Kate Hunter1, Lisa Keay, Judy M Simpson, Julie Brown, Lynne E Bilston, Maureen Fegan, Louise Cosgrove, Mark Stevenson, Rebecca Q Ivers. 1. Kate Hunter, Lisa Keay, and Rebecca Q. Ivers are with the Injury Division, The George Institute for Global Health, The University of Sydney, Sydney, Australia. Judy M. Simpson is with the Sydney Medical School, The University of Sydney, Sydney. Julie Brown and Lynne E. Bilston are with Neuroscience Research Australia, The University of New South Wales, Sydney, Australia. Louise Cosgrove and Maureen Fegan are with Kids and Traffic Road Safety Education Program, Macquarie University, Sydney, Australia. Mark Stevenson is with the Accident Research Center, Monash Injury Research Institute, Monash University, Melbourne, Australia.
Abstract
OBJECTIVES: We sought to identify the program fidelity factors associated with successful implementation of the Buckle-Up Safely program, targeting correct use of age-appropriate child car restraints. METHODS: In 2010, we conducted a cluster randomized controlled trial of 830 families with children attending preschools and long day care centers in South West Sydney, New South Wales, Australia. Families received the Buckle-Up Safely program in the intervention arm of the study (13 services). Independent observers assessed the type of restraint and whether it was used correctly. RESULTS: This detailed process evaluation showed that the multifaceted program was implemented with high fidelity. Program protocols were adhered to and messaging was consistently delivered. Results from multilevel and logistic regression analyses show that age-appropriate restraint use was associated with attendance at a parent information session hosted at the center (adjusted odd ratio [AOR]=3.66; 95% confidence interval [CI]=1.61, 8.29) and adversely affected by the child being aged 2 to 3 years (AOR=0.14; 95% CI=0.07, 0.30) or being from a family with more than 2 children (AOR=0.34; 95% CI=0.17, 0.67). CONCLUSIONS: Findings highlight the importance of parents receiving hands-on education regarding the proper use of age-appropriate child restraints.
RCT Entities:
OBJECTIVES: We sought to identify the program fidelity factors associated with successful implementation of the Buckle-Up Safely program, targeting correct use of age-appropriate child car restraints. METHODS: In 2010, we conducted a cluster randomized controlled trial of 830 families with children attending preschools and long day care centers in South West Sydney, New South Wales, Australia. Families received the Buckle-Up Safely program in the intervention arm of the study (13 services). Independent observers assessed the type of restraint and whether it was used correctly. RESULTS: This detailed process evaluation showed that the multifaceted program was implemented with high fidelity. Program protocols were adhered to and messaging was consistently delivered. Results from multilevel and logistic regression analyses show that age-appropriate restraint use was associated with attendance at a parent information session hosted at the center (adjusted odd ratio [AOR]=3.66; 95% confidence interval [CI]=1.61, 8.29) and adversely affected by the child being aged 2 to 3 years (AOR=0.14; 95% CI=0.07, 0.30) or being from a family with more than 2 children (AOR=0.34; 95% CI=0.17, 0.67). CONCLUSIONS: Findings highlight the importance of parents receiving hands-on education regarding the proper use of age-appropriate child restraints.
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