00) times more likely at 6 months in the intervention group. There was no effect of the intervention on changes in other target behaviors. Over the 6-month follow-up period, the risk of reinjury requiring medical attention did not differ between treatment groups. CONCLUSIONS: Brief BCC can be delivered to adolescents undergoing treatment for injury in the ED and can be used to address injury-related risk behaviors. The intervention was associated with a greater likelihood of positive behavior change in seatbelt and bicycle helmet use. This effect lasted over 6 months of follow-up. BCC was not associated with changes in other risk behaviors and could not be shown to significantly reduce the risk of reinjury.
RCT Entities:
OBJECTIVE: To determine whether a brief session of behavior change counseling (BCC), offered to injured adolescents in the emergency department (ED) as a therapeutic intervention, could be used to change injury-related risk behaviors and the risk of reinjury. STUDY DESIGN: A randomized, controlled trial. PARTICIPANTS: Adolescents between 12 and 20 years old who were undergoing treatment for an injury in the ED and who were cognitively able to participate in the intervention. SETTING: An urban ED at a level 1 pediatric trauma center. INTERVENTION: Study participants completed a baseline risk behavior prevalence assessment. Participants were then randomly assigned to receive BCC or routine ED care. Those in the treatment group underwent a brief session of BCC with a study social worker focused on changing an identified injury-related risk behavior (seatbelt use, bicycle helmet use, driving after drinking, riding with an impaired driver, binge drinking, or carrying a weapon). Participants were recontacted 3 months and 6 months after enrollment to assess the prevalence of positive behavior change and the interim occurrence of medically treated injuries. RESULTS: We enrolled 631 participants (78% of those eligible) and obtained follow-up for 76% at 3 months and 75% at 6 months. The relative risk of a positive behavior change with respect to seatbelt use was 1.34 (95% confidence interval [CI]: 1.00, 1.79) at 3 months, favoring the intervention group. The relative risk for the same outcome was 1.47 (95% CI: 1.09, 1.96) at 6 months. A positive change in bicycle helmet use was 1.81 (95% CI: 1.02, 3.18) times more likely at 3 months and 2.00 (95% CI: 1.00, 4.00) times more likely at 6 months in the intervention group. There was no effect of the intervention on changes in other target behaviors. Over the 6-month follow-up period, the risk of reinjury requiring medical attention did not differ between treatment groups. CONCLUSIONS: Brief BCC can be delivered to adolescents undergoing treatment for injury in the ED and can be used to address injury-related risk behaviors. The intervention was associated with a greater likelihood of positive behavior change in seatbelt and bicycle helmet use. This effect lasted over 6 months of follow-up. BCC was not associated with changes in other risk behaviors and could not be shown to significantly reduce the risk of reinjury.
Authors: Wendy C Shields; Elise Omaki; Eileen M McDonald; Ruth Rosenberg; Mary Aitken; Martha Wood Stevens; Andrea C Gielen Journal: Pediatr Emerg Care Date: 2018-12 Impact factor: 1.454
Authors: Rebecca M Cunningham; Stephen T Chermack; Marc A Zimmerman; Jean T Shope; C Raymond Bingham; Frederic C Blow; Maureen A Walton Journal: Pediatrics Date: 2012-05-21 Impact factor: 7.124
Authors: Patrick M Carter; Maureen A Walton; Manya F Newton; Michael Clery; Lauren K Whiteside; Marc A Zimmerman; Rebecca M Cunningham Journal: Pediatrics Date: 2013-07-08 Impact factor: 7.124
Authors: Vivian H Lyons; Frederick P Rivara; Alice Ning-Xue Yan; Cara Currier; Erin Ballsmith; Kevin P Haggerty; Lauren Whiteside; Anthony S Floyd; Anjum Hajat; Ali Rowhani-Rahbar Journal: J Behav Med Date: 2019-08-01
Authors: Federico E Vaca; Jessica M Walthall; Sheryl Ryan; Alison Moriarty-Daley; Antonio Riera; Michael J Crowley; Linda C Mayes Journal: Ann Adv Automot Med Date: 2013
Authors: Rebecca M Cunningham; Maureen A Walton; Abby Goldstein; Stephen T Chermack; Jean T Shope; C Raymond Bingham; Marc A Zimmerman; Frederic C Blow Journal: Acad Emerg Med Date: 2009-11 Impact factor: 3.451